Executive summary

AuthorDirectorate-General for Health and Food Safety (European Commission)
The organisation of resilient health and social care
following the COVID-19 pandemic
The COVID-19 pandemic has put national health systems in Europe and beyond under
immense pressure. Health systems were largely unprepared for an outbreak of this
magnitude. The crisis tested their resili ence, in other words, their ability and capacity to
absorb, effectivel y respond and adapt to shocks and structural chan ges while sustaining
day-to-day operations.
Health system resilience has been on the policy agenda for many years and, already,
numerous assessments of the responses of health systems in Europe to the COVID-19
pandemic have been published. However, there is a need to look beyond the current
pandemic to think about how health systems can prepare better for future crises that
threaten the ability to deliver health car e. In response, the Expert Panel is requested to
provide an opinion on the organisation of resilient health and social care following the
COVID-19 pandemic.
We start this Opinion by reviewing the building blocks of a health system, then proposin g
a new framework to assess the different elements needed t o ensure resilience of health
systems. Based on these el ements, we explore capacities needed for resilient health and
social care delivery and the policies to sustain healthcare provision, especially for those
who are most at risk in a crisis. Then, we address the conc ept of vulnerability, and
identifying vulnerable groups in the population. Finally, we propose a methodology for
undertaking a resilience test of healthcare systems.
We concl ude with a series of recommendations regarding the u se of European funds to
support resilience testing implementation, including development of a manual and toolkit
for resilience testing of health systems. A further three recommendations relate to
specific issues, highli ghting the need to strengthen action on corruption in the health
sector, improve procurement during emergencies, and take advantage of the
opportunities offered by cross-border collaboration. We also make recommendations
regarding preparedness and respons e to COVID-19-like situations (be prepared an d act
quickly in order to avoid prolonged and costly containment and mitigation measures;
ensure adequate surge capacity; invest in the health workforce; strengthen primary
health care and mental health services; ensure close international cooperation). We
identify a need for practical guidance on continuity of care, development of digital
solutions for self- and home-care, and measures to reduce social and ethnic dispariti es.
In additi on, we stress the imp ortance of disaggregated data by sex, age, ethnicity, and
socioeconomic status, as well as on comorbidities a nd long-t erm care facility residence,
as these are essenti al to take a comprehensive whole-of-society approach to health and
social care. Finally, we recommend establishing mechanisms to share best practices in
prevention of the spread of infections, in outbreak control, in support and care of

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