EHMA Conference 2013

EONS Board Member Françoise Charnay-Sonnek attended the recent congress of the European Health Management Association (EHMA). Here is her write-up of the event.

The 2013 EHMA congress explored different ways of providing health services that are better, quicker and delivered at a lower cost - a real challenge in these times of financial and economic constraint. During the three days of the congress, the collective aim of delegates was to be creative by using this period of austerity as an impulse to review our practice and to do better with our existing resources.

Fundamental questions need to be asked:

  • How do health services respond to a higher demand for health care with reduced funding?
  • How can services be improved (such as adopting better quality and safety procedures)?
  • How do we deliver services more quickly, e.g. by reducing waiting lists?
  • How can we do all this when budgets are squeezed by the demands to make our organizations leaner and more efficient?

To achieve the aim of better health services at lower cost requires high standards of professionalism at all levels, in a patient-centered organisation that is demand-driven rather than supply-driven. Health services must be centred upon a realistic and feasible health policy based on continuous evaluation and a fine balance between competition (continuous improvement) and collaboration must be struck. Above all, primary care must be boosted.

Several managerial practices from the world of industry, such as focused management and lean management, were discussed. The principles of focused management are based on doing more with existing resources and not fewer resources. The manager is not an optimizer wanting to make the best possible decisions but a satisfier making good enough decisions with the resources he has at his disposal. He focuses on one part of a system, identifying the constraints and finding solution with simple tools, cutting garbage time (Boaz Ronen).

Lean management does not just mean reducing waste, such as long waiting times for patients. It is much more about changing the organisation’s culture and involving all the professionals in this process, maximizing their potential and empowering them to do their jobs more effectively (Paul Button, Luigi Marroni).

The use of an action-learning pedagogic approach to develop managers’ resilience was also very interesting. Indeed, to support its senior leaders within this challenging context, NHS London commissioned a programme of Action Learning, its aim to provide rapid and responsive leadership development, designed to enhance resilience. The results of this programme were very convincing (Elaine Clark).

Also discussed was the need to place the patient at the centre of the care he receives, in a sense to put him in control of the treatment process.

The congress also emphasised the role of nurses as nurse practitioners. The need to respond more effectively to the higher demands of health care, particularly in the context of physician numbers, requires the delegation of more medical tasks to nurses, reinforcing the important role of nurse practitioners. This was proposed in different presentations as a sustainable solution, offering a great deal of value added in terms of patient satisfaction, access to care and reduced waiting times.

In terms of health policy, Nick Fahy, EU consultant, and Mrs Paola Testori-Coggi, DG SANCO, clearly indicated that the EU commission will have a greater influence on future health programmes within the EU member states through the European Semester (the annual cycle of economic policy coordination). Health is a pan-European issue, because a healthy population and a sustainable health system are vital for economic growth.

EPAAC - the European partnership against cancer - was a DG SANCO project that aimed to develop a European cancer policy centred around cancer promotion and prevention, screening, integrated care, research, cancer data and information, and national cancer control plans. The work package 7 was concerned with cancer care and focused on guideline development, palliative care and pediatric oncology. Now EPAAC will conclude this year and introduce “Cancer Control”. Cancer control projects should now be more of a platform for the definition of topics, the organisation of debate sessions and the preparation of position papers.

In conclusion: there are solutions available to practitioners: now is the time to put those solutions into practice!