March – April 2017

President message

Dear EFN Members and Colleagues,

It was with great pleasure that the EFN Executive Committee Members met on 17 February, in the EFN Brussels’ Office, for their first annual meeting. This was the opportunity to discuss the future EFN political agenda and prepare the recommendations for the next EFN General Assembly to take place in Malta end of March, on: 1/ Directive 2013/55/EU, for which the EFN is watching carefully the transposition into national law, with some infringement procedures to be started by the European Commission for those countries not fulfilling the process, knowing that the deadline to transpose it was 18 January 2016; 2/ Nursing workforce & skills – with the Joint Action on EU health Workforce Planning and Forecasting now being finished, and the new type of Joint Actions excluding the EU Stakeholders as partners, it is now time for nurses to focus on the European Commission partnerships, especially on skills, and on the New Skills Agenda for Europe launching several actions to ensure that the frontline support is available throughout the EU; 3/ Patient Safety & Quality of Care, focusing on ‘Value-based Health and Social Ecosystem’, and ‘Virtual Coaching’.

Also, Robotics has been taken up in our lobby work, especially with the European Parliament. The nursing and health sector can benefit greatly from the use of modern technologies and nurses’ engagement in their design is crucial. Having already contributed to many European policy initiatives in the area of eHealth and eSkills, namely with the publication of the five Guidelines (EFN project ENS4Care) and the eHealth stakeholder group policy document on eSKills for health professionals, the political discussion at EU level is an opportunity for the nursing profession, and lead these fit-for-purpose innovations.

Finally, gender is high in the EFN political agenda, knowing that 92% of nurses are women. Since the beginning of the economic crisis, nurses are subject to lower wages, uncertain and precarious employment conditions. The improvement of labour legislation, the increase of salaries, the promotion of collective bargaining, and the protection of maternity, are amongst some of the most needed measures to achieve gender equality. Being currently debated at EU level, namely in the European Parliament, the EFN believes that the possible solutions, as tabled in the EMPL Committee report ‘Working conditions and precarious employment’ voted on 6 February, relate to the increase of wages; better social protection (i.e. paid maternity leave) and improving working conditions for women within the EU Single Market.

Looking forward to seeing all the EFN Members in Malta.

Marianne Sipilä
EFN President

News from EFN

People at the Centre: The Future of Health
Participating at the OECD Health Policy Forum “People at the Centre: The Future of Health”, held in January 2017, in Paris, aiming to explore how healthcare systems can be better organised around the needs, preferences and capabilities of individuals using health systems and society more broadly, the EFN Secretary General made it clear that people at the centre, implies nurses and patients at the centre. There will be no better health outcome if we do not support frontline more. Asking them to collect more but useless data, will drive them away from frontline care. We will get the opposite results. Therefore, the EFN is calling on the patients’ organisations and health professionals to build strong alliances to jointly agree on health system reform, preferable in a non-disruptive way. Women’s voice is also key in this debate. We need to empower women more in getting the value based health and social ecosystem work better. The meeting brought together patient and consumer groups, providers, governments, academia and industry from 35 OECD countries and emerging economies.

The EFN also participated in the OECD Stakeholder Consultation meeting, held in February, where the OECD study on Health Workforce Skills Assessment was presented. The study explores the feasibility of carrying out a sector-specific survey of the skills of health professionals to provide more robust evidence on skills requirements, skills use and skills mismatch in workplaces. EFN and ICN will work closely to not reinvent the wheel again! The meeting brought together representatives of the governments, healthcare providers, and health professional associations from the EU and EFTA countries.

Meeting with European Commission DG GROW
In the context of the Directive 2013/55/EU on Mutual Recognition of Professional Qualifications, the EFN has been in close contact with the European Commission DG GROW, namely to be updated on the state of art of the implementation of the Directive by the EU Member States and on the European

Professional Card latest developments, and to discuss the next steps for a Delegated Act to modernise Annex V of the Directive. In the last meetings, the EFN Secretary General, Paul De Raeve, made it clear that the modernization of DIR36 is not completed if the Annexe is not modernized too (now topics from 1970!) All Sectoral Professions are lobbying to hope DG Grow would act. For EFN, it is crucial Annex V, through a delegated act, gets connected with the eight competencies in article 31, so they are interpreted in the same way in all 28 EU Member States. It is clear that collecting data on compliance and transposition of article 31 in the nursing curricula, becomes a priority for EFN. We need to be 100% sure all nursing students become DIR55 nurses and benefit from free movement in the EU and use the Professionals Card.

European Parliament Committees
For the EFN, the European Parliament is, next to the European Commission, the place to be to push its political agenda forward. As such, the EFN has been following very closely some of the European Parliament Committees’ meetings having an impact for nurses and the nursing profession and making sure that the nurses’ concerns are picked. We focused mainly on ENVI, IMCO, JURI, EMPL, and FEMM, where our advocacy work focused on: Robotics, and MEP Delvaux report on “Civil Law Rules on Robotics”; European Semester 2017; Transposition of the Directive 2013/55/EU on Mutual Recognition of Professional qualifications – One year after the transposition, where are we? And the European Professional Card (Besides the problems with the transposition of the Directive, the nurses are using the EPC); Commission proposal on safety measures in the work place (EU-OSHA); European Pillar on Social Rights, and the impact of automatization and upscaling the skills of European workforce, with the European funding coming from Lifelong Learning Programme, developed under Erasmus + Programme.

News from the EU

Investing in Europe’s Youth
Following on the Commission’s December Youth initiative, which proposed a package of measures aimed at improving young people’s skills and opportunities in order to tackle youth unemployment and increase youth participation and learning mobility, the Council adopted conclusions on investing in Europe’s youth, focusing on the European Solidarity Corps. The Ministers also discussed the contribution that education and training can make to social cohesion and the promotion of common European values. From a nurses’ perspective, this is very positive, if we take into account that some EU Member States governments are downgrading the nursing education. In line with the EFN views, the Ministers highlighted that education policies play a fundamental role in promoting inclusion and that the fundamental values of the EU and the European education model must be preserved.

Robotics and nursing
As far as EU legislation is concerned, Ms. Delvaux (MEP, S&D) recent own-initiative report of the Legal Affairs Committee on the topic of robotics and Artificial Intelligence (AI) was adopted by the European Parliament on 16 February 2017. Some EU Member States have already started to reflect on possible legislative changes to consider the emerging applications of such technologies. Robots can perform tasks that complement the work of nurses, lowering their workload and supporting continuity of care with technology advances, and assist nurses in their daily practice in ways that were unthinkable before. For these developments to take the right direction, non-disruptive, a stimulating legislative framework is needed as well as a continuous dialogue between industries in all fields and the nursing profession. We need co-design to achieve the best return on investment. As such, the EFN is encouraging the national and European policy-makers to start considering robotics and artificial intelligence legislation, especially in the areas of liability and ethics, taking into account the nurses’ experiences in working with robots, particularly in elderly care. The EFN is even exploring the public procurement debate as nurses play a central role in buying equipment. Therefore, it is also important that the nursing researchers bring efforts and findings together to support EU policies with evidence in the field of robotics, as it is crucial to allocate funds to further research and innovation

in this area both at national and European level. Advanced robotics skills are a new field of expertise to be developed for and with the nurses. Only then there will be return on investment!

Next to that, the OECD has published a report on the management of new healthcare technologies, entitled “New health technologies – managing access, value and sustainability”, that highlights the need for an integrated and cyclical approach to managing health technology in order to mitigate clinical and financial risks, and ensure acceptable value for money. ICN and EFN have a crucial role to play in this debate.

ManpowerGroup, one of the world’s largest jobs companies, has also released a report entitled “The Skills Revolution”, in Davos (Switzerland), that stresses how the technological revolution is going to change the employment market forever, explaining that the Skills Revolution requires a new mindset for both employers trying to develop a workforce with the right skill sets, and for individuals seeking to advance their careers. CPD will therefore play a central role to secure engagement, safety, quality and sustainability. The report also stresses that robots are more likely to replace activities within jobs – not the jobs itself. Indeed, professions do not get automated, but rather specific tasks. As such, nurses will be able to improve their work by having more time to care for their patients, and concentrate on the tasks that require experience, judgement, intuition or creativity. We need to increase urgently the direct patient/citizen time, especially now nurses are rated the highest trustful profession (94%). It, therefore, becomes clear how robotics can be an opportunity for nurses, not a treat!

Agreement sealed with trade unions in Germany
Last 17 February, Germany’s federal states agreed with trade unions an increase of 4.35 percent for more than two million civil servants and other public sector employees. An increase that will be split in 2 wages: 2 percent in 2017 and 2.35 percent in 2018, and which is expected to boost consumer spending at a time when vibrant domestic demand has replaced exports as the main growth driver in Europe’s largest economy. “We have reached a deal with significant real wage increases,” said Frank Bsirske, head of Germany’s biggest white-collar union Verdi, member of EPSU. Congratulation!


Book News

Environmental Health in Nursing
Published by “Alliance of Nurses for Healthy Environments (ANHE)”, this book entitled “Environmental Health in Nursing” brought together leading environmental health nursing experts to share their environmental health knowledge, expertise and experiences; essential information for nurses new to the topic as well as those with advanced environmental health experience, taking into account that all nurses and other health professionals are called upon to include the environment in their practices whether it is clinical practice, education, policy and advocacy, and/or research.

EU Citizenship Report 2017
The European Commission published its third European Citizenship Report presenting the main initiatives taken since 2014 to ensure citizens can fully enjoy their rights when working, travelling, studying or participating in elections. The report also sets out the Commission’s priorities in further raising awareness of these rights and making them easier to use in practice.

Gender Equality Strategy 2014-2017 – Annual report 2016
The Council of Europe published its annual report 2016 on the implementation of the strategy for gender equality 2014-2017, that shows that the EU Member States have continued to engage in activities related to the Council of Europe Gender Equality Strategy. Most member States are developing new laws, policies and measures to prevent and combat violence against women and domestic violence, and

are actively addressing the need for gender mainstreaming in all policies and measures. Ahead of the Women’s Day to be celebrated on 8 March, it is important to remind that gender equality is crucial in our society. As such, the EFN, representing a large number of nurses/women, sees this as a positive step forward that needs to be developed even more, to bring positive outcomes and close the gender gap.

The Institutions of the European Union
This new published book is key those who want to know more about the EU Institutions – from the Council of Ministers to the European Central Bank – all of the most important organisations are analysed and explained by international experts. This third edition has been fully updated and includes the impact of the ratification of the Lisbon Treaty and the financial crisis in the Eurozone on the EU’s institutions.

The “populist moment”: a trend towards a post-liberal Europe?
The West is experiencing a “populist moment” and continental Europe is not an exception to this rule. In this context Thierry Chopin aims to show that the various forms of populism – which are feeding a Eurosceptic and even a Europhobic discourse – all converge towards a crisis of liberalism which has to be overcome if we do not want our societies to close on the modern world.



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