January-February-March 2019

President message

Dear EFN Members and Colleagues,

With the start of the New Year we can reflect and be proud as EFN members of all the work achieved in 2018, for nurses and nursing in a complex and challenging political environment.  Through relentless lobbing and political engagement, EFN has established the foundation for the important challenges in 2019. The European Social Pillar developments are an essential policy agenda for the 3 million nurses in the EU. EFN Members committed to the design and implementation of the 20 principles enshrined in the European Pillar of Social Rights. A robust implementation framework that includes nurses into the development and delivery, is crucial to achieving concrete outcomes in the healthcare sector. Therefore, nurses play a central role in the accessibility to healthcare services, including prevention and EFN is working relentlessly to advocate for the promotion of empowered and skilled nurses as crucial means to accessibility and ensuring the best healthcare outcomes for patients and EU citizens.

Now more than ever, it is an imperative for nurses to engage and proactively influence EU policies that impact on population health. The uptake of health technologies and digital solutions cannot be implemented without the end-user co-designer. The success of the development and deployment depends on fit-for-purpose solutions that centrally involve frontline healthcare professionals.

In parallel, further action is required to ensure that the nurses’ education is in line with the Directive 55. The EFN Competency Framework and EFN Workforce Matrix 3+1 are guiding tools for EFN members and stakeholders to work

towards the right workforce composition, and to provide clarity to the different nurses’ roles and responsibilities. We consistency need to highlight and remind policy-makers and politicians that highly qualified, motivated frontline nursing workforce are essential to deliver on their political aspirations.

In 2019, we have a real opportunity with the European Parliament elections and the upcoming new Commission to make a real difference. Nurses collectively across Europe have the voting power to ensure the politicians they elect, are committed to investing in health and nursing to benefit all the citizens of Europe Speaking with one voice nurses can influence the European Institutions, the Commission, the European Parliament and Council, to ensure EU legislation reflects EU citizens needs. The voting power of 3 million nurses cannot be ignored.

Finally, I want to thank you for your commitment and hard work over the past year and I look forward to working with you in 2019.

Wishing you and your families a wonderful holiday season and peace, happiness and continued success for the New Year.

Elizabeth Adams
EFN President


“Rule of law, justice and fundamental rights are of course of utmost priority for the process of EU enlargement if we are to achieve peace, security and stability in Europe, but equally important is to evaluate the mechanisms by which EU accession negotiations are processed. The progress made so far is an important step forward, but there can and should be no shortcuts on the way to the European Union”.
EFN article on “Future EU Enlargement – Fit for purpose accession negotiation mechanisms needed”, in “Health Europa Quarterly” (Issue 07 – November 2018)

News from EFN

EFN is the Nursing Now European regional leadership group
During the last General Assembly held in Slovakia, the EFN Members expressed their support to the Nursing Now global campaign. As EU leader, the EFN receives formal recognition and endorsement from the Global Nursing Now Campaign Board. As stated by the Co-Chair of Global Board, Lord Nigel Crisp, the biggest thing we can do to improve health globally is to empower nurses – who represent health of the health workforce of the world!

Erasmus+ looks at nursing mentors’ education
The EFN is a partner of the consortium working on the EU-funded project QualMent – Quality Mentorship for Developing Competent Nursing Students, within the framework of the Erasmus+. The project is aiming at addressing the clinical mentor’s lack in nursing education and develop the clinical mentor’s competence with mentor education for national and international nursing students. The kick-off meeting held in Celje, Slovenia, was a chance for all the partners, coordinated by the College of Nursing in Celje to discuss the first steps and the future objectives of the project.

Electronic Health Record co-designed with 3 million nurses!
With the objective to ensure a greater engagement of end-users, nurses, in the development of digital health solutions, the EFN is now part of two EU-funded projects, under H2020, working to empower the citizen and unlock health data from local silos, using a bottom-up approach for EHR Interoperability. The first project, Smart4Health – Citizen-Centred EU-EHR Exchange for Personalised Health, is

coordinated by UNINOVA (Instituto de Desenvolvimento de Novas Tecnologias (Portugal), and will develop, test and validate a platform prototype for the Smart4Health citizen-centred health record EU-EHR exchange. Another project that includes EFN contribution is Interoperable EHRs at user edge (InteropEHRate) – Coordinated by Engineering Ingegneria Informatica (ENG – Italy). The aim of this project is to provide European citizens with a complete view of their health history, shareable with health operators and researchers. Both Kick-off meetings are planned for January after signing the Grant agreement. This will be an exciting work for EFN members as the Commission just launched the consultation on a roadmap on European Electronic Health Record (EHR) Exchange Format. This work perfectly fit within the nursing profession work on integrated care and continuity of care, in which frontline nurses play a central role.

EFN calls on the European Commission to empower nurses for deployment – we need implementation!
With the next elections for the European Parliament approaching, the EFN is regularly in contact with the EU Institutions to ensure that nursing needs will be taken into account in the political agenda of the next EU Commission. Meeting the Deputy Director General DG SANTE, Martin Seychelles, the EFN emphasised the importance of supporting the nursing workforce in valuing their best practices, especially linked to the ageing population (Long-term Care) and digitalisation (EHR, e-health services). Optimal working conditions and CPD are crucial aspects of this strategy. DG Sante welcomed and appreciated the work of EFN members and follows their practical solution with interest, acknowledging the need to explain to the future MEPs what the Health Policy Agenda is all about. The EFN has always worked very closely with dedicated health MEPS to advance trialogue meetings on specific files. This success story needs to continue.

News from the EU

Healthcare expenditure in the EU
The most recent statistics on health care expenditure published by Eurostat indicate the range of expenditure on health care across European Union (EU) in 2016, in terms of both expenditure per inhabitant and the share of gross domestic product (GDP). Health care expenditure per inhabitant was €5, 000 or higher in three EU Member States in 2016: Luxembourg (€5,600), Sweden (€5,100) and Denmark (€5,000). The three countries with the lowest health care expenditure per head in 2016 were Romania (€400), Bulgaria (€600) and Poland (€700). In terms of health care expenditure as a percentage of GDP, the highest figure recorded in 2016 was in France (11.5 %), followed by Germany (11.1 %) and Sweden (10.9 %). The three EU countries with the lowest shares of GDP were Romania (5.0 %), Luxembourg and Latvia (both 6.2 %).

Europe to lead in blockchain technology
The European Commission is committed to adopt a comprehensive EU strategy to boost innovation and exploitation of blockchain technology. During a roundtable that took place in Brussels, the Commissioner for Digital Economy and Society, Mariya Gabriel, reiterated the importance to gather support among EU industry leaders, governments and policy makers, with the aim to boost innovation and exploitation of blockchain technology. The European Commission aims to develop a common approach on Blockchain technology for the EU in the international arena. EFN presentation at the OECD in Paris indicated clearly the it is key to put a human face to blockchain as it will be an enabler to boost integrated care and continuity of care.

Member States and Commission to work together to boost artificial intelligence “made in Europe”
To deliver on its strategy on artificial intelligence (AI) adopted in April 2018, the Commission presented a coordinated plan prepared with Member States to foster the development and use of AI in Europe. This plan proposes joint actions for closer and more efficient cooperation between Member States, Norway, Switzerland and the Commission in four key areas: increasing investment, making more data available, fostering talent and ensuring trust. Stronger coordination is essential for Europe to become the world-leading region for developing and deploying cutting-edge, ethical and secure AI. Nurses, at European and global level can contribute to these developments as the better informed the nurses are in the process of care, the better outcomes can be achieved. We encourage the Commission and Industry to engage nurses as end-users in the co-design of new technologies and innovation, to make it all deployable, fit-for purpose.

The Steering Group on Health Promotion, Disease Prevention and Management of Non-Communicable Diseases holds First Formal Meeting
The Steering Group on Health Promotion, Disease Prevention and Management of Non-Communicable Diseases held its first formal meeting in Luxembourg in November 2018. The meeting was an opportunity for the representatives of Member States, the European Investment Bank and several European Commission services to discuss a wide range of public health policies and initiatives, including the future cooperation with the Expert Group on Health Information and the results of the first meeting of the subgroup on proton therapies. The Steering Group also decided that mental health would be the priority area for best practices and screening of implementable research results in 2019. The next meeting of the Steering Group is scheduled for February 2019 and it is planned to be a joint meeting with the Research Programme Committee. Due to its importance, we encourage the Commission and Member States to select nurses as experts. If you really want change, nursing leaders and professors need to join the Steering Group.


Health at a glance
The OECD, together with the European Commission, launched its publication “Health at a Glance: Europe 2018”. The report provides a set of key indicators of health status , risk factors to health, health expenditure, access to care and quality of care, together with a discussion of progress in improving the effectiveness, accessibility and resilience of European health systems, in 36 European countries (28 EU Member States, 5 candidate countries and 3 EFTA countries), and calls for improving mental health and preventing mental illness that not only have social consequences but are also estimated to cost more than 4% of GDP across the EU. It also calls for addressing risk factors like smoking, alcohol and obesity, reducing premature mortality, ensuring universal access to care and strengthening the resilience of health systems. Nurses can play a key role in this, due to their great contribution to improving patients’ health and well-being, not only in hospitals, in long-term care institutions, but also in primary care and in home-care settings.

Study on fragmented care and chronic conditions
The study “Whether Fragmented Care Is Hazardous Depends on How Many Chronic Conditions a Patient Has” found that patients with more chronic conditions are more likely to visit the emergency department and to be admitted to the hospital.

The authors obtained this result by comparing patients with different numbers of chronic conditions and highly fragmented care. They argue that focusing on these patients could have an impact on overall health care costs and inefficiency.

Report on Clinician to chief executive
A report on “Clinician to Chief Executive – Supporting leaders of the future” show advantages clinicians bring to the chief executive and other executive director roles. One of the advantages put forward is the deep understanding of what matters most to patients and staff. This report, made out of a collection of NHS hospital chief executives’ experiences (UK), encourages clinicians to consider the chief executive and other executive board roles as a way to enrich their career and continue to take care of the lives of treated people and co-workers.

QualMent EU project first eBulletin
The EU-funded project has released its first eBulletin, providing insights on the project development and partners’ activities. To read it click here.


To view the upcoming meetings’ dates, click here.

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