February-March-April 2018

President message

Dear EFN Members and Colleagues,

Reflecting on last year, it is with acknowledgement and sincere appreciation that in solidarity, EFN members addressed many challenges and through intense lobbying ensure the voice, potential and expertise of the nursing profession is clearly articulated across Europe. Collectively we are in a strong position to face the challenges in terms of health and wellbeing. With austerity measures adopted in all EU Member States, nursing education has experienced a range of severe cuts. In addressing ongoing societal challenges, governments and employers short sighted policies have enormous implications on quality of life, morbidity and mortality of EU citizen and a detrimental effect on the nursing workforce and their ability to effectively and efficiently deliver nursing care. To tackle this trend, the EFN has restlessly worked to advocate for the promotion of empowered and skilled nurses to work to the full scope of their practice and potential, as critical element to ensure the best healthcare outcomes for patients and EU citizens.

Now more than ever it is crucial for nurses to engage and proactively influence EU health policies. EFN emphasises that nurses’ engagement in policy design is fundamental to close the EU implementation gap. Therefore, 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 evolving the appropriate workforce composition, and to provide clarity to the different nurses’ roles and responsibilities.

To this end, the conclusions drawn by the Country Health Profiles have emphasised the importance of a fundamental rethink of service delivery for health and social systems. A strong primary care service guiding the citizens through the health systems, while avoiding wasteful spending by early skilled nursing intervention is the way to implement such rethinking, and numbers are clear with nurses performing 2/3 of the work in primary care. It is crucial to acknowledge that advanced nurse practitioners are part of the solution across the EU, with advanced nurse practitioners with the appropriate scope of practice and assuming certain competences as independent professionals.

Nurses input is fundamental to establish a strong European leadership guaranteeing that health will remain a high priority on the EU political agenda, as indicated in the European Pillar for Social Rights. To this purpose, EFN members collectively and in partnership will work to make sure that nurses’ views, expertise and valuable contribution is taken into account in the development of the EU policies linked to the implementation of the 20 principles enshrined in the European Pillar of Social Rights. A thorough implementation of such principles, reflecting the 3 million EU nurses’ needs, their pragmatic approach and expertise, is crucial to achieving concrete outcomes for the sustainability of the health and social care sector.

I look forward to welcome once again, all the EFN members in Brussels in April for the 107th General Assembly, where these key nursing challenges and opportunities will be discussed.

Elizabeth Adams
EFN President

News from EFN

Combating Antimicrobial Resistance remains key priority
Nurses are continuously active in advancing their commitment to tackling AMR, frontline! The tremendous negative effect of AMR on outcomes is stressed in all EU meetings as if AMR cannot be countered by 2050, ten million people would die each year, combined with a reduction in global GDP of 2% to 3.5% and a total cost of 100 trillion dollars. But how do you translate these numbers to frontline support? The EFN has demonstrated how nurses can effectively contribute addressing AMR. However, the ongoing Joint Action, led by France, excludes Healthcare Professions as partners. The EFN has clearly stated that the EU approach needs to be more concrete and go beyond consultation, awareness raising and keeping repeating the terrible statistics. Accelerate progress to manage antibiotics better can only be done by involving and engaging frontline, bedside health professionals and supporting them with concrete actions. Stop Talking, Start Acting!

EFN as frontline defender
The European Union Agency for Fundamental Rights (FRA), in cooperation with the European Economic and Social Committee’s Liaison Group launched a report on ‘Challenges facing civil society organisations working on human rights in the EU’. 3 Million nurses work every day to ensure that EU citizens and patients receive the care they need, according to their requirements and complex environment they live in. The FRA report highlights that the threat civil society experience across the Member States has a strong impact on the delivery of human and fundament rights. Civil society’s input should be taken more serious by engaging substantially NGOs in the co-design of health

policies. Developing roadmaps and reports is no longer enough. EU citizens need concrete actions and nurses can greatly contribute to delivering health as a fundamental human right.

Centralise the gender issue
As 92% of the nursing workforce is composed by women, the gender perspective stays crucial among the EFN objectives. In this context, the EFN participated in the event organised by the European Institute of Women’s Health “Resetting the Agenda in Women’s Health in Europe”, to discuss the European Action Plan for Women’s Health, where the EFN emphasised that, if frontline is not empowered, person-centred care cannot work. Therefore, you need highly educated nurses, women, and Directive 2013/55/EU helps us doing so. Nowadays it is extremely difficult to recruit and retain nurses as the profession lost attractivity due to terrible working conditions and low salaries. It is time the EU Commission starts supporting nurses and nursing in all the Member States!

Nurses support value-based healthcare if it brings nurses closer to patients!
The EFN is following the debate on value-based healthcare and how it can tackle the challenges of future healthcare systems by shifting to integrated care models that improve health outcomes for patients and foster sustainability. To make it work, patients, healthcare providers and researchers should work together on the optimisation of value, going beyond outcomes and costs measurements. Clinical pathways nurses deal with are often complex and nurses’ experiences and views need to be taken up in the algorithm. The creation of value for patients and citizens incorporates nurses’ frontline experiences. Value-based health care is supported by the nursing profession if it goes beyond cost-control: quality and safety should drive better outcomes.

News from the EU

Bulgaria holding the new Presidency of the Council of the EU
On 1st January 2018, Bulgaria took over the rotating Presidency of the Council of the EU, the first time since Bulgaria joined the EU in 2007, aiming to work on unity among the EU Member States, with a new impetus to future EU enlargements. The Bulgarian presidency priorities look at improving conditions of stability, security and solidarity for Europe and EU citizens, and at digital economy and skills needed for the future. The EFN member, and Executive Committee member, Milka Vasileva will do everything in reach to make the EU nurses views known: support frontline health workforce through coherent investments to reduce the increasing burden of major societal challenges in Europe.

WHO/Europe boosts AMR fight with online course on prescribing and using antibiotics wisely
WHO/Europe has launched a newly developed online course – Antimicrobial stewardship: A competency-based approach –  that aims to equip clinicians, especially nurses, with the information they need to prescribe antibiotics appropriately and wisely. Nurses in advanced roles, prescribing medication, are key to combat antimicrobial resistance. Using case-based examples, it highlights how antimicrobial stewardship principles can be applied to common clinical scenarios. Due to their close relationship with the patient, nurses are naturally equipped to perform this crucial role, that could – and should – be further empowered extending nurse prescribing roles in all EU Member States!

Launch of the EU Health Promotion and Disease Prevention Knowledge Gateway
From the collaboration of DG SANTE and the Joint Research Centre, the European Commission has recently launched the Health Promotion and Disease Prevention Knowledge Gateway, aiming to provide public health policy-makers with information on topics related to the promotion of health and well-being, in particular the prevention of non-communicable diseases. The OECD Better Life Index is also very interesting, as there is more to life than the cold numbers of GDP and economic statistics!

Important data on increase of dementia come from WHO
The WHO Global Dementia Observatory has highlighted that the number of people living with dementia is expected to triple from 50 million to 152 million by 2050. Another terrible statistic! Dementia is a key area for nurses daily work, playing a key role both in managing and preventing this condition. But more needs to be done to overcome the EU policy implementation gap to manage the burden of dementia

and promote relevant interventions and pathways that increase the safety and quality of life of those living with dementia, their families and carers. The current EU Joint Action is not inclusive enough!

The EU commitment in addressing gender gap…
In line with the principles included in the European Social Pillar on equal opportunities and access to the labour market, the European Commission has adopted an Action Plan to tackle the gender pay gap, combining legislative and other measures. In 2018, the European Commission will look closer at the need to clarify the legal provisions on equal pay that are in the Directive on equal treatment between women and men in employment and occupation (Directive 2006/54/EC). The EFN strongly encourages the EU Commission to include the gender dimension in the design of EU policies. For nurses, this is particularly relevant both in terms of work-life balance measures to retain nurses in the profession and, to allow women being key players in the co-design of health and social policies, that will allow to build resilient health and social ecosystems in the EU.

… and digital skills
In parallel, to deliver on the first principle of the Social Pillar – education, training and life-long learning – the Commission has adopted new initiatives: 1) a Council Recommendation on Key Competences for Lifelong Learning, aiming to improve the development of key competences of people of all ages throughout their lives and to provide guidance to Member States on how to achieve this objective; 2) A Digital Education Action Plan that outlines how the EU can help people, educational institutions and education systems better adapt to life and work in an age of rapid digital change; 3) A Council Recommendation on common values, inclusive education and the European dimension of teaching, that proposes ways in which education can help young people understand the importance of and adhere to common values.

So, the EU Social Pillar is in its design, but its potential remains unknown to the EU citizens
As expressed several times by the EFN, to bring EU citizens closer to the EU, it is fundamental to concretely support and involve civil society in the co-design of EU policies. However, a recent survey (only available in French), published on behalf of the French social protection group Humanis, highlights that the European Social Dialogue is still struggling to reach workers, still being misunderstood, despite its thirty-year history. Particularly alarming is the fact that only half of the EU workers know that rights, as the maximum working time and parental leave, are governed by European agreements. It is about time for the EU to enact concrete actions to reconnect to its citizens. So, join the Citizens Dialogue with EU Commissioners in your country!


European Parliament supports healthcare in the next EU budget
The European Parliament Budgets Committee has released its Draft report on the next Multiannual Financial Framework (MFF) post 2020. The text recognises the European added value in addressing common public health threats, and stresses that no single Member State can tackle cross-border health challenges alone. The EP Committee calls for the next MFF to reflect the EU’s responsibility to support Member States in reducing health inequalities, clarifying that it should include a robust next generation Health programme that addresses these issues on a cross-border basis.

Health Programme – Work Programme 2018
The Commission adopted the Health Programme’s Work Programme for 2018 setting out the priorities and actions to be undertaken in 2018. The overall budget for 2018 is just over €62 million, with 64% being allocated to grants, 24% to procurement and 12% to other actions including prizes. The updated list of national focal points is now available.

Trust in health apps
A research by PatientView as part of Deloitte’s report ‘Pharma and the connected patient’ highlights that the level of trust in health apps differs deeply if created by pharma or

patients’ groups. It is also interesting to note that nurses, together with doctors, are the second top source of apps where patients’ groups have ‘high trust’ (44%).

28 Country Health Profiles
As part of the two-year cycle “State of Health in the EU”, the 28 Country health profiles describe the individual context and specificities of each EU country, assess the strengths and challenges in their respective health systems.

OECD & WHO Europe
How long it takes to make Institutions work together? On 15 January 2018, the OECD & WHO Europe, strengthened their commitment to collaborating on infectious diseases and disease outbreaks by establishing operational guidelines on collaborative actions.

Public consultation on EU funds
The European Commission launched a Public consultation in the area of investment, research & innovation, SMEs and single market, including funds in the area of health. Deadline 8 March 2018.


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