The Sciana Network has drawn up several major trends in health and healthcare to better prepare Fellows for future scenarios. These are common themes The Health Foundation, Careum, and the Bosch Health Campus see as a priority and are working on outside of the Network.

These trends also serve as inspiration for cohort themes and, therefore, have a direct link to the Sciana Challenge. These areas are revised regularly to ensure they remain relevant and reflect the challenges being faced in the health systems of the countries that participate in the Sciana Network.

Better health and wellbeing for all through more prevention, health promotion and health literacy

The World Health Organization (WHO) estimates that non-communicable diseases (NCDs) are responsible for 90% of deaths and 85% of years lived with disability in Europe. Many of these diseases are more common in people from lower socio-economic backgrounds and are preventable.  

Existing action to improve population health relies too heavily on healthcare systems and underplays the role of social and economic determinants of health.

Key questions:

• What role can a range of different actors, including individuals and stakeholders within our health systems play in influencing the wider determinants of health?
• How can we translate national and European policy into actions at the community level so that everyone’s needs are met where they are actually needed?
• How can innovation and digital transformation encourage health systems to shift an emphasis onto prevention and away from cure?

System reforms and leading into the future in times of uncertainty

Introducing reforms to health systems can be difficult, especially when these changes, deemed necessary for improving patient care and outcomes, are then abandoned due to political and financial reasons.

Key questions:

• How can we develop health systems so that they are fit for the future?
• What types of leadership do our health systems need to not only navigate these reforms but to implement them effectively and sustainably?
• How do you lead in a system where digital transformation often outpaces reform?
• What does leadership mean in an environment that is dynamic, challenging, and has constrained budgets?

Workforce shortages and skills

The pandemic has exacerbated the already critical shortage of health workers across all professions in our health systems. The impact of demographic changes in our populations and in a workforce striving to meet complex needs has continued to magnify long-existing challenges.

Key questions:

• How can countries increase the supply of health and care workers without relying on international migration?
• How can skills be adapted and existing staff trained so they can deliver effective care for people with multiple conditions?
• What should the workforce of the future look like, and what skills mix is required to meet future needs?
• How can leaders in the health system support their healthcare professionals’ physical and mental wellbeing to retain and enable staff to provide the care they have been trained to give?

New forms of healthcare for better outcomes

According to the WHO, the population aged 60 and over in the WHO European Region is projected to be over 300 million by 2050. In 2021, this figure was 215 million.

Many people will develop NCDs even if preventative efforts are increased. A first step is to understand the likely pattern of health and care services for the older age group and to challenge the long-accepted myths about the resources that will be necessary.

Reforming fragmented health and care services to meet the needs of people of all ages with multiple conditions is a common goal for many health systems. However, evidence about what works best in different contexts is still emerging.

Technological developments provide new and exciting opportunities for innovation while raising questions about data sharing, digital health literacy, and social inclusion. Meeting these challenges requires coordination, cooperation and a review of existing professional and organisational profiles in the health sector.

Key questions:

• How can we redefine relationships between individuals, healthcare professionals, society and health systems?
• How can we reduce the burden on our health systems and encourage a healthier population?

Climate change

The NHS has developed its own net-zero plan, which the WHO describes as the first healthcare system to do so. More action will be needed in the future as climate change accelerates, as well as a better understanding of the impact of climate change on public health.

Education, prevention, collaboration and conscious leadership are needed to meet not only the implications of climate change that we are experiencing today but also those that we will continue to face in the future.

Key questions:

• What role should health leaders play in driving effective change by recognising and reducing the impact of climate change on our systems and introducing measurable actions to meet the challenges head-on?
• What action should healthcare systems be taking to reduce their own emissions?

Digital transformation

Our health systems are in the middle of an ongoing digital transformation, which will continue to be dynamic. Digital transformation is often seen as the solution to many of the problems our current and overstretched health systems are facing. Advances in technology mean that people live longer, and treatments are more effective.

At the same time, further issues are coming to the fore that need to be addressed to ensure that the implementation of these digital technologies actually benefits patients and the workforce, as well as the system. In addition, huge amounts of data are being generated that can provide valuable insights and evidence to improve health, care, and the patient experience.

Key questions:

• How can we ensure that the digital transformation is meeting individual needs?
• What is the relationship between digitalisation, AI, and ethics?
• What should we be doing with all this data and who should (or shouldn’t) be doing it?
• What tools, knowledge and skills do leaders in the health system require to make the right decisions in such a complex field?
• In addition, how can our leaders ensure that even vulnerable groups are included and have access to our digital world?