January-February-March 2021

President message

Dear EFN Members and Colleagues,

In 2021 COVID-19 continues to impact on the health of citizens with ongoing challenges for our frontline nurses and health services. However, there is hope with the news that some European countries will start vaccinating their populations in early 2021 – once the European Medicines Agency is assured of safety and approves appropriate use. The EFN office is monitoring this closely, and proactively lobbying that the nursing workforce and vulnerable citizens are the first to be vaccinated.

A truly great news story is that the EFN has been awarded the prestigious 2020 Women of Europe Awards (in the ‘Woman in Action’ category) – received on your behalf by myself, as EFN President, for all nurses across Europe and all our member National Nursing Associations. Commissioner for Equality, Helena Dalli opened the fifth annual Women of Europe Awards jointly organised by the European Movement International and the European Women’s Lobby. The judging panel recognized the exceptional selfless commitment of the nursing profession during the pandemic, which saved so many lives of so many citizens of Europe with incredible care, compassion and expertise while risking their own lives and that of their families. A video of the award ceremony and further information can be accessed here.

On another positive note, the EFN successfully arranged two high-level political meetings with two EU CommissionersStella Kyriakiders (for Health), and Nicolas Schmit (for jobs

and social rights) with the EFN President and EFN Executive Committee. At both these strategically important meetings, the Commissioners were briefed on the enormous challenges faced by nurses on the frontline with constantly deteriorating working environments and relentless pressures due to nursing shortages, the Commissioners were asked to take immediate action to alleviate the ongoing crisis. The Commissioners recognised the sense of urgency, while acknowledging the unique contribution of nurses to our healthcare systems and patients. They promised to do all that falls within their realm of action to design policies that will support nurses.

In addition, I would like to sincerely thank all the EFN members again for the clear strategic and political direction agreed at the EFN virtual General Assembly last October and endorsing our 2021-2027 SOLP – Strategic and Operational Lobby Plan- that will guide our actions to effectively influence and shape the European Institutions policies and decisions. The EFN has already progressed the political priorities and points that EFN members raised during the General Assembly meeting will continue to drive policy based on the discussions.

Finally, it is important to recognise the exceptional leadership that all our member National Nursing Association members have demonstrated during such difficult times – now more than ever it is essential that we represent and strongly lobby for the nursing profession with our united powerful voice.

I hope that you and your families remain well and stay safe in 2021, as we respectfully reflect on all our beloved colleagues, friends and families lost. We live in the hope that the new year and the many lessons learnt will bring significant change and an optimistic future.

Elizabeth Adams
EFN President

News from EFN

EFN receives the European Women’s Prize
For the very first time since its establishment, and in this special year of the nurses – the International Year of Nurses and Midwives, the EFN is proud to announce that the EU nurses have been awarded the prestigious 2020 Women of Europe Awards, in the ‘Woman in Action’ category, for their instrumental role and exceptional commitment to working on the frontline during the COVID-crisis, providing expert care 24/7 at  the bedside of patients, in the most difficult unprecedented circumstances, risking their own lives and that of their loved ones.

The prize was received by Elizabeth Adams, EFN President, in a virtual ceremony. While picking the prize on behalf of all the EFN Members and the frontline nurses the EFN represents, she stated that “We are genuinely overwhelmed and delighted for this exceptional recognition. It is just wonderful for the millions of frontline nurses across Europe that have relentlessly and selflessly provided life-saving care to the Citizens of Europe during the pandemic while risking their own health and that of their families. This is a great surprise, and our nurses are so honoured to receive this prestigious award. With so little real recognition for their commitment and bravery this is so valued, cherished and celebrated award for all our nurses and their families”.

EFN signs the Manifesto for a European Health Union
During her “State of the Union” speech, in September, the European Commission President Dr Ursula von der Leyen expressed the need to create a stronger European Health Union, building on recent efforts by the European Commission to take action on cross border health threats. Over the years, the governments of the EU Member States, in successive Treaties, have committed to a high level of human health protection, to humanity, dignity, and solidarity, and to a sustainable future for all. They are also all committed, as members, to the Constitution of the World Health Organization. But these safeguards for health are not, on their own, sufficient. Therefore, it is crucial that the EU political leaders bring this to a next level and commit to creating a European Health Union. To address all these, a Manifesto has been launched, addressing three key issues: 1) It calls on the political leaders of Europe in the framework of the Conference on the Future of Europe to commit to creating a European Health Union; 2) It invites the people of Europe to engage in building a health policy that contributes to the long-term sustainable development of the European Union; 3) It sets out a vision of a European Health Union (with goals, policies, measures, principles). The EFN has already signed it and encourages all its members to do it also, thus strengthening the call to all Members of Parliaments and European leaders for a better EU role in health. To sign it, click here.

EFN reports on COVID-19
The EFN National Nurses Associations, met online for the 111th EFN General Assembly, on 15 October 2020, taking this opportunity to share key information on the COVID-19 crisis management at national level and to discuss the key findings of an EFN survey on COVID-19 impact on nurses’ health & wellbeing – based on which the EFN developed 2 important reports (EFN report on COVID-19 crisis management at national level & EFN report on COVID-19 impact on nurses’ health & wellbeing – Biological Agent Directive 2020/739). All the evidence points to nursing infection rates being very high across the EU Member States. The measures to protect our nurses are extremely urgent considering the high levels of infections and rising levels across Europe. The EFN Members raised how more than ever it is crucial, in this context of COVID-19 crisis, to apply the EU Directive 2013/55/EU in relation to the appropriate content and levels of nursing education (theorical and clinical) in all the EU countries. The importance of qualified and competent nursing personnel is intrinsically linked to appropriate, safe and high-quality care for all patients and citizens in all health settings.

EFN meeting with Commissioners Stella Kyriakides (Health) and Nicolas Schmit (Employment)
Beginning of October the EFN met Commissioner Stella Kyriakides to discuss the ongoing contribution of frontline nurses to our healthcare systems during the COVID-19 pandemic and the EFN’s Report on Lessons Learned from Ebola & COVID-19. For Commissioner Kyriakides it is clear that throughout COVID-19 pandemic, nurses have been putting themselves at risk to protect us all, and that it is now time to provide them, as frontline, providing care and hope for millions of patients, with the support they need.

Besides, the EFN, including its Execute Committee Members, had a thoughtful meeting with Commissioner Schmit, in November, to exchange views on concrete EU actions to tackle key

challenges the nursing profession is facing in the EU due to the COVID-19 pandemic. The EFN Executive Committee took this opportunity to raise the working conditions of nurses across Europe – including wages, shortages and failing recruitment strategies.

The major takeaway from both meetings is the shared perception between the Commissioners and the EFN on the urgency to act now, to alleviate and improve the situation at the nursing frontline. The European Commission promised to look further into this and take concrete actions in 2021.

High-Level Conference on Digital Health
As one of the highlights of Germany’s Presidency of the Council of the EU, the country organised a High-Level Conference titled “Digital Health 2020 – EU on the Move”. The conference brought together representatives from all parties involved in advancing digital health – decision-makers from politics, science, medicine, business, civil society, including patient representatives, and healthcare professions – to discuss the current and future applications of Big Data and Artificial Intelligence in the healthcare sector and both its potentials and possible risks. This is seen by the EFN as a key topic in its political agenda, as AI and new digital health technologies can bring added value that the EU and Europe, as a common economic, legal and value-based community, have to offer in the field of Big Data and AI for science-driven, value-based and patient-centred healthcare.

AI Standards for Health
The EFN participated in October on a virtual workshop on “Artificial Intelligence in healthcare: paving the way with standardization”, organised by CEN-CENELEC, aiming to explore how Artificial Intelligence can pave the way for the future of healthcare.

AI has become one of the top strategic priorities in the EU policy agenda, and as such in the EFN lobby agenda, and a key driving force of economic growth. The potential of this game-changing technology in the healthcare sector will make a huge difference for both professionals and patients. The main conclusion is that  End-Users and developers have, in fact, the same concerns: is what we are developing fit-for-purpose? How do we know this? Explicability and stakeholder engagement go hand in hand. And in this co-design with nurses is key to ensure frontline deployment and trust.

Every year, on 18 November, takes place the European Antibiotic Awareness Day (EAAD), a European health initiative coordinated by ECDC, with the aim of raising awareness on the issue. This year has a special taste due to COVID-19 pandemic, and the theme chosen for the EAAD 2020 was “In times of COVID-19, don’t give up on antimicrobial resistance (AMR) and stay united to preserve antimicrobials”. As every year, the EFN was involved in the campaign with some social media done in its social media network (Facebook/Twitter/Instagram/LinkedIn) to raise awareness on the issue. To tackle AMR frontline, health policies need to be ‘fit for purpose’, and the AMR national Action Plans need to reflect the nurses’ voice. But, European initiatives to tackle AMR do not take up in a systematic way the health professionals’ frontline perspectives into account. It is time that the EU policy makers understand that a greater involvement of nurses in initiatives promoting prudent antimicrobial prescribing and management could substantially increase the extent to which these actions can improve health outcomes.

World Mental Health Day 2020
10 October marks, every year, the “World Mental Health Day“ – an opportunity to remind all healthcare stakeholders and citizens of the importance of mental health – in conjunction with physical health – and the importance of breaking the social stigmas around it. The 2020’s theme was “Move for mental health: Increased investment in mental health”. The EFN, in the representation of 3 million EU nurses, took this opportunity, through its social media network, to remind all EU stakeholders and officials that since the beginning of the COVID-19 outbreak the frontline nurses have been greatly exposed to unprecedented situations, to a lot of pressure and to responsibility towards the decisions they had to make (which were often taken in insufficiently funded healthcare systems). Altogether, these have taken a toll on the mental health of nurses – which is something we should all tackle to improve the situation. COVID-19 has shown that more than ever, it is vital to provide the appropriate EU tools to help frontline nurses cope with the burden that fear, fatigue, uncertainty, and frustration takes.

News from the EU

ECDC’s COVID-19 Situation Dashboard
The European Centre for Disease Prevention and Control (ECDC) has designed and published online a new COVID-19 situation dashboard, which provides users with a simple and user-friendly platform to explore the latest available COVID-19 data from Europe and worldwide. It also allows users to view and export data on subnational levels of transmission in the EU/EEA and the UK, as well as enhanced data on subsets of cases, including age, gender, hospitalisation and admission to intensive care.

Antimicrobial resistance
The European Commission published its 5th progress report on the implementation of the European One Health Action Plan against Antimicrobial Resistance. The report shows that several AMR initiatives have been continued or put in place in recent months. The next progress report is planned to be published in mid-2021.

The European Commission seeking to revive EU enlargement
The European Commission has published a new enlargement package in a new attempt to revive the stalled process with promises of more substantial economic assistance in exchange for reforms. The package includes country-specific reports on the progress of the six Western Balkans countries and Turkey. The document is available here.

EXPH opinion on “The Organisation of Resilient Health and Social Care following the COVID-19 pandemic”
The COVID-19 pandemic has raised questions about the resilience of health systems across the globe. Many analyses of its impact and the responses adopted have already been published. The Expert Panel on Effective Ways of Investing in Health (EXPH), an interdisciplinary and independent group established by the European Commission to provide non-binding independent advice on matters related to effective, accessible, and resilient health systems, received a mandate to look beyond the current crisis and consider how health systems can prepare better for future threats. The EXPH recommendations are the following: creating adaptive surge capacity, taking into account solidarity mechanisms within and across borders; investment in primary care and in mental health; patient data disaggregation to ensure equity-driven decision making; strategies to monitor and reduce disinformation; linking databases across systems and sectors, in line with an integrated whole-of-society approach; providing specific training on dealing with socially deprived and minority groups; developing a resilience test toolkit and implementation methodology for health systems. The full opinion report with the recommendations is available here. An accompanying factsheet is available here.


Long-term care workforce
Eurofound just published a new report on “Long-term care workforce: Employment and working conditions” at the request of the European Commission in the context of the forthcoming report on long-term care, which maps the LTC workforce’s working conditions and the nature of employment and role of collective bargaining in the sector. It also discusses policies to make the sector more attractive, combat undeclared work and improve the situation of a particularly vulnerable group of LTC workers: live-in carers; and highlights the expected staff shortages and the challenges around working conditions.

New Strategy to strengthen the application of the Charter of Fundamental Rights
On 2 December 2020, the European Commission presented a new Strategy to strengthen the application of the Charter of Fundamental Rights in the EU. In order to ensure that the Charter becomes a reality for all, the strategy sets out the direction of the Charter implementation for the next 10 years, focussing on four pillars: 1) Effective application by the Member States; 2) Empowering civil society organisations, rights defenders and justice practitioners; 3) The Charter as a compass for EU institutions; 4) Strengthening people’s awareness. The full new strategy is available here.

Commission’s 2020 Women in Digital Scoreboard
The European Commission published the Commission’s 2020 Women in Digital Scoreboard, which shows that women have spearheaded innovation essential to the advancement of digital technology – from computer algorithms to programming. Yet, they are still less likely to have specialist digital skills and work in this field compared to men – only 18% of information and communications technology specialists in the EU are women. Only when looking at the basic digital skills, the gender gap has narrowed, from 10.5% in 2015 to 7.7% in 2019. The European Commission’s initiatives encourage and empower women to play a more active role in the digital age.

AI watch, assessing technology readiness levels for artificial intelligence
The Joint Research Centre (JRC) of the European Commission has published a technical report on how Artificial Intelligence (AI) offers the potential to transform our lives in radical ways. However, not only do we lack the tools to determine what achievements will be attained in the near future, but we even underestimate what various technologies in AI are capable of today. Certainly, the translation from scientific papers

Season Greetings!

As we come to the end of 2020, the EFN wishes to express our sincere appreciation to all for generously giving of your time, expertise and wisdom to drive the EFN work. Looking forward to working with you all in 2021. We wish you and your families a wonderful holiday season and hope the New Year will bring you all happiness, health and success.


and benchmark performance to products is faster in AI than in other non-digital sectors. However, it is often the case that research breakthroughs do not directly translate to a technology that is ready to use in real-world environments. The full publication is available for free here.

OECD Forum Network article on the impact of COVID-19 on vaccine hesitancy
The Organisation for Economic Co-operation and Development (OECD) Forum Network (gathering experts and thought leaders from around the world and all parts of society) have published an analysis on how COVID-19 vaccination hesitancy may become a problem when administering the vaccine to the broader population. For the nurses, being at the frontline, this is of key concern. As a reminder, the EFN is co-chairing a European Coalition for Vaccination of healthcare professionals (the other two co-chairing organisations represent medical doctors – CPME, and community pharmacists – PGEU). This initiative, to which the European Commission gives administrative support, is combating vaccination hesitancy and misinformation spreading across the European healthcare workforce.

Asija, a nurse from Croatia working in the UK, and collaborating on regular basis with EFN, believes that the recent research on a COVID-19 vaccine is a positive step in the fight against the pandemic. Asija contracted the virus while working in the hospital. She hopes that a vaccine against coronavirus will be a path back to normal life. See her interview here.

OECD Forum Network article on violence against women
The OECD’s Forum Network have published an article containing several testimonies of women who have suffered from violence, on any of its forms. The article raises that countries around the world are taking action with 21 of the 37 governments adhering to the OECD Gender Recommendations list violence against women as one of the three most urgent gender equality issues in their countries. Many are updating legislation, abolishing discriminatory laws and implementing strategies to prevent and address violence. Yet, only 133 of the 180 countries covered by the OECD’s Social Institutions and Gender Index (SIGI) criminalise domestic violence, and just 110 treat sexual harassment as a criminal offense. The article is available here.


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