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Despite differences in political approaches and institutional frameworks, health and social services in all European Union (EU) Member States face similar challenges, notably the need to adjust to demographic ageing and to changing employment and family patterns. This article takes a closer look at some of those issues (drivers) that are likely to have significant implications for the future of the sector. On this basis, three diverging “integrated visions” for health and social services are presented. The first vision is a “best guesstimate” and assumes that current developmental targets, for example, on reducing cardiovascular disease, are generally met. The second vision is a “problem‐plagued” view of health and social services, where targets are missed and the current level of service generally stays the same or deteriorates. Finally, the third vision presents a more “visionary” picture of health and social services where services are largely transformed from what is known today. All “integrated visions” have been constructed from existing health‐care scenarios as well as the drivers identified earlier. The paper is rounded off with an account of some of the policy measures being implemented by the European Commission and Member States in addressing several of the areas highlighted as important for the future of the sector.

The Maturity Matrix is a tool designed in the UK to assess family practice organisational development and to stimulate quality improvement. It is practice‐led, formative and undertaken by a practice team with the help of trained facilitators. The aim of this study is to assess the Maturity Matrix as a tool and an organisational development measure in European family practice settings.

Using a convenience sample of 153 practices and 11 facilitators based in the UK, Germany, The Netherlands, Switzerland and Slovenia, feasibility was assessed against six criteria: completion; coverage; distribution; scaling; translation; and missing data. Information sources were responses to evaluation questionnaires by facilitators and completed Maturity Matrix profiles.

All practices taking part completed the Maturity Matrix sessions successfully. The Netherlands, the UK and Germany site staff suggested including additional dimensions: interface between primary and secondary care; access; and management of expendable materials. Maturity Matrix scores were normally distributed in each country. Scaling properties, translation and missing data suggested that the following dimensions are most robust across the participating countries: clinical performance audit; prescribing; meetings; and continuing professional development. Practice size did not make a significant difference to the Maturity Matrix profile scores.

The study suggests that the Maturity Matrix is a feasible and valuable tool, helping practices to review organisational development as it relates to healthcare quality. Future research should focus on developing dimensions that are generic across European primary care settings.

The purpose of this study is to develop a methodology for the identification, categorization and prioritization of operational government-supported healthcare supply chain barriers (GHSCBs).

This study develops a theoretical background for identifying and segregating relevant GHSCBs and proposes a 5W2H (a Toyota production system) with fuzzy DEcision MAking Trial and Evaluation Laboratory (DEMATEL) embedded approach to quantify the causal–effect relationships among the identified operational GHSCBs.

Seven GHSCBs (i.e. uncertainty of demand management, lack of continuous improvement and learning, lack of deadline management, lack of social audit, warehousing equipment unavailability, human resource shortage and inadequate top level monitoring) were identified as significant cause group where the government, top management and decision-makers of government-supported healthcare supply chain (GHSC) have to put efforts.

The results obtained are specific to the GHSC of Indian perspective, which could be extended to global context. However, the proposed approach can be a base and provide a platform to understand and analyze the interactions among GHSCBs.

The proposed methodology will show the appropriate areas for allocating efforts and resources to mitigate the impact of GHSCBs for successful implementation of healthcare supply chain.

According to best of the authors' knowledge, this is the first study of operational barrier for GHSC in India in specific. The use of 5W2H embedded fuzzy DEMATEL approach for the development and analysis of the theoretical framework of Indian GHSCBs is unique in barrier literature.

The substitution of generic prescription medicines for branded medicines is being practiced in most westernised countries, with evidence of a strong focus on evaluating and monitoring its economic impacts. In contrast, the purpose of this paper is to explore the generic substitution experience of customers and pharmacists in a pharmacy practice setting.

The study applied a phenomenological method using the narrative inquiry technique combined with critical event analysis, in order to understand the generic medicine experience as perceived by customers and pharmacists as key substitution actors. Interviews were conducted with 15 pharmacists and 30 customers in Australia, Finland and Italy, using a narrative inquiry technique combined with critical events and metaphors.

The findings show that customers, with poor awareness of generic prescription medicine when offered as a substitute, were likely to become confused and suspicious. Pharmacists related how they felt challenged by having to facilitate generic substitution by educating unaware customers, in isolation from both the prescribing doctor and the government/insurer. They also experienced frustration due to the mistrust and annoyance their customers displayed.

The findings suggest that to increase generic substitution, open dialogue is paramount between all the participants of this service network, along with the development of targeted promotional materials.

Little is known about how customers and pharmacists experience the service phenomenon of generic medicine substitution. This paper explores how the key actors at the point of substitution make sense of the process. Additionally, the methodology provides a technique for obtaining a deeper understanding of both the customer and pharmacist experience of generic medicine, along with insights into how the uptake of generic medicine might be improved.

This chapter summarises the role of EU actions in supporting healthcare policies in the EU Member States, both looking at implemented actions and describing current priorities for the future. It argues that these coordinated actions can be beneficial for EU Member States by helping them to avoid duplication of effort and to attain economies of scale. Moreover, data sharing with proper safeguards can unleash vast amount of ‘learning what works’ both for medical treatments and for healthcare sustainability measures. The need for this common learning appears ever more urgent while facing the health and economic consequences of the present pandemic.

This study aimed to describe facilitators and barriers in terms of regulation and financing of healthcare due to the implementation and use of person-centred care (PCC).

A qualitative design was adopted, using interviews at three different levels: micro = hospital ward, meso = hospital management, and macro = national board/research. Inclusion criteria were staff working in healthcare as first line managers, hospital managers, and officials/researchers on national healthcare systems, such as Bismarck, Beveridge, and mixed/out-of-pocket models, to obtain a European perspective.

Countries, such as Great Britain and Scandinavia (Beveridge tax-based health systems), were inclined to implement and use person-centred care. The relative freedom of a market (Bismarck/mixed models) did not seem to nurture demand for PCC. In countries with an autocratic culture, that is, a high-power distance, such as Mediterranean countries, PCC was regarded as foreign and not applicable. Another reason for difficulties with PCC was the tendency for corruption to hinder equity and promote inertia in the healthcare system.

The sample of two to three participants divided into the micro, meso, and macro level for each included country was problematic to find due to contacts at national level, a bureaucratic way of working. Some information got caught in the system, and why data collection was inefficient and ran out of time. Therefore, a variation in participants at different levels (micro, meso, and macro) in different countries occurred. In addition, only 27 out of the 49 European countries were included, therefore, conclusions regarding healthcare system are limited.

Support at the managerial level, together with patient rights supported by European countries' laws, facilitated the diffusion of PCC.

Fragmented health systems divided by separate policy documents or managerial roadmaps hindered local or regional policies and made it difficult to implement innovation as PCC. Therefore, support at the managerial level, together with patient rights supported by European countries' laws, facilitated the diffusion of PCC.