Home EFN Update – July-August-September 2022

EFN Update – July-August-September 2022

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President’s Message

Dear EFN Members and Colleagues,

Welcome to the summer edition of the EFN Newsletter. In these challenging times it is more important than ever that EFN in solidarity with all National Nursing Association (NNA) members collectively support, protect and advocate for the many concerns and solutions raised by our nursing colleagues and address the broader policy decisions that are negatively impacting on quality of care and safe working environments. In recent times with the backdrop of the pandemic, the war in Ukraine, years of underinvestment and other evolving challenges, issues highlighted by our nursing profession have become more profound and alarming. With widespread nursing shortages, deteriorating working and care environments, economic uncertainty and the rising cost of living impacting negatively on salaries and wellbeing, lack of respect and engagement by some employers has translated into forcing NNAs at national level to raise disputes and take the necessary action. The EFN in partnership with our NNAs remains steadfast in our commitment to supporting all measures that will protect health, patient care and nurses on the frontlines.

The EFN continues to contribute to the implementation of the European Pillar of Social Rights 20 principles with a specific focused on four: Education; Wages; Healthcare; Long-term Care.  Commissioner Nicolas Schmit, European Commissioner for Jobs and Social Rights, present as a keynote at the 114th EFN General Assembly recognised the fundamental role of nurses as a significant human dimension in the resilience of our societies. He also shared information on the Biological Agent Directive and the European Care Strategy. Margrieta Langins, Nursing and Midwifery Policy Adviser, World Health Organisation (WHO) Regional Office for Europe presented on the WHO Roadmap to guide the implementation of the Global Strategic Directions for Nursing and Midwifery in the WHO European Region. In a constantly changing and evolving nursing society, nurses play a central role in achieving optimal health outcomes. Therefore, it is essential to invest in the retraining of the nursing workforce and in education, especially as part of the continuous development of the European Care Strategy.

The European Commission continues to drive a number of other important policy initiatives, of particular note on the 22 June Commissioner Stella Kyriakides, European Commissioner for Health and Food Safety launched The Healthier Together – EU Non-Communicable Diseases (NCDs) – Initiative to support EU countries in identifying and implementing effective policies and actions to reduce the burden of major NCDs and improve citizens’ health and well-being by supporting action of the Member States and stakeholders. She highlighted that NCDs represent 80% of the disease burden in the Member States. Complementing the Europe’s Beating Cancer Plan, the Commission is addressing the main NCDs in a newly ambitious and systematic approach. The Initiative covers the period 2022-2027 and includes five strands: 1. a horizontal strand on shared health determinants, focusing on population-level health promotion and disease prevention of NCDs (complementing the actions of Europe’s Beating Cancer Plan); 2. diabetes; 3. cardiovascular diseases; 4. chronic respiratory diseases; and 5. mental health and neurological disorders. The Healthier Together – EU NCDs Initiative is a toolkit identifies effective policies and best/promising practices selected by Member States and stakeholders. It also maps the legal and financial tools that can be used to implement those actions. The EU NCDs Initiative is also innovative as a process: the document is being co-created with the Member States with input from stakeholders with consultation of Commission services, the WHO, the OECD and the European Investment Bank.

Other important developments of note include the new European Semester Spring Package 2022 and the national recovery and resilience plans. The European Commission encourages the Member States to link the European Semester, the Recovery and Resilience Facility and REPowerEU to support the creation of quality jobs and to make progress towards achieving the United Nations Sustainable Development Goals. Creating resilient healthcare systems is a fundamental foundation to support nurses and healthcare professionals at the frontline. In addition, digitalisation is more and more critical in the health systems, the European Health Data Space (EHDS) also plays a key role. Recently launched by the European Commission, it represents one of the central building blocks of a strong European Health Union and will allow individuals to check and use their health data in their own country or in other Member States, fostering the development of a digital healthcare market. The EHDS represents a great opportunity for nurses and for all the healthcare professionals to have an easy access to the health data of patients, ensuring protection and high-quality care. EFN continues to focus on the health data space and is working towards the conclusion of two EU projects: Smart4Health and InteropEHRate.

The EFN Members are strongly engaged and committed to making a difference to the current EU policy agenda and are working relentlessly to ensure that 3 million nurses’ contribution is valued, and the potential of the nursing profession is maximised to positively benefit patients and health systems.

Finally, we are looking forward to meeting with you all in person at the 115th EFN General Assembly in Bled, Slovenia on 13-14 October 2022 kindly hosted by the Nurses and Midwives Association of Slovenia.

Wishing you a safe and relaxing summer and I look forward to meeting you again at our next EFN General Assembly.

Elizabeth Adams
EFN President

News from EFN

Joint Statement – List of Antimicrobials
EFN, CPME, EPF, and 16 other organisations for health, animal welfare and the environment have expressed their concerns in a joint statement on the lack of antimicrobials vital to human health in the draft list of antimicrobials to be reserved for human health proposed by the European Commission. They requested the European Commission to change the current proposal to make it more suitable for addressing antimicrobial resistance (AMR). The Commission recognises in its draft implementing act that “certain antimicrobial medicinal products should be reserved for treatment of certain infections in humans, with a view to better preserve their efficacy for human medicine and to supporting the fight against antimicrobial resistance.” But the proposed list only includes one out of the five Highest Priority Critically Important Antimicrobials (HPCIAs) designated by the WHO as the last treatment available for some infections in humans. A letter, signed by EFN and 16 other EU organisations, was also sent to the MEPs, calling on the European Parliament to approve objection and ask the European Commission to review the list, considering the evidence-based advice from human health experts throughout this process. The European Parliament has rejected the objection by a margin of only 11 votes. The European Commission is now likely to move forward with the list proposed. Antimicrobial resistance is a silent enemy that must be treated carefully for the well-being of human health. The EFN will follow this development closely.

Coalition for Supporting Ukraine and neighbouring countries
Following the creation by the European Commission of a dedicated stakeholders’ network on the Health Policy Platform to support Ukraine, neighbouring EU Member States and Moldova, which includes over 250 patient organisations, health professionals, NGOs and industry interested in sharing knowledge to avoid duplicating efforts, the EFN has been requested to co-chair the network together with 2 other organisations (European Cancer Organisation (ECO) & European Reference Networks (ERNs)). Over the last weeks, the 3 Co-Chairs and Liaisons have met and have identified four work priorities to work on: 1) Supporting displaced Ukrainian patients, including support on EU Member State to Member State transfers, removing bottlenecks and harmonisation of rules in different Member States 2) Facilitating partnerships and funding support for civil society organisations in Ukraine, Moldova and impacted EU Member States 3) Mental health support for refugee patients and healthcare professionals 4) Recognition and support for healthcare professionals arriving in EU Member States and Moldova, e.g. professional qualification recognition. The Co-Chairs and the HPP network are meeting on regular basis. The next meeting of the HPP Network is taking place on 30 June.

News from the EU

EU Parliament pushes for an EU Mental Health Strategy
Covid-19 pandemic and the war in Ukraine have severely tested the mental health of citizens and healthcare professionals, including nurses, at the frontline. In this context, attention must be paid to the mental health and well-being of nurses and of all healthcare professionals who continue to face constant challenges that strain their psychophysical well-being. During a plenary debate between the European Commission and the European Parliament, MEPs called for the development of an EU mental health strategy. In connection with the EU’s ‘Healthier Together’ NCD initiative – a €156 million initiative to support EU Member States to reduce the burden of EU Non-Communicable Diseases (NCDs) – the European Commission noted that an action plan on mental health was in preparation.

Mental health will also be among the priorities of the Czech EU Presidency in the second half of 2022, starting on 1st July, and some Czech MEPs are advocating for 2023 to be the European Year of Mental Health. From its side, WHO published a report that highlights the urgent need to transform mental health and mental health care, and that urges mental health decision makers and advocates to step up commitment and action to change attitudes, actions and approaches to mental health. Support nurses and sustain their mental health are key for delivering high quality care and creating a resilient healthcare ecosystem. Therefore, it is crucial to put in place national and local programmes to support frontline nurses who are caring for patients to preserve their mental health and prevent psychological trauma, and to work closely with the nursing profession to develop policies that protect frontline staff from unnecessarily difficult or unsafe working conditions.

Conference on the Future of Europe – Next Steps
The Conference on the Future of Europe has now come to an end. After one year of deliberations, debates and discussions between citizens, regional, national and European politicians, EU institutions, organised civil society and social partners a common trajectory for the future of the European Union has been reached. On the Europe Day (9 May), in Strasbourg, the President of the European Parliament, Roberta Metsola, the French President Emmanuel Macron, on behalf of the Council Presidency, and the President of the European Commission, Ursula von der Leyen, received the final report from the co-chairs of the Conference Committee. 49 proposals have been presented, which include more than 320 measures across 9 themes. This Conference allowed EU citizens to contribute to the shaping of the future of Europe and EFN was part of these discussions, with nurses at the forefront of change to build resilient health systems.

European Semester 2022 – Spring Package
The European Commission’s 2022 European Semester Spring Package has been revised and published taking into account the economic fallout stemming from Russia’s invasion of Ukraine. This document provides a connection between the semester, REPowerEU’s mechanism for recovery, resilience and political progress for Member States in the coming months. According to this package, the general safeguard clause will be extended throughout 2023 and deactivate it beginning of 2024. The European Commission also assesses the recent evolution of macroeconomic imbalances between countries under the Macroeconomic Imbalance Procedure framework.

Evaluation of Directive 2011/24/EU on Patients’ Rights in Cross-Border Healthcare
The purpose of the Directive 2011/24/EU was to facilitate access to safe and high-quality healthcare in another EU member state, to ensure patient mobility and to promote cooperation between member states in the field of healthcare. The European Commission has developed concrete follow-up actions to improve the implementation of the Directive: 1/ Reduce & simplify administrative procedures for access to cross-border healthcare; 2/ Reduce financial risk to patients; 3/ Improve information to patients, raise awareness of patients’ rights to cross-border healthcare, including recognition of prescriptions. A recent study shows that some important barriers to cross-border care persist, such as a general lack of awareness of patients of their rights and entitlements, issues regarding information provision by the EU Member States, and problems with the national implementation of some of its provisions that have led to complicated administrative procedures. The European Commission has systematically checked compliance of national transposition measures with the Directive’s provisions, focusing on the four priority areas that have the greatest potential to act as barriers to patients if left unaddressed: systems of reimbursement, prior authorisation, administrative procedures, and charging of incoming patients. The European Commission is continuing its structured dialogue with the Member States to achieve the best possible implementation of the Directive. A lot has been done at national level for the benefit of patients. However, further efforts are necessary.

Furthermore, in the context of the electronic exchange of health data under Cross-Border Directive 2011/24/EU, the European Commission has published a eHealth Network Guideline, which primary objective is to provide common grounds for the implementation of cross-border health data exchange scenarios, as: Exchange of Patient Summaries; Exchange of ePrescription and eDispensation; European Digital COVID Certificate;Exchange of Laboratory Results; Organizational Framework for the National Contact Point for eHealth.

Health Systems Resilience Toolkit
Over the years, the need to achieve greater resilience of the healthcare systems to address increasingly frequent health crises has grown. The need to move from theory to practice has become essential. Therefore, WHO is proposing the Health System Resilience Toolkit – that serves as a compendium of technical resources to support countries in strengthening the resilience of their health systems – articulated in 4 investments levels: Understanding of the concept of health systems resilience; Integrated policy-making and planning for health systems resilience; Health systems resilience at the implementation and operational level; Monitoring and evaluating of health systems resilience. In this context, creating resilient healthcare systems means engaging nurses in co-creation, empowering them and making their contribution impactful. Nurses really know what the healthcare systems need the most, so their input is essential to create systems able to face current and future crisis.

COVID-19: Occupational Diseases
In May 2022, the Member States, workers and employers in the EU Advisory Committee on Safety and Health at Work (ACSH) reached an agreement on the need to recognise COVID-19 as an occupational disease.This recommendation includes nurses and assistant nurses in hospitals and other medical facilities, care workers in public, non-for-profit and private care homes and other similar domiciliary assistants. It represents an important step forward in the recognition of all the sacrifices of nurses and all healthcare professionals every day and, above all, during the pandemic. This agreement is an important step to implement the EU Strategic Framework on Health and Safety at Work 2021-2027.

New EU Global Health Strategy
At the G7 Development and Health Ministerial, Commissioners Kyriakides and Urpilainen have announced the launch of the work on a new EU Global Health Strategy. They believe that the lessons must be learnt and that the Sustainable Development Goals must be put back on track. Health is the foundation for resilient, equal and just societies. It is therefore time to act, and improve health systems so that they can more effective, address inequalities and advance towards universal health coverage.


Involvement of the social partners in the national recovery and resilience plans
According to the report published by Eurofound “Involvement of the social partners in the national recovery and resilience plans”, the quality of the involvement of the social partners in the preparation and implementation of the recovery and resilience plans in the various countries was rather low. The parties complained about poor planning and organisation of the consultation process. This situation could be improved by ensuring a more timely and meaningful involvement of the social partners in order to enhance the effectiveness of planned actions and reforms.

Rebuilding for sustainability and resilience: strengthening the integrated delivery of long-term care in the European Region
The pandemic has demonstrated and accentuated the important gaps in the provision of long-term care services across the WHO European region. To build and strengthen health systems, it is essential to implement a broader dialogue to gather a common vision and bridge the gap that exists between the different countries. In this dialogue, the contribution of nurses is essential, as they really know what the health system needs to ensure high quality care. WHO Europe published a Policy Brief, where it proposed a conceptual framework that maps long-term care actions within the health and social policy landscape and highlights the need and potential for greater integration and coordination between systems.

The Future Health Index 2022
Being the largest global survey, analysing the top priorities and concerns of almost 3,000 healthcare leaders in 15 countries, Philips’ Future Health Index 2022 report explores how healthcare leaders are harnessing the power of data and digital technology as they look to address their key challenges coming out of the pandemic, and shows that healthcare leaders are rebooting priorities as they emerge from the pandemic. The health sector is radically re-evaluating priorities as it strives to deliver improved patient care.

Understanding healthcare workers’ confidence in AI
The report developed and published by Health Education England and the NHS AI Lab explores the factors that influence the trust of health professionals in technologies based on artificial intelligence (AI). This report main recommendation is to develop and deploy educational pathways and materials for healthcare professionals at all career points and in all roles, to equip the workforce to confidently evaluate, adopt and use AI. AI and digital tools can really help frontline nurses and all healthcare professionals, but they need to be engaged in co-creation to really developing something useful for their daily job.

Advanced robotics and AI for the automation of tasks at work
Automation in the workplace is constantly increasing. The rise of new technologies and the constant digital development bring out great opportunities from a professional point of view, but also new important challenges and concerns. As part of its four-year digitisation research program, EU-OSHA has published an initial report addressing the types and definitions of artificial intelligence (AI) and advanced robotics for automating tasks at work. Develop technologies which can really facilitate the job of frontline nurses and help to manage the workload is a great opportunity, but to reach this ambitious goal it is essential to engage them in the co-creation of the entire digital process.

Impact of Long COVID on workers and workplaces
The recent report published by OSHA explores the challenges for the prevention and management of occupational safety and health risks caused by Long COVID. The report also provides an overview of the measures that could be at the policy, research and implementation level to reduce the impacts of Long COVID. Covid-19 continues to have an impact on society, both on a social and health level. Frontline workers and nurses need to be protected and protected. Creating good working conditions is now more crucial than ever.

Fundamental Rights Report 2022
The EU Agency for Fundamental Rights published its Fundamental Rights Report 2022, that identifies achievements and areas of concern, on: equality and non-discrimination; racism, xenophobia and related intolerance; Roma equality and inclusion; asylum, borders and migration; information society, privacy and data protection; child rights; access to justice; and implementation of the EU Charter of Fundamental Rights and the UN Convention on the Rights of People with Disabilities. It also reviews the COVID-19 pandemic’s impact on people’s social rights, such as access to education, employment and healthcare.

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