May-June-July 2018

President message

Dear EFN Members and Colleagues,

It was a great pleasure to host the EFN 107th General Assembly in Brussels, the first of the 2018 biannual meeting. The EFN Members had the opportunity to analyse the key political topics that are driving the EU agenda and discuss the nursing contribution, in addition to their impact on the nursing profession and the citizens of Europe. We also welcomed the four Directors of the European Nursing Research Foundation, who presented and reported progress on their work to support the EFN members to ensure EU policies are informed by nursing and underpinned by best evidence.

From our meeting with the Commissioner, Vytenis Andriukaitis, who is very positive about supporting nurses and nursing in the EU, the proclamation of the European Pillar of Social Rights has created a momentum to address key political topics that are crucial to nurses. The EFN is carefully monitoring the initiatives that the EU is undertaking to ensure the implementation of the Pillar’s 20 Principles. As one of these pillars, work-life balance, constitutes a core priority to retain nurses in the profession, the EFN contribution to the EU legislative initiatives is building on the current debate of the EU Parliament on work-life balance for parents and carers.

Improving the quality of working conditions for nurses and ensuring that the workforce remains skilled and motivated are

key priorities for the EFN. As such, the EFN is focused on working to promote the right workforce composition and to provide clarity in relation to the different nurses’ roles, responsibility and scope of practice. To ensure this vision becomes a reality it is important that we continue to call on the EU Institutions to use the EFN Workforce Matrix, which is underpinned by Article 31 of Directive 2013/55/EU. Advanced Nurse Practitioners are central to achieving many of the EU legislative priorities to improve the health and social circumstances of the citizens of Europe.

To measure progress throughout the EU, our attention is cast on the developments of the European Semester. As the Country Reports have demonstrated, some work still needs to be done in terms of ensuring timely access to affordable healthcare to EU citizens, being one of the pillars of the European Social Rights agenda.

Nurses’ advanced roles are also crucial in boosting patients’ empowerment and the implementation of meaningful value-based healthcare systems. Nurses’ close relationship with patients is fundamental to ensuring what is developed in policy is delivered appropriately in practice. Therefore, EU and national governments need to concretely engage the nursing leaders in the co-design of the health and social care systems in the EU.

The EFN Members are strongly engaged to make a difference to the current EU policy agenda and are working relentlessly to ensure that 3 million nurses’ contribution is valued and the potential of the nursing profession is maximised to positively benefit patients and health systems.

Elizabeth Adams
EFN President


News from EFN

The EFN welcomes its new Vice-President
The EFN Members are delighted to announce that during the last EFN General Assembly, the Executive Committee has been joined by a new member: Nina Hahtela, from the Finnish Nurses Association, who has been appointed EFN Vice-President. With the appointment of Nina, the EFN has further strengthened the female composition of its leading body, stressing the importance of the gender dimension in the delivery of healthcare. Congratulations Nina!

The EFN General Assembly supports the European Pillar of Social Rights
The EFN Members discussed the EFN position on the European Pillar of Social Rights, with particular attention to Principles 6 ‘Wages’, 16 ‘Health care’ & 18 ‘Long-term Care’. These principles are crucial to advance the nursing profession in the EU and improve the delivery of high quality healthcare services, therefore involving frontline nurses in their implementation is key! Furthermore, the EFN General Assembly was for the members an opportunity to share best practices on well-functioning “Primary Care models”, and clinical practices led by nurses. These collected good practices could be upscaled throughout the EU and will be relevant for future research and policy developments. Nurses play already a significant role in enhancing primary care, now EU policy-makers and politicians need to translate this evidence into EU policies and funding programs. The EFN is strongly committed in advocating for the implementation of a health and social care ecosystem where the creation of value for patients and citizens is the main objective of all actors involved. The EFN has emphasised that patients should be further empowered, and their priorities reflected in the outcome measurement. Such approach requires a re-focus on ‘moving care back to the community’ by designing, in co-creation with advanced nurse practitioners, a more holistic and economic approach to value-based health and social care.

EU Health Commissioner acknowledges the nursing potential
During a meeting with the EU Commissioner for Health, Vytenis Andriukaitis, the EFN President, Elizabeth Adams,  and the EFN Secretary General, Paul De Raeve, had the chance to exchange views regarding the main priorities currently affecting the nursing profession. The Commissioner appeared very open to the nurses’ concerns, recognising their key role in addressing important topics such as vaccination/vaccine hesitancy/health literacy/education and training of healthcare professionals.

The EFN reminds the Commission of the importance of co-designing
The EFN is very committed in highlighting the role of nurses in co-designing digital health solutions able to empower citizens/patients and simplify the communication between the provider and the user. Nurses have a clear potential in empowering patients through coaching and supporting patients/citizens in the use of eHealth solutions thanks to the close relationship between patients and nurses. The Commission needs to make sure that frontline end-users are involved since the start of the co-design process to make solutions more fit for purpose and as such allowing nurses to spend more time with patients, so increasing the direct-patient care time.


News from the EU

The European Parliament supports civil society organisations
To support civil society in the EU, MEPs have called on the EU to set up a funding instrument – the European Values Instrument – to promote and protect EU values, especially democracy, freedom, the rule of law and fundamental rights, within the EU budget of the next Multiannual Financial Framework (MFF). The new instrument should fund civil society organisations which are active at local and national levels in promoting and protecting these values. This initiative is welcomed by the EFN, who strongly advocates for involving citizens in EU policy making.

Transparency needed in EU legislative processes
To improve transparency in the EU legislative mechanisms, the European Ombudsman, Emily O’Reilly, has called the Council of Ministers to record the identity of Member States taking positions during discussions on draft legislation and to clarify the criteria for using the ‘LIMITE’ status on Council documents. The initiative aims at reducing the ‘behind-closed-doors’ approach that risks alienating citizens and feeding negative sentiment.

The EU Commission invests in Balkans
The Commission launched its new Western Balkan Strategy, proposing six initiatives to boost the region’s economic and political stability. Among others, the programme includes an initiative for a digital agenda aiming at supporting the development of eHealth and digital skills. These policies are crucial to align healthcare professionals’ skills to the deployment of eHealth services.

Robots: an opportunity to handle carefully
The European Commission has recently looked at the relationship between workers and robots, and the way the latter are changing the way of working. It emerges that robots and new technologies can open up workplace opportunities for workers and are likely to create new jobs in the future. The EFN believes that it is key to examine areas such as ethics, liability, safety and security. In particular, it is crucial to involve the nursing sector in the design and creation of robots to fit nurses’ needs and create a return on investment.

Same story for Artificial Intelligence
As recently declared by Roberto Viola, Director-General at DG CNECT, when developing EU policies on Artificial Intelligence (AI), it is crucial to ensure that Europeans make the most of new technologies, not the other way around. The human touch still remains fundamental in the deployment of digital solutions that should ease human work. AI and eHealth can bring big progress to healthcare delivery, and nurses should be engaged in their co-design to guarantee the success! As such, the European Commission presented a European approach to boost investment and set ethical guidelines for AI, aiming at: boosting financial support and encouraging uptake by public and private sectors;

Preparing for socio-economic changes brought about by AI; and Ensuring an appropriate ethical and legal framework. According to recent studies, eHealth solutions have not reached their full potential across Europe. Issues related to reliability, data protection concerns, and a lack of health system endorsement have slowed down the uptake of digital solutions.

The Digital Single Market needs to deliver in improving healthcare delivery
On the occasion of the Digital Day 2018, Commissioners, Ministers and representatives of Member States renovated their commitment to complete the Digital Single Market, and agreed to work together more on key areas for Europe’s future, as: artificial intelligence, blockchain, ehealth and innovation. The EU Commission also took this opportunity to present some EU-funded success stories on the potential of technology. These included the project My Health My Data, that will create a platform relying on the blockchain system, a digital ledger where data transactions are visible to the entire network of stakeholders, minimizing any possibility of fraudulent usage. In this context, 22 European countries have signed a Declaration on the establishment of a European Blockchain Partnership. The Partnership will be a vehicle for cooperation amongst 22 European countries have signed a Declaration on the establishment of a European Blockchain Partnership. The Partnership will be a vehicle for cooperation amongst Member States to exchange experience and expertise in technical and regulatory fields and prepare for the launch of EU-wide blockchain applications across the Digital Single Market for the benefit of the public and private sectors. This initiative follows the launch of the EU Blockchain Observatory and Forum in February 2018.

The EU Commission Communication on eHealth
The European Commission also just published a communication on ehealth that includes measures such as a recommendation on a European exchange format for electronic health records, a mechanism for voluntary coordination in sharing data (including genomic data for prevention and personalised medicine research), as well as proposals on the exchange of innovative and best practices, capacity building, and technical assistance for health and care authorities.

Proportionality Directive is heading to its final steps
With the endorsement by the EU’s Committee of Permanent Representatives (Coreper) and the approval of the Internal Market and Consumer Protection (IMCO) Committee, the Proportionality Directive is near to be finally adopted. The negotiated text brings positive outcomes for nurses who welcomes the specificity recognised to the health professions, the strengthened stakeholders’ involvement and the important role given to CPD.


Opinions on health
The Expert Panel on effective ways of investing in health has adopted three Opinions related to access to healthcare, innovative payment models for high-cost innovative medicines and performance of primary care. The opinions analyse how national pricing and reimbursement authorities could improve patients’ access to innovative medicines and foster innovation that matters whilst ensuring that health systems are financially sustainable; how to identify the distribution of unmet needs and how to address challenges by mobilising resources available at national and European level; and how to measure the performance of primary care.

Opinion on future of work/skills
The European Economic and Social Committee (EESC) has adopted an Opinion on the future of work/skills. The text analyses the impact of digitalisation on the labour market ad emphasises the importance of quality education. The EFN has frequently stressed the key role of digitalisation in health and the need for health professionals and support staff of education and training for all aspects of eHealth.


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