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.
