WHO’s ambitious plans to tackle Greek health quality [Advocacy Lab Content]

The first National Strategy on Quality of Care, Patient Safety, and Patient Experience is being developed in Greece. It aims to build, strengthen, and consolidate the quality of care through national policies.

The project has been launched by the WHO Athens Quality of Care and Patient Safety Office, under the European Program of Work, 2020-2025 “United Action for Better Health in Europe,” in collaboration with the Greek Ministry of Health, the Agency for Quality Assurance in Health (ODIPY), and with the backing of the European Commission (DG REFORM).

“Greece, like many other European countries, faces challenges in terms of the health sector.” Dr Valter Fonseca, Technical Officer, Health Systems at the WHO Office on Quality of Care and Patient Safety in Athens, told Euractiv, adding that “we need to build more resilient, more sustainable, more efficient systems across the world, and in the European region.”

“The Commission is committed to turning this project into concrete actions on the ground that improve the quality of healthcare in Greece,” a Commission Spokesperson told Euractiv. They explained that the Commission provides tailor-made technical support to many EU Member States through the Technical Support Instrument (TSI) to facilitate reforms in the healthcare sector.

For Dr Valter Fonseca, a quality-of-care perspective is necessary to achieve universal health coverage.

“If you just increase access and you don’t assure that the services people receive are of high quality, then you will not necessarily increase health outcomes.”

“In the case of Greece, the Commission is aware of the need to improve access to treatments, to strengthen patient experience, and to help maintain high-quality care services such as rehabilitation, mental health, and long-term care. Enhancing the quality, resilience, and sustainability of the health system is a key objective for the Greek authorities,” the Commission Spokesperson told Euractiv.

Tailored healthcare policies

The Athens office highlighted the need for tailored healthcare policies and evidence-based measures in the Greek health system to tackle challenges and address healthcare quality disparities.

At the same time, challenges exist in each level of care and across all of them.

“Quality of care aims to have a system that follows the patient wherever the patient is,” Dr Fonseca remarked. “It doesn’t matter if it is primary care or hospital care. This is about the patient in the centre of the system, and the system is being adjusted to the patient’s needs. All levels of care work together to attain people’s needs,” he added.

But there are different challenges. “For instance, healthcare-associated infections are an important challenge for hospital care. Greece is taking important steps to strengthen -primary health care, and we are here to consolidate and support them.”

As one of the challenges in the Greek system is decreasing health inequalities through a quality-of-care perspective, the way to address it is through the involvement of all the health regions, as Dr Fonseca explains, referencing a series of workshops with the seven healthcare regions.

Patient safety and effectiveness is another important dimension of quality of care that should be strengthened and consolidated. “People need to feel safe when receiving care,” WHO’s technical officer explains.

For the WHO team, developing this Strategy needs to be done in a participative way.

That means involving patients, families, and caregivers. The Greek Patient Association is invited to the workshops to aggregate the patients’ perspectives in the consultations.

Governance and data

According to Fonseca, governance is also a key factor in a quality-oriented health system. “We are also putting efforts into how quality can be governed better in terms of the teams, the people, their training, and their skills.”

He also underlines the importance of data for quality of care and patient safety. “For any decision-making process, data is a critical element,” he said.

“This strategy is also focused on training and capacity building of professionals that can then use a more diverse skill set to participate in data collection and, more importantly, learn from the data,” he added.

He also clarifies that “standardisation doesn’t mean that we need to do everything in the same way without considering the specificities of each country, each region or each population.” Similar projects will be developed for other countries.

Clear message

The strategic aims of the plan move on two axes: “One is the vision for quality of care. The second one is to define it so everyone can understand,” Valter Fonseca said.

“If you understand what quality of care is, you will be the first one demanding quality”, he explains. “The most important thing we can do is to have everyone demanding higher quality.”

Specific objectives will be set so the system can work towards them, alongside a training curriculum for all people working in hospitals, including managers, with guidance on what is needed to strengthen the quality of care across the country.

Implementation

“Together with the WHO, the Commission has designed the technical support in a way that would address Greece’s most crucial priorities in a clear and structured way that is fully tailored to the realities of the Greek health system,” the Commission Spokesperson said.

The TSI project on strengthening the quality of care in Greece “has now entered a crucial stage, that of discussing with national, regional, and local stakeholders of each health region before kicking off the key elements of the new strategy on quality of care,” they added.

The project’s first step is to collect the best practices across European countries on quality of care and patient safety and to have a very solid scientific background.

The second step is the stakeholders’ consultation, the seven workshops, one per health region, which Fonseca describes as the heart of the project.

“We are here taking a bottom-up approach. So, we are first of all listening to the people’s voices, what they consider to be the main challenges in the country and each region, the priorities, and the recommendations regarding the quality of care.”

“Sometimes people think that a strategy is just a document,” said Fonseca, “I think this is the first step to ensure it will be implemented.”

The final step involves compiling all the inputs from the first two steps to draft a strategy.

“Our effort is always to translate the recommendations into real-life actions. With the support of the Director of the Division of Country Health Policies and Systems, Dr Natasha Azzopardi Muscat, and the Head of the Athens Quality of Care and Patient Safety Office, Dr Joao Breda, we are strongly working on improving the quality of care and patient safety across the WHO European Region based on recommendations.”

“But this is not a project that WHO/Europe is doing alone. This is the Ministry of Health in Greece, which is highly committed to the project, together with ODIPY and the funds from the European Commission, all working towards this objective. So, we are firmly convinced that this will be a set of recommendations that can, over time, translate into concrete actions,” explained Fonseca.

[By Vasiliki Angouridi, Edited by Brian Maguire | Euractiv’s Advocacy Lab]

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