The EHFF is a not-for-profit organisation improving the health of European citizens through an open, interactive and inclusive forum.It is open-source, crosses interdisciplinary boundaries and engages citizens by employing methods, techniques & expertise in thinking, debating and shaping the future.

1. European Health Futures Forum
FAN Club 01.02.13,LSBU
Marius Buiting, David Somekh
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2. The future of European healthcare – a possible scenario
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3. Adapted
from
Kees
van
der
Heijden
Scenarios:
the
art
of
strategic
conversa;on:
2004
3

4. Source: Hans Kluge. Director Division of Health Systems and PH, WHO Europe 4

5.
5

6. 6

7. Comment: note the ‘solutions’ in the previous two slides.
The whole presentation is a convincing over view of current
threats to EU health systems.
What is not convincing however is the proposal to do what
EU health systems have signally failed to over the last 20
years (make significant inroads into the estimated annual
25% wastage of resources across the board). Systems are
to be ‘strengthened’, not changed.
Ironically, it shares characteristics of the ‘future is techno.’
approach (e.g. see Mike Jackson’s presentation on
Shapingtomorrow, which skillfully scans potential
technological advances and their impact but because of the
audience it was aimed at doesn’t tackle the ‘elephant in the
room’ issue that unlike airlines or production lines, present
day health is manpower intensive and complex and
especially vulnerable to the vagaries of the human psyche).
7

8. To summarise:
‘Sickness care’ in its present form is notoriously wasteful and
significant savings are likely to be achieved only by substantial
change in the form of care delivery. There are many barriers, both
institutional and political which hamper this transformation
Increasing life expectancy results in an increased burden of
potential healthcare costs which ironically may be exacerbated by
increasing expectations from the public for care, the effects of greater
health inequalities and of other factors such as migration, climate
change etc.
In the present setting, financial forecasts suggest that the
envelope for healthcare spending has limited capacity for
expansion
Chronic mismanagement of workforce planning makes it likely that
serious shortfalls will impact on quality of care
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9.
9

10.
10

11. 11

12. 12

13. 13

14. There
is
indisputable
evidence
that
European
healthcare
systems
are
simply
not
sustainable
–
even
in
the
medium
term
future,
but
percep%on
of
threat
cannot
in
itself
bring
about
societal
change.
If
the
possibility
of
a
poten;al
collapse
of
the
system
can’t
be
contemplated,
people
will
behave
as
if
it
isn’t
there.
Just
like
they
did
in
the
banking
crisis.
Analysis
over
a
number
of
years
of
the
barriers
to
fundamental
change
in
health
delivery
systems
leads
to
the
inevitable
conclusion
that
there
is
huge
vested
interest
in
maintaining
the
status
quo:
• For
many
clinicians
(and
some
pa;ents),
the
cultural
change
is
just
too
threatening
• Despite
accumula;ng
evidence,
policy-­‐makers
are
simply
not
convinced
about
cost/
or
poli;cal/benefit
• Ci;zens
are
not
sufficiently
persuaded
that
personal
responsibility
pays
off:
being
all
too
human
• For
business,
stable
condi;ons
protect
shareholder
value
14

15. If
all
four
major
players
are
not
really
signed
up
to
the
concept
of
co-­‐crea;ng
health,
perhaps
its
because
the
implica;ons
of
doing
so
are
poten;ally
a
profound
change
in
the
nature
of
Health(care)
provision,
which
inevitably
threatens
the
vested
interest
of
any
of
these
stake-­‐holders.
Its
like
a
ra;onal,
progressive,
energy
policy:
the
means
are
there,
but
the
resistance
to
change,
from
so
many
sources,
is
just
too
great.
15

16. The
Cassandra
dilemma
16

17. An
interes%ng
idea
Several
years
ago
(at
the
end
of
2006
to
be
precise)
a
group
of
us
found
ourselves
in
a
very
unusual
situa;on
.....we
were
drinking
in
the
bar
of
a
hotel
in
a
European
capital
city,
late
at
night.
We
had
by
then
spent
many
years
working
on
improving
healthcare
quality,
but
recognised
that
the
results
of
the
labours,
not
just
our
own,
but
those
of
other
prac%%oners
in
the
field,
represented
a
very
poor
return
on
investment.
We
concluded
that
what
was
required
was
a
radical
transforma;on
in
the
way
that
healthcare
was
delivered;
an
ac%ve
collabora%on
between
representa%ves
from
Industry,
Educa%on
and
Healthcare,
crossing
tradi%onal
boundaries.
This
we
called
our
BIG
IDEA.
However,
it
took
several
years
to
find
a
means
to
put
the
idea
into
prac;ce…
17

18. In addition to our existing expert knowledge, we started to
look at futures methods, such as scenario planning, horizon
scanning and wild cards and weak signals methodology, to
see to what extent these techniques had successfully been
applied in the health field.
We discovered William Gibson (author of ‘Neuromancer’)…
“The
Future
is
already
here
–
it
is
just
not
evenly
distributed”
We decided to use what we had achieved thus far within
Europe to establish quite a different enterprise…
18

19.
ESQH
was
set
up
as
a
European
NGO
in
1998.
It
is
registered
as
a
charity
in
Ireland
and
the
idea
was
to
create
a
society
of
na;onal
healthcare
quality
socie;es,
to
represent
the
grass-­‐roots
staff
across
Europe
and
whose
mission
statement
was:
• to
promote
communica;on
between
the
stakeholders
in
European
health
quality
• to
champion
quality
in
healthcare
in
Europe
• to
s;mulate
innova;on
in
healthcare
quality
in
Europe
19

20. Networks
of
networks
EU
agencies
and
Associates
Offices
Socie;es
20

21. ESQH
offices
–
loca%on
and
func%on
semi-­‐autonomous
franchise
of
ESQH
brand
London:
Pa;ent
safety
Krakow:
Quality
Networks
in
Eastern
Europe
Aarhus:
Indicators
Padua:
Pa;ent
par;cipa;on
Utrecht:
Research
in
effec;veness
Gothenburg:
Transfer
of
methods
from
Industry
to
Health
Barcelona:
Quality
in
Mental
health,
Elderly;
Social
Care
Lisbon:
Health
Futures
(established
November
2010)
Vienna:
Collabora;on
between
Health
and
Industry
Sussex:
Governance
Athens:
Cross-­‐border
Healthcare
Berlin:
Guidelines
21

22. Rela;onship
to
various
European
agencies
• Links
to
EC
– Membership
of
Health
Policy
Forum
and
PSQCWG
– SANCO
projects
and
networking
– FP7
projects
• WHO
-­‐
Europe:
joint
conference
Copenhagen
‘05
• OECD
-­‐
involvement
two
indicator
projects
’04/5
• Council
of
Europe
-­‐
working
rela;onship
on
PS
• EOQ
and
EHTEL
-­‐
memoranda
of
understanding
• HOPE,CPME,EPF,
EHMA
-­‐
ac;ve
rela;onships
22

23. In summary, there are several reasons that ESQH
is well placed to provide a springboard for a new
European NGO which concentrates on health
futures. Among these are:
It has a well established network involving 20 countries and
contacts within several stakeholder groups in each
Experienced at becoming involved with policy issues at a
significant level, starting from scratch and building a brand
Run as a lightweight, flexible but effective organisation that
is more or less virtual but has appropriate governance
Will build on ESQH’s work but will create its own brand and
intends to operate faster, smarter and more effectively
23

24. What are the key features in the current context
that provide a rationale for EHFF?
• Overall turbulence and interconnectedness of systems
• Failure of experts to consider contingencies, even
when recognising threats
• Prevalent culture that supports innovation but is confused
about the meaning and implications of the concept
• Slow-adapting systems that are embracing sustainability
but not resilience and do not espouse a holistic model of health
24

25. What are the USPs that EHFF offers, that merit
participating in its development?
• Supporting disruptive innovation with a cross-sectoral
focus using a network structure
• Offering an approach to health scenarios which fosters
on-going multi-stakeholder dialogue
• Aiming to collect data that identifies potential threats to
health systems in a more realistic timescale
• Operating in a 21st century organisational mode, with an
effective but fluid, inclusive and open-source orientation
• Cognisant of current policy but side-stepping political
pressures and the constraints of traditional institutions
25

26. Consistency of EHFF principles with Foresight
concept
26

27. Brief
summary
of
what
EHFF
will
aKempt
to
do
Create
an
open
interac%ve
forum,
whose
members
will
seek
out,
process
and
exchange
knowledge
and
informa%on
in
real
%me
that
may
either
influence
the
future
of
health
and
healthcare
in
Europe
and/or
provide
a
beKer
understanding
of
future
possibili%es
and
risks
in
this
area.
We
aim
to
facilitate
beKer
ques%ons,
not
offer
solu%ons.
The
business
model
involves
establishing
a
diversely
populated
not
for
profit
legal
en;ty
and
incrementally
building
web
presence,
funding
streams,
eclec;c
network
of
expert
associates
linked
to
current
network,
involvement
in
relevant
European
ac;vi;es,
ini;a;ng
own
projects,
on-­‐going
horizon
scanning
and
promo;on
of
values.
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28. Elements of first two years’ work plans
• Set up and refine web portal
• Initiate marketing and fund-raising for projects and core
operational costs
• Align activities to current EU policy initiatives both at
central level (EC) but potentially with selected regional
initiatives also
• Develop model for establishing mutual benefit network
with wide range of partners
• Create one innovative European event per year which
reflects the philosophy and values of EHFF
• Establish mechanism to attract young citizens, students,
and entrepreneurs to become involved in EHFF activities
28

29. The
three
ini%al
work
streams
(project
categories)
• A
Europe-­‐wide
innova;on
laboratory
for
improving
health:
its
first
projects
would
be
a)
involvement
in
European
projects
on
pa;ent
self-­‐management
b)
the
young
health
innovators
project:
EVY
(a
network
project)
c)
a
community
of
prac;ce
for
those
at
the
leading
edge
of
health
professional
educa;on
d)
other
poten;al
projects
under
review
• The
first
ever
Europe
wide
scenarios
exercise
for
health
that
includes
all
the
stakeholders
• Linked
to
web-­‐portal,
begin
scanning
exercise
on
emerging
health
trends
using
sophis;cated
techniques
imported
from
other
fields
29

30. Thank
you
for
your
;me.
Now,
how
might
we
work
together?
EHFF will become an established legal entity very shortly,
at which time its web portal will become accessible
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