Tackling Europe’s ageing population

ageing population

The European Federation of Nurses Associations speaks to SciTech Europa Quarterly about tackling Europe’s ageing population.

Established in 1971, the European Federation of Nurses Associations (EFN) represents over 36 National Nurses Associations and its work has an effect on the daily work of three million nurses throughout the European Union and six million in Europe. The EFN is the independent voice of the nursing profession and its mission is to strengthen the status and practice of the profession of nursing for the benefit of the health of the citizens and the interests of nurses in the EU and Europe.

The EFN provides a broad platform for developing health and social EU policy by supporting the European Union decision-making process on all areas which affect the nursing profession. The EFN is also a strong advocate in working towards a unified voice for nursing in the EU, and promoting the value of nursing at EU level, within the remits of its Strategic Lobby Plan (SOLP), taking into account the EU citizens challenges to be addressed by EU initiatives.

The EFN SOLP focusses on ensuring that citizens/patient, nurses and nursing are central to the development of Social and Health Policy and its implementation in the EU and Europe. Therefore, supporting and facilitating a qualitative and equitable health service in the EU and Europe by a strategic contribution to the development of a sufficient, effective, competent and motivated workforce of nurses is key. This can only be done by strengthening the EFN representation in the EU and Europe and develop its key role as a bridge between the National Nurses’ Association/Organisation (NNA) and the decision-makers in the EU institutions.

EFNs Secretary General, Paul De Raeve, and Vice President, Nina Hahtela, speaks to SciTech Europa Quarterly about the EFN and Europe’s growing aging population.

Can you explain the EFN Strategic Lobby Plan? How is this being achieved?

From an EU policy perspective, there are three major areas that are high on our political agenda: education, EU workforce for health, and patient safety and quality of care (including digitalisation.) The Council, Commission and European Parliament have these priorities also on their agenda, especially within the 20 principles of the European Social Pillar. Working towards bringing to the attention of the EU Institutions the health and social needs of the population throughout the Union will make policies fit-for-purpose.

The EFN has always worked very closely with dedicated health MEPS to advance trialogue meetings on specific legislative files of the European Commission, in which alliances with key influential people is key for successful outcomes. Building alliances and creating partnerships with key organisations to work on particular issues has been the top priority for the EFN, as this is a means of strengthening civil society in the policy-making process and to get successful outcomes not only at EU level but also at national and local levels.

With all the work done throughout these last years, we can say that the EFN and its members have created practical tools and trust, which is a key component for change. The EFN lobby activities and outcomes would not have been possible without the continuous support of all the EFN Members providing valuable input, data and views, and the reliable alliances of key health and social stakeholders at EU level. The nurses and the nursing profession in the EU are very visible, with a strong voice towards the European organisation, positioning nurses, women, prominently on the political agenda.

The biggest problem facing Finland is its ageing population. Those aged over 65 make up 21.4% of Finland’s population according to 2018 statistics. Proposed reforms to alleviate the strain on healthcare have fallen through, and the government announced its resignation over this issue in March. What are your thoughts on this? How can the EFN tackle issues like this?

Considering that with the current challenges of ageing and chronic diseases, more than ever we need a highly qualified workforce to ensure that patient safety and quality of care are maintained. The sustainability of the European national healthcare systems faces challenges often related to the ageing population, the increase of chronic diseases and, therefore, to the provision of long-term care services.

As the European Semester Country Reports have previously stated most of the EU Member States suffer from a growing ageing society, leading to long-term care costs expected to increase significantly. In October 2018, the EFN collected best practices that are implemented/deployed at national level, from its members. The report drafted from this valuable input under five key areas of activity:

1)         LTC & Workforce,

2)         LTC & Quality indicators,

3)         LTC & Digitalisation,

4)         LTC & Financing,

5)         and LTC & Standards.

This shows the extent to which nurses’ roles are relevant in the delivery of community care across Europe and how their contribution becomes central to support the EU long-term care political agenda, and that it is crucial to co-design with frontline nurses EU policies to make them fit for purpose and as such ensure a sustainable and efficient approach in the development of an EU LTC policy.

The current Finnish EU Presidency is therefore key for EFN. We learned from the previous Finnish EU Presidency that ‘health in all policies’ is a key driver for change. Compared to other OECD countries, the healthcare services provided in Finland are high in quality in many respects, but access to treatment is still lacking and in need of improvement. Several governments in Finland have tried to achieve a total reform of the public health and social services during the past years in Finland, but once again the reform collapsed in the last spring. It has been said that the main goal of reform was missed as the late government tried to include into the reform the regional governments reform and freedom of choice of services.

Nevertheless, the need for the reform is widely approved. The goal of social and healthcare reform has been to narrow the differences in people’s wellbeing and health, to improve the equality and accessibility of services, and to reduce costs. The Finnish Nurses Association (FNA) believes that strengthening primary healthcare should be the focus of the reform. It is essential for the citizens/patient to get access to the healthcare provider, e.g. a doctor, a nurse, fluently. Especially nurses are a key group of providers when the social welfare and healthcare sector seeks new ways of delivering high quality and safe services to meet citizen’s needs. Increasing attendance towards nurses will improve access to patient care, speed up the start of treatment, boost continuity of care, and enable more flexible and streamlined interventions in the facilities. Well-functioning basic healthcare also reduces the cost of specialised medical care. Moving care back to the community is a challenge, but politically and professionally a priority, with digitalisation supporting this process of change, by being involved as end-user in two H2020 projects on EU EHR, Smart4Health and InteropEHRate, working to empower the citizen and unlock health data from local silos, using a bottom-up approach for EHR Interoperability. And we know Finland wants the whole process of finding digital solutions speeded up in the promotion of health, healthcare and social policies.

What are the main limitations dealing with issues like this?

In the future, services will be increasingly provided at places other than social welfare and health care units. Electronic, mobile, outreach and home-based services will be developed in a variety of ways. The population wishes for individual, tailored health services. Furthermore, the significance of self-care will increase, and citizens will need support from professionals in its implementation. In the coming years, aging and increasing chronic diseases will increase the demand for healthcare services, while the sustainability gap will make their funding more difficult. Due to the sustainability gap, services must be provided more efficiently and productively than before. Developing the division of duties may curb the increase in social welfare and health care personnel and improve the effectiveness of services, thereby slowing down the increase in the sector’s costs.

Over the last 48 years, the EFN has addressed many of these challenges at the EU institutions, and through intense lobby work the potential and the expertise of the nurses and the nursing profession is considered when designing EU policies. Politicians in Brussels listen to the nurses, lucky us! Collectively we are in a strong position to face the challenges in terms of health and wellbeing, especially ageing. As such, now more than ever it is crucial for nurses to engage and proactively influence EU health and social policies, namely on the EFN key priorities: education, workforce and quality & safety, including digitalisation as cross cutting theme.

What is next for EFN?

The EFN Members are strongly engaged to make the difference to the current EU policy agenda and are working relentlessly to ensure that three million nurses’ contribution is valued, and the potential of the nursing profession is maximised to positively benefit patients and health ecosystems. With the new European Commission, Parliament & Council, it is a crucial moment to continue our political efforts on challenges that are with us for many years already, but have not been solved, instead became worse, examples are AMR, Vaccination and Ebola to name a few. And the nurses’ voice is key for these to change for the better, to make sure that the EU institutions include health in all policies to tackle the EU, European and global challenges and enhance nurses’ ability to shape and deliver effective and efficient EU policies that impact positively on EU citizens.


Paul De Raeve

EFN Secretary General

Nina Hahtela

EFN Vice President

European Federation of

Nurses Association

+32 2 512 74 19



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