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PHSSR – The Greek Study: 23 Proposals for a sustainable and resilient Health System

4 Mar 2024,

The initiative Partnership for Health System Sustainability and Resilience (PHSSR) is an international collaboration between universities, non-governmental organizations, life sciences, health sciences and businesses, with the main goal of ensuring the resilience of health systems in the face of future crises.

He made special reference to the global initiative of the company PHSSR, recently speaking at Greek News and Radio FL, Ms. Elena Houliara, President & CEO of the pharmaceutical company, AstraZeneca, highlighting the need to strengthen the resilience of the national health system, and pointing out the following: 

"On the occasion of the Covid-19 pandemic, we decided to establish the PHSSR international partnership in collaboration with the London School of Economics and the World Economic Forum. Its purpose was and is to answer the question of whether there is a way to better restructure countries' health systems to withstand strong shocks and recover quickly."
Ms. Houliara also pointed out that, in Greece, the initiative bore fruit extremely immediately, led by the relevant study Professor Kostas Athanasakis from the University of Western Attica, surrounded by a group of 20 distinguished scientists and health professionals. 

"The results of the study are already available with the 23 key findings and recommendations of the scientific team being the best possible basis for drawing up new health policies. In order to create a sustainable and resilient health system for the future, we need policies, which will be created based on the demand, that is, the needs of the patients and not based on the supply as it is done today" emphasized Ms. Houliara, who noted speaking to Greek News and Radio FL that "some of the proposals of the study are being implemented, but many related to the support of the National Health Service, are still pending".

More about the PHSSR collaboration on health systems sustainability and resilience

Before the pandemic, many health systems around the world were already struggling to contain costs and meet demand while the population ages and grows and the prevalence of communicable diseases magnifies. To these challenges are added - among others - the issues of human resources. The pandemic further aggravated the above problems and highlighted the weaknesses of the health systems.

Looking to the future, healthcare players have begun to look at how best to restructure health systems. To this end, the PHSSR partnership was established in 2020. The partnership was initiated by the London School of Economics, the World Economic Forum, and AstraZeneca, later joined by other global partners, including Royal Philips, KPMG, Apollo Hospitals and Center for Asia-Pacific Resilience & Innovation. 

The PHSSR partnership is already active in more than 20 countries and includes organizations at regional and national level. 

The PHSSR partnership and its contributors work at the local level, with academics, governments, policy makers and other stakeholders, such as health care providers and payers, to contribute knowledge and provide guidance for action based on research findings with evidence-based policy recommendations to improve the sustainability and resilience of health systems;

The perspective and purpose of the PHSSR Country Studies are determined by 2 dimensions 

  •        Sustainability – Health System Sustainability

The ability of the health system to improve the health of the population, ensuring the uninterrupted fulfillment of its essential functions, now and in the future.

  •        Health System Resilience

The ability of the health system to prepare, absorb, adapt and overcome crises, health and social, in order to mitigate as much as possible their impact on the health of the population.

PHSSR – The Greek Study

The key question of the Greek study was where the health system stands in Greece after an extensive recession – but also a pandemic.

The study captured the current state of the country's health system and identified the "threats" as well as the "opportunities" for the sustainability and resilience of the system. The following methodology was then followed to produce proposals for the future of the system:

  •        Formation of a Committee of Experts for the Study, with a strong interdisciplinary character
  •        Incorporation of Expert opinion based on the Delphi methodology, which resulted in a series of proposals evaluated on the dimensions of effectiveness and feasibility and produced 55 Policy Proposals
  •        Submission of the Final Proposals of the Study, which were the result of Unanimity of the Committee of Experts for both dimensions and led to 23 proposals structured on the basis of the 7 Pillars of the study.

The analysis framework of the Study (PHSSR framework) focuses on seven areas of system operation, as shown in the infographic below:

thumbnail 1709326389016blob

The proposals to the government and the Ministry of Health:

Lessons from the pandemic:

Conduct a structured public dialogue with the participation of key stakeholders to assess the responsiveness of the health system to the pandemic. The lessons learned should be recorded in a special, public report.

Monitoring Action Plans:

Establishment by the Ministry of Health of an independent monitoring committee for each National Health Plan, which will periodically review the progress of each Plan/Policy, based on pre-agreed targets and indicators.

Data analysis and informed policy:

Creation of teams to analyze the collected data within the health system with the aim of processing it to feed the health policy decision-making process. Provision for public availability of collected data.

New ways of financing:

Introduction of consumption taxes on activities or goods considered harmful to health (sin taxes), to improve the financial base of the health system and limit the population's exposure to health risk factors.

PHY: Results-based compensation:

Development of compensation schemes for primary health care physicians based on results (payment by results) in Primary Health Care.

Health benefits for real needs:

Establishment of periodic re-evaluation of the EOPYY health benefits regulation with the participation of the parties involved.

NHS staffing based on health needs:

Introduction of an annual/long-term recruitment planning process in the health system structures based on the health needs of the reference population.

Increasing the number of nurses:

Prioritizing the increase in the number of nurses serving in public hospitals, with the aim of converging with the average staffing in the EU.

Job satisfaction in the NHS:

Implementation of a policy of systematic measurement of the job satisfaction of the human resources of the National Health System, under the responsibility of the administration of the system's structures.

Continuing education in Health:

Introduction of mandatory continuing education programs for health professionals serving in the structures of the health system.

Preparation of National Drug Policy:

Elaboration of a five-year National Drug Policy, with the participation of all the parties involved.

Open Health Data:

Creating a framework and mechanism for analyzing data from the use and outcomes of health technologies and making them available to the scientific community.

Domestic production of Health technologies:

Create incentives for the domestic production of health technologies (e.g. medicines) through sectoral/industrial policy with the aim of improving the international marketability of produced products and the system's response to emergencies or crises.

Agency for Health Technology Assessment:

Creation of an autonomous Organization for Health Technology Assessment.

Extension of ATY beyond medicines:

Creation of a health technology assessment (HTA) process beyond medicines (e.g. biomarkers, digital applications, etc.).

Real World Data – RWD:

Public availability of the electronic prescription data for the consumption of the drugs and start recording the therapeutic outcomes in order to connect treatments with results.

Evaluation of prevention programs:

Defining specific objectives and evaluation criteria for the implementation of population screening programs.

PHY: Monitoring the reform:

Determining indicators of accessibility and user satisfaction with health services to monitor the attempted reform in PPH.

National Program on Childhood Obesity:

Implementation of information and health promotion programs in schools and the family for the early recognition and treatment of childhood obesity.

National policy on health inequalities:

Creating a national policy framework against health inequalities by measuring them based on indicators, defining goals and actions, monitoring and evaluating the actions, and preparing a relevant periodic report.

Energy efficiency of hospitals:

Inclusion of the actions to improve the energy efficiency of the hospital in the periodic evaluation indicators of the Governors of the country's nursing institutions.

Climate Change Policy:

Policy development to assess the future impacts of climate change on the health system.





photo https://www.phssrgreece.gr/ 



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