October-November-December 2019

President message

Dear EFN Members and Colleagues,

It is with pleasure that I will soon see you all at the EN’s 110th General Assembly, taking place on 17 and 18 October in Athens, Greece. I would like to take this opportunity to thank the Hellenic Nurses Association (HNA) for organising this gathering. I am positive this meeting will be an excellent opportunity to discuss the ongoing challenges the nursing profession is facing, and how to face them.

During the past summer break, we have seen how many profound changes have occurred at the EU level. The “new” European Parliament is starting its activities, with newly elected MEPs taking their positions. The new President of the European Parliament is Mr David Sassoli, an Italian politician and journalist. The same applies to the European Commission, for which Ms Ursula von der Leyen (a centre-right German Politian) was elected as President. As for the rotatory presidency of the Council of the EU, right now it is in Finland’s hands, until the end of December.

In this context, the EFN has continued its activities by mapping the new political landscape and identifying key EU stakeholders with whom to engage. The nursing profession priorities remain the same as before, keeping digitalisation high on the agenda. Healthcare systems are being digitalised, and it is key for the nursing workforce to keep up with these changes. Nurses should be co-designers of digital innovation tools. Their day-to-day experience can ensure that these tools are fit-for-purpose. In another vein, vaccine-hesitation is a hot

political topic in the EU. A high-level summit was organised last September, with the presence of Mr Jean-Claude Juncker (outgoing President of the European Commission) and Mr Tedros Adhanom (Director general of the WHO). The EFN was invited to attend the Summit. In parallel to it, we are also in discussions with other EU healthcare professionals’ organisations that represent other healthcare professions to see how we can upscale nursing best practices for vaccination.

The EFN keeps making progress in its three EU-funded projects: Smart4Health and InteropEHRate (both of these projects are developing cross-border systems for Electronic Health); and QualMent (a project addressing the clinical mentor’s lack in nursing education by developing a clinical mentor’s competence with mentor education for national and international nursing students in line with Directive 2013/55/EU).

To conclude, I sign this EFN Update with the certainty that we will work together towards the same goals and make a positive difference for the nursing profession.

Elizabeth Adams
EFN President

Predictive models on health and social care requirements for the next quarter of a century report a staggering shift in population age, multimorbidity, and complexity of need. This is leading to the widespread realization that change is needed to ensure that health care throughout the world meets the emerging needs of humankind.Article “Future Proofing: The Nursing Now Campaign”, by Elizabeth Adams, Nursing Administration Quarterly journal.

News from EFN

Finnish EU Presidency
Last July 2019, Finland took over the rotatory Presidency of the Council of the EU, until the end of December. The new presidency’s programme includes four priorities: 1) to strengthen common values and the rule of law, 2) to make the EU more competitive and socially inclusive, 3) to strengthen the EU’s position as a global leader in climate action, and 4) to protect the security of citizens comprehensively. The EFN deeply regrets that none of these directly relate to healthcare or nursing. Hence, we are opting for a “Health in all policies” approach, trying to get as much healthcare into the Finnish presidency as possible. And, in doing so, defending and promoting the interests and values of nursing in the EU.

Healthcare professionals cooperating towards a Coalition for Vaccination
The EFN is working on close cooperation with other EU healthcare professions (the doctors, represented at the EU level by CPME, and the pharmacists, represented by PGEU) and the European Commission towards a Coalition for Vaccination. The urgency of this initiative comes from the growing phenomenon of vaccination-hesitancy that is currently taking place in several EU Member States and the current challenges it poses. In this context, last 11 September an event was organised in the European Commission premises by the EFN, together with CPME and PGEU, and attended by many EU and healthcare stakeholders, to exchange views on how the different healthcare professions can combat vaccination hesitancy at EU level. Furthermore, this event was a great opportunity for the EFN to disseminate its nursing best practices on vaccination.

On 12 September the European Commission, together with WHO, organised a high-level event on Vaccination, to boost global political commitment to vaccination, engage political leaders and opinion makers to discuss and identify solutions

towards eliminating vaccine-preventable diseases. Having vaccination high in EFN agenda, the EFN President, Elizabeth Adams, and EFN Secretary General, Paul De Raeve, were invited to participate in the event, bringing the nurses’ voice into the debate. The European Nursing Student Association had also the opportunity to be part of this key event. Among others, the event counted with the presence of Mr Jean-Claude Juncker (outgoing President of the European Commission), Mr Tedros Adhanom (Director general of the WHO) and Her Majesty the Queen Mathilde of Belgium.

Nursing Now Europe
During these last months, the Nursing Now campaign continues progressing raising awareness across Europe on the importance of the nursing profession for the sustainability of our healthcare systems. The constitution of the new European Parliament and European Commission marked an opportunity for the EFN, Nursing Now Europe lead, to continue promoting the campaign at EU level taking the opportunity of all the different meetings the EFN has been attending and/or organising to communicate on the developments of Nursing Now Campaign. Examples are the meetings of the EU Coalition for Vaccination, in which several EU healthcare Stakeholders are working together towards strengthening efforts towards elimination of vaccine-preventable diseases. Besides, the EFN President, Elizabeth Adams, also a member of Nursing Now Board, participated in the Board meeting in Singapore, on June 2019, and met with EFN members to discuss and plan campaign initiatives in individual countries.

News from the EU

First electronic health records of patients exchanged between EU countries
Last June, the first health records of patients were exchanged in the EU thanks to the cross-border electronic health services. As of now, healthcare professionals from Luxembourg can receive electronic health records of travellers coming from Czech Republic. Moreover, Finland and Croatia are also exchanging electronic prescriptions: Finnish citizens can retrieve in Croatian pharmacies the medicines that were electronically prescribed to them in Finland. Vytenis Andriukaitis, European Commissioner for Health and Food Safety, said: “I congratulate Czechia, Luxembourg and Croatia for taking their steps in eHealth cooperation, and I hope other countries will follow soon.”

The EFN has digitalisation high on its agenda, as it has the potential to give patients’ access to their health records and improve communication between different healthcare professions. This is a key priority for the incoming health Commissioner, Stella Kyriakides, as she addressed in her answers to the EP hearings. We will get a strong team of Commissioners, all 3 women, Vestager, Gabriel and Kyriakides, on whom we can count on to make the health and social care ecosystems work for better citizens/patients’ outcomes.

Hence, the EFN is part of two EU-funded projects on Electronic Health Records: InteropEHRate and Smart4Health providing end-user input, and making sure that these digital solutions/tools developed are fit-for-purpose and useful for the nursing community. As such, the EFN participated in the last General Assemblies of both projects, held in Lisbon (Smart4Health) & Athens (InteropEHRate), from 25 to 27 September. Both meetings came out with concrete outcomes and clear next steps to be taken forward in the upcoming months.

The European Court of Auditors take on EU cross-border healthcare
The European Court of Auditors argues in their last report on EU cross-border healthcare that although EU actions in cross-border healthcare are indeed enhancing Member States’ collaboration, the real benefits for patients are still limited. Despite the progress made on providing EU

citizens with information on cross-border healthcare, this information is still difficult to access in some areas. Moreover, the report also identifies some weaknesses in the European Commission’s strategic planning and project management in this regard. As a result, the recommendations provided focus on the Commission’s support for National Contact Points, the deployment of cross-border exchanges of health data, and EU’s actions in the field of rare diseases.

Studies on eHealth, Interoperability of Health Data and Artificial Intelligence for Health and Care in the EU
In the same context of digitalisation, the European Commission is launching a tender for two studies to survey and analyse progress on the digital transformation of healthcare in the EU. Particular attention is given to the EU citizens able to access their own Electronic Health Records (Lot I) and to the adoption and use of artificial intelligence (Lot II). The results aim at supporting and informing the ongoing work of the EU and the Member States on the interoperability of EHR systems, in particular concerning the development of the European EHR exchange format. The maximum amount allocated to the studies is EUR 300 000 for Lot I and EUR 200 000 for Lot II. The closing date of the call is 23 September 2019 at 15:00. Applications are received via the TED portal.

Healthcare personnel statistics – nursing and caring professionals
The Eurostat (the European Commission’s department in charge of publishing official statistics) has published an article presenting an overview of the EU statistics on nursing and caring professionals, including an infographic on the number of working nurses per 100 000 habitants across all EU Member States. In their statistics, they have included qualified nurses and midwives, associate nurses. and other caring personnel (aids and assistants).

Amparo Poch Prize – Public Procurement of Innovation in Health
The Amparo Poch Prize is an award that recognises the best initiatives in Public Procurement of Innovation that aim to optimise Health services. The prize, which is endowed with 1.500€ in each category, is open to public institutions related to the Health sector focusses on two categories: 1) Best Public Procurement of Innovation in Health, or 2) Best initiative for the promotion of Public Procurement of Innovation. The awarded public institutions will be announced during the II Congress of Public Procurement of Innovation in Health, to take place in Zaragoza on 24-25 October 2019.


How to improve health, wellbeing and ageing with the help of Information and Communication Technology
The European Commission has published a report that examines how research and innovation in the field of Information and Communication Technology (ICT) has had a positive impact on health, wellbeing, and ageing. Several research and innovation projects have been included into this brochure, covering four different categories: 1) projects that help patients and healthcare professionals to manage a certain condition, 2) projects that innovate the health and care system and the way it works, 3) ICT solutions supporting active and healthy ageing, and 4) projects funded by the SME Instrument, accelerating market introduction of ICT solutions for Health, Well-being and Ageing Well.

“Manual for gender mainstreaming – Employment, social inclusion and social protection policies”
The Publications Office of the European Union has made available the “Manual for gender mainstreaming – Employment, social inclusion and social protection policies”. This manual offers a four-step method, which can be easily followed by policymakers: getting organized, learning about gender differences, assessing the policy impact and redesigning policy. It aims to be an effective guide to all actors, especially those working on employment, social inclusion and social protection policies in the Member States, to better implement gender mainstreaming in these policies and thereby better serve the needs of citizens, both women and men.

“Age and quality of life – Who are the winners and losers?”
The Publications Office of the European Union has also published a book titled “Age and quality of life – Who are the winners and losers?” that looks at inequalities in the quality of life of Europeans across six age groups. It examines developments between 2011 and 2016 to assess whether the impact of the economic crisis on the quality of life has decreased with the economic recovery, for which age groups and in what countries.

“Strengthening health systems through nursing: Evidence from 14 European countries”
The European Observatory on Health Systems and Policies (an intergovernmental partnership, hosted by the World Health Organization Regional Office for Europe) has published a book titled “Strengthening health systems through nursing: Evidence from 14 European countries”, authored by Anne Marie Rafferty, Reinhard Busse, Britta Zander-Jentsch, Walter Sermeus and Luk Bruyneel. This book looks at the variations in structure and organization of the nursing workforce across the different countries of Europe. It argues that as health systems shift radically in response to rising demand, the role of nurses becomes even more important.


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