Latest EHFF Newsletter no 12

Editorial by David Somekh , Director EHFF

We’ve waited some time to send out a Newsletter since our end of the year 2021 offering. We’ve been scanning the horizon as ever, and there’s a lot going on! The world is if anything even more turbulent than before, which provides a backdrop, a context to the content of this Newsletter, as you would expect given our holistic and systems-based approach to what concerns us most; a healthy society in a healthy planet.

In this edition then, we first offer a thought piece from Lars Munter on what’s happening in Ukraine. Lars draws analogies between the need for concerted action against tyranny with the need for greater unity in Europe to deal with current and future health threats. There is another knock-on effect of the Ukraine situation. Like the pandemic, a major crisis brings into focus other things that went on in the background but which weren’t given sufficient attention: here the whole issue of the growth of migration which has huge implications for European health systems. We’ll discuss this in our next newsletter.

Six months ago, we announced the official launch of our All-Ireland WEAll hub. We now have a place on the WEAll website, where there is up-to -date news. https://weall.org/ireland  Our latest activity in this process of developing the Hub is what we call “cultural creative”. The idea is to tap the social imagination via the arts and creative artists to find a narrative that will engage the public and harness the social capital necessary to get traction for our bottom-up leverage to bring about economic change. Our latest event was on March 25^th: ‘The role of the artist in catalysing a wellbeing economy on the Island of Ireland’. The work continues, in alliance with other WEAll hubs across the world, with whom we meet virtually – as a community of practice – monthly.

After Lars’ piece, I’ll report on three projects we’re currently engaged in; two you will have heard of before, firstly the CEmPaC patient empowerment project which has now finished its 3-year funding from the Bosch Foundation and is moving forward under its own steam (with a bit of support from EHFF!). Secondly the scoping project funded by the Johnson & Johnson Foundation, which has completed its six month remit. Finally, a new enterprise we’re partners in, an Erasmus+ project called well@sme on promoting mental health awareness in small businesses.

An important footnote. Sean Conlan was one of the founders of EHFF and was previously a close associate of ours since 2003. At our AGM in March, the Board sadly accepted his resignation as Trustee and Director. Sean is stepping back from his work with us to concentrate more on his work as an environmentalist, but will, we’re pleased to say, retain his link with us by joining the EHFF Advisory group, as another of our founders, Dr Marius Buiting, former Chair of the Board, did previously. We’re very grateful for the continuing interest of both Sean and Marius in our venture. More grandees, and a pressure on us to get younger colleagues engaged with our strategic direction. We’re actively pursuing a Director and Trustee to take Sean’s place. Nevertheless, it’s difficult to capture just how important Sean’s presence has been on the Board for the last 10 years or so. Warmest wishes in his ‘retirement’ (we know he’ll be working as hard as ever. Especially planting trees!).

War in Europe – health transformation walking backwards? by Lars Munter

For decades, European integration was about avoiding war. Having been the scene of strife and atrocities for far too long and too frequently, European political leaders embarked on a new approach for safety and wellbeing, peace.
This was certainly a novel concept at the time. That peace could be an active goal and not just the absence of the then usual modus operandi for resolving conflicts; soldiers and war.
And thus, for decades – as a lot of you know and witnessed – political initiatives pulled economies and people tighter together, some via trade and education, some via research and innovation, and some via agriculture and joint industry. And it worked well. So well, one might argue, that it was key to ending the first Cold War. And the early 1990s held the promise of a different future for the entire continent. Those were indeed happy days of hope and joint development. With exception of the violence in Romania and the meltdown of Yugoslavia, Europe seemed to have learned a valuable lesson. The Good Friday Agreement came about. The Basque Country found a non-violent resolution of key differences.
But perhaps by complacency – or as an often-occurring outcome of economic crisis – this was not to last. And some things that should not have been forgotten were lost. History became legend. Legend became myth. Or – to stay in the fiction metaphors – the Devil finally managed to convince the world that he didn’t exist, and apparently a certain element of hubris set in. Is it a tragic twist of history that Brexit – the largest challenge to the European Union in decades – is followed now by the largest war on the European continent? Coincidence? Maybe.

Regardless, the key challenge for both the strife and resolution is the lack of policies to secure prosperity, health and wellbeing for people and planet across borders. And while these policies cannot always be handled by appeasement, they could certainly have been in a different situation, if solid investments in health literacy and pandemic response had recognized the existence of black swans. And if massive energy investments had already made dependency on fossil fuels a thing of the past. But we didn’t. The policies didn’t. And the growth mindset were allowed to create politically imaginary boundaries for our possible future that stopped a lot of more holistic policies in its tracks.

So instead of peace and prosperity we are dealing with strife, pandemic, and war. But perhaps we can draw some hope from this too. Gone must be the illusion of peace without good climate policies. Without a European Health Union – or at least policies to the same effect. And gone must be the illusion that countries could or should be competing. So, while war in Europe is certainly a challenge and a massive blow to our system and future, it might also hold the hope of us finally recognizing the need for wellbeing economies in Europe with health and prevention at the core. And – well, I am naïve at times – a future reunification of the forces for peace in Europe; because the challenge of war is never far away if policies don’t ensure healthy transformation in time.

Our Patient and Community Empowerment – an end and a beginning  

We’re very grateful indeed to the Robert Bosch Stiftung for their patience and generosity in enabling the development of our European resource centre,CEmPaC  http://www.cempac.org

The next, imminent venture for CEmPaC is to put on a major event, partnering with close colleagues (from the CEmPaC Expert group), representing the European Patients Forum, the Global Health Literacy Academy (based in Denmark), the Personal Care Institute (part of NHS England) and CEREF, the research institute based in Padova. The event planned is an open, free half-day conference, looking at latest developments on the wide spectrum of patient empowerment activities, on the afternoon of June 13^th. This will be followed by a Roundtable of international experts by invitation, on the morning of June 14^th, spending time looking at the future of the concept and what implications that might bring (with the idea of a publication to collate the results of the session). Here is a link to the preliminary ‘save the date’ flyer, with more information to be released shortly. Please share this with colleagues:

Our Conclusion of the EHFF/J&JF scoping project on Redesigning European Healthcare
(supporting transformation of the European health ecosystem) 

EHFF has now completed its brief a few weeks over time on the six-month contract we had with the Johnson & Johnson Foundation which began in October last year. This scoping exercise was to prepare a possible bid for longer-term funding for a project which is a practical implementation of what we have learned from the Three Horizons exercise on transforming the health ecosystem. This latter is the work we did during 2020 and 2021 and which readers will have seen described in earlier Newsletters throughout 2021 (you can access the website here for previous Newsletters).

Our scoping project helped us analyse current activity within the Horizon 2 focus and to explore where we wanted our ‘transformational catalyst’ activity to be piloted. Input from Steve Waddell and Sandra Waddock from the US, helped us understand this concept better and how it might be applied. We have agreed that the three areas to concentrate on, taken from the model as levers for change would be (i) community engagement (social mobilisation), (ii) digital enablers, and (iii) health literacy. Two other important additions for us in the ‘how to’ toolbox are the use of connected communities of practice in transformation and creating a persuasive narrative around our holistic transformation concept. Lastly, we are looking to how these ideas might be translated in different neighbouring European health systems, taking into account historical development and cultural differences.

There is a possibility of longer-term funding from this Foundation, but equally we feel that we have a model that we could take to other potential funders and also, we are looking at how we might progress some aspects of the work without additional funding. Also, we are examining what implications this major project has for other work that EHFF does. Could all this be integrated around the transformational catalyst concept?  These questions will first be addressed at our upcoming annual strategy meeting on May 7th, and we’ll report back.

Meanwhile we owe a debt of gratitude to Marion Burnstill and colleagues at the Foundation for their advice and support during the last few months. The funding for the scoping exercise has really helped us move forward in our thinking around this exciting development.

Sounds like it will be quite a challenge!