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Europrean Health Futures Forum FAN Club Presentation


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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.

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Europrean Health Futures Forum FAN Club Presentation

  1. 1. European Health Futures Forum FAN Club 01.02.13,LSBU Marius Buiting, David Somekh 1  
  2. 2. The future of European healthcare – a possible scenario 2  
  3. 3. Adapted  from  Kees  van  der  Heijden  Scenarios:  the  art  of  strategic  conversa;on:  2004   3  
  4. 4. Source: Hans Kluge. Director Division of Health Systems and PH, WHO Europe 4  
  5. 5.     5  
  6. 6. 6  
  7. 7. Comment: note the ‘solutions’ in the previous two slides.The whole presentation is a convincing over view of currentthreats to EU health systems.What is not convincing however is the proposal to do whatEU health systems have signally failed to over the last 20years (make significant inroads into the estimated annual25% wastage of resources across the board). Systems areto be ‘strengthened’, not changed.Ironically, it shares characteristics of the ‘future is techno.’approach (e.g. see Mike Jackson’s presentation onShapingtomorrow, which skillfully scans potentialtechnological advances and their impact but because of theaudience it was aimed at doesn’t tackle the ‘elephant in theroom’ issue that unlike airlines or production lines, presentday health is manpower intensive and complex andespecially vulnerable to the vagaries of the human psyche). 7  
  8. 8. To summarise:‘Sickness care’ in its present form is notoriously wasteful andsignificant savings are likely to be achieved only by substantialchange in the form of care delivery. There are many barriers, bothinstitutional and political which hamper this transformationIncreasing life expectancy results in an increased burden ofpotential healthcare costs which ironically may be exacerbated byincreasing expectations from the public for care, the effects of greaterhealth inequalities and of other factors such as migration, climatechange etc.In the present setting, financial forecasts suggest that theenvelope for healthcare spending has limited capacity forexpansionChronic mismanagement of workforce planning makes it likely thatserious shortfalls will impact on quality of care 8  
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  14. 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. 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. 16. The  Cassandra  dilemma   16  
  17. 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. 18. In addition to our existing expert knowledge, we started tolook at futures methods, such as scenario planning, horizonscanning and wild cards and weak signals methodology, tosee to what extent these techniques had successfully beenapplied 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 withinEurope to establish quite a different enterprise… 18  
  19. 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. 20. Networks  of  networks   EU  agencies  and  Associates   Offices   Socie;es   20  
  21. 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. 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. 23. In summary, there are several reasons that ESQHis well placed to provide a springboard for a newEuropean NGO which concentrates on healthfutures. Among these are:It has a well established network involving 20 countries andcontacts within several stakeholder groups in eachExperienced at becoming involved with policy issues at asignificant level, starting from scratch and building a brandRun as a lightweight, flexible but effective organisation thatis more or less virtual but has appropriate governanceWill build on ESQH’s work but will create its own brand andintends to operate faster, smarter and more effectively 23  
  24. 24. What are the key features in the current contextthat 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. 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. 26. Consistency of EHFF principles with Foresightconcept 26  
  27. 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.       27  
  28. 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. 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. 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 30