Periodic Reporting for period 3 - TO-REACH (Transfer of Organisational innovations for Resilient, Effective, equitable, Accessible, sustainable and Comprehnsive Health Services and Systems. ) Periodo di rendicontazione: 2019-12-01 al 2021-05-31 Sintesi del contesto e degli obiettivi generali del progetto Over the last decades, European health systems have faced growing common challenges. Key among these is the rising burden of chronic diseases and multimorbidity, combined with population ageing and increasing frailty. Threats arising from new communicable diseases, as the COVID-19 outbreak has shown, lead to growing demand on already stretched services. Climate change is also another crucial theme that communities and systems will globally face in the next future.A shared European approach to health services and systems research can contribute to addressing the challenges described above by, first, more effectively addressing common challenges by working together; and, second, putting in place the framework conditions needed to support the necessary research and implementation across the region and beyond.In this view, in order to strengthen the sustainability and resilience of health services and systems a unique consortium of 28 governmental and funding organizations plus research institutes and European-level bodies from 20 countries (15 EU Member States and 5 non-EU Countries such as United-States, Canada, Israel, among others), has expressed the ambition to systematically learn from the organisation of care in other settings. Overall objective of TO-REACH is to provide groundwork for a future joint research programme that will contribute to the resilience, effectiveness, equity, accessibility and comprehensiveness of health services and systems. To achieve its central aim, TO-REACH focused on two main work streams:1) To develop, conceptually and methodologically, a research programme supporting the transnational learning to identify innovation in service and policy and the conditions needed to transfer them to other settings for implementation (figure 1);2) To enhance sustainable cooperation between Ministries and funding bodies as well as their link with other existing or upcoming funders networks in order to facilitate such a joint international research programme. An important barrier has been the existence of fragmentation in research funding and execution across Europe in this field. This makes transfer or up-scaling cumbersome or inefficient: many countries duplicate research on comparable topics without facilitating cross-border learning, while other themes of potential joint interest remain underfunded.Given the complexities of the challenges contemporary health services and systems are facing, there is a need for innovative solutions that can overcome some of the persistent barriers between several different subsystems involving public health, health care and social care, and the wider regulatory framework within which these are embedded. Novel solutions are also required that take account of the complex set of interests and priorities of those involved in the organisation, delivery and financing of services, which are likely to differ at the different tiers of the system and across different sectors. Lavoro eseguito dall’inizio del progetto fino alla fine del periodo coperto dalla relazione e principali risultati finora ottenuti TO-REACH has identified means to overcome persistent barriers between different healthcare subsystems, and notably has uncovered several gaps in our knowledge and understanding of the transferability of service and policy innovations in health. In addition, the project identified a number of key priority areas for cross-country learning and innovation. The key results are set out in two policy briefs: one sets out how we can improve our ability for European health systems to learn from each other, while the other focuses on what topics this work should address.These main substantive priority areas in which service and policy innovation is needed and the main research input needed to inform the potential transfer and joint development of service and policy innovation supported the development of a Strategic Research Agenda, the main outcome of the TO-REACH Project.In particular, the document provides a European strategy to advance our knowledge and understanding of the adoption, implementation, potential scale-up and joint development of service and policy innovations and their translation to other settings within and across countries. In particular, the document sets out strategic European research priorities through a conceptual model, which brings together identified priority challenges and the key research needs to propose specific European research priorities for transfer and joint development of service and policy innovation (figure 2).Putting the SRA into practice requires a partnership and cooperation approach, bringing together stakeholders including funders, researchers, policymakers, practitioners and the wider public. In fact, too often innovative solutions that work in small-scale pilot studies fail to live up to expectations when rolled out in national strategies, or fail to transfer from one country to another as a result of contextual differences. Progressi oltre lo stato dell’arte e potenziale impatto previsto (incluso l’impatto socioeconomico e le implicazioni sociali più ampie del progetto fino ad ora) The TO-REACH goals go beyond the involvement of partner organisations and have the ambition to foster the European coordination and research alignment and inspire future national and European research activities in the broad domain of health services and systems research. A common vision based on mutual learning and collaboration among countries and regions in Europe is a key to allowing a transformation of health and care systems, making them stronger and more efficient and to tackle existing and future challenges.Indeed, to maximise its impact and be of added value, future cross-country cooperation in the field of health services and systems research should be supported by the necessary framework conditions and foster collaborative ties between key stakeholders involved in policy generation, programme management, and research. This includes the decision-makers responsible for designing policies and managing programmes whose decisions shape implementation and scale-up processes, as well as the practitioners and front-line workers who ultimately implement these decisions along with researchers from different disciplines who bring expertise in systematically collecting and analysing information to inform research questions. The COVID-19 pandemic has illustrated both the challenges and the opportunities of learning between health systems. While the TO-REACH project work was carried out before the pandemic struck, the challenges and potential solutions this project has identified will be even more relevant in the future reshaped by COVID-19. These findings will be especially important for the future European Partnership on Health and Care Systems Transformation envisaged under the Horizon Europe Research and Innovation Framework Programme. In this view, many of the organisations involved in TO-REACH are engaged in the preparation of the Partnership. Figure 2. Priorities for better learning between health systems Figure 1. Developing a Strategic Research Agenda on Health Services and Systems research
