>> The opinions of the Expert Panel on Health are intended to support the EU Commission by presenting the Panel's views, based on evidence, on issues that can bring about real change in the reforms and investments of health systems in the EU. The aim of the hearings in early June this year was to give stakeholders the opportunity to present their views on the draft opinion of the Health Care Expert Panel, which was published on the Panel's website (1) ahead of the hearing.
There were two hearings; on the one hand, that on “Value-based Healthcare” (2), in which the experts Prof. Claudia Wild, Prof. Jan De Maeseneer, Prof. Lasse Lehtonen, Prof. Luigi Siciliani, Dr. Dionne Kringos, Dr. Aleš Bourek, Prof. Walter Ricciardi and Assoc.Prof. Liubove Murauskiene took part; on the other hand, that of “shifting tasks in health systems” (3).
In her presentation, Wild explained that three external experts were included in the working group because value-based healthcare is a very broad topic. She also pointed out that the use of the term leads to inflation on the one hand, but also a “dilution of its contents” on the other, which was the subject of the research itself. For this reason, the European Commission commissioned the group to assess the question of what exactly is the value of value-based healthcare and how exactly this concept is defined. And once it was defined, it would also be necessary to answer the question of what measures the member states can derive to improve the resilience of their health systems.
To accomplish this task, the working group first analyzed the current situation, identified initiatives to increase value; evaluated established instruments and methods, identified key values and finally made the requested suggestions and recommendations for possible implementation principles.
According to the definition proposed by the working group, the concept of “value-based healthcare” is a comprehensive concept based on four value pillars:
• appropriate care to achieve patient-specific goals (“personal value”),
• achieving the best possible results with the available resources (technical value),
• the fair distribution of resources across all patient groups (allocative value) and
• the contribution of health care to social participation and connectedness (social value)

According to Prof. Wild, one of the most important principles for this is improving health awareness. This is an “essential investment in an equal and just European society and in the centrality of European solidarity values”. Wild: “Health is wealth.” In order to achieve the goal of a transition from a low-value care system to a high-value care system, a long-term strategy must be developed.
She went on to say that analysis of the current situation had shown that 10 to 34 percent of healthcare resources were wasted, which was also suggested by an OECD estimate (4). There are several reasons for this, e.g. B. unwarranted fluctuations in investment, activity, access and results. Another factor is the insufficient use of effective measures such as prevention or early detection. On the other hand, there is an overuse of resources, such as overdiagnosis and overtreatment.
This leads to health systems no longer functioning optimally due to the enormous increase in the volume and intensity of their activities. Despite ever-increasing costs, the health effects remain low and sometimes even harmful.

At the second hearing on “shifting tasks in health systems” (4) – the experts Dr. Ales Bourek, Dr. Dionne Kringos, Prof. Luigi Siciliani, Prof. Martin McKee and Assoc. Prof. Liubove Murauskiene – McKee referred to the WHO definition of task shifting. According to this, “the rational distribution of tasks among health workforce teams” would, where appropriate, “shift certain tasks from highly qualified health professionals to less qualified health professionals in order to make more efficient use of the available human resources for health”. However, he also noted that there is also “significant evidence” that on the one hand “some tasks need to be shifted to more qualified workers”, but on the other hand there are also many things that “may be influenced by the patients, their carers and the technology “could be done.” Therefore, according to McKee, the shifting of tasks could take place in the following main lines:
1. From healthcare professionals to patients,
2. Shifting tasks to community health workers,
3. Shifting tasks from health workers to machines,
4. Shifting tasks to different types of health workers. <<

1: https://ec.europa.eu/health/expert_panel/home_en
2: https://ec.europa.eu/health/expert_panel/sites/expertpanel/files/ev_20190604_frep_en.pdf
3: https://ec.europa.eu/health/expert_panel/sites/expertpanel/files/ev_20190605_frep_en.pdf
4: OECD 2017: Tackling Wasteful Spending on Health. Report. https://www.oecd.org/health/tackling-wasteful-spending-on-health-9789264266414-en.htm