Proceedings

Fourth International Meeting of the European Platform for Supervisory Organizations (EPSO)

24-25 October 2002

Gardermoen, Norway

Participants

Dr Hilde de Nutte

Dr Jan Vesseur

Mr Matt Tee

Dr Jørgen Hansen

Dr Pirjo Pennanen

Dr Ulla Fryksmark

Mr Gunnar Östling

Mr Per Haugum

Ms Linda Grytten

Ms Astri Teien

Ms Jo Kittelsen

Mr Jostein Ingulfsen

Prof Lars Hanssen

Apologies:

Prof dr J. Herre Kingma

Dr Geir Sverre Braut

(For a detailed list of participants, see List of Participants, page 6)

Programme

Thursday 24 October

1800 Getting to know each other. History of EPSO. Topics for discussion.

1930 Dinner

Friday 25 October

0900 Proposal for statutes of EPSO. Discussion of possible formal obstacles

1030 Coffee break

1100 Specific topics for future work

1200 Lunch

1300 Plenary session

1400 Closing of the meeting

Proceedings of the Meeting

Thursday 24 October

Introductory session. 18.00-19.30

The introductory session was led by Dr Jan Vesseur.

History of EPSO:

EPSO was founded in 1996.

The First International Meeting of EPSO was held in Noordwijk, the Netherlands, 1214June1996. The aim of the meeting was to establish a European network of officials who have a duty to supervise and monitor the quality of health care in their countries. It was decided that a meeting of EPSO should be held once a year, and that the Dutch Inspectorate for Health Care would provide the chair and the secretariat for five years (1996-2000).

The Second International Meeting was held in Lisbon, Portugal, 1314November1997. The meeting had two aims: first, to give the representatives the possibility to present the situation in which they were working: responsibilities, tasks etc; second, to identify issues relevant to the international context of the supervisory organizations.

The Third International Meeting was held in Stavanger, Norway, 34June1999. Topics discussed were risk analysis and quality improvement. The meeting had a tragic end, with the sudden death of Jitze Verhoeff of the Dutch Inspectorate of Health Care, the founder of EPSO. The next meeting was planned for October 2000.

For a detailed account of the previous meetings, see the Proceedings of the First, Second and Third International Meetings of EPSO.

There have been no activities of EPSO since the meeting in Stavanger.

Topics for discussion

The following topics for discussion were outlined by Dr Vesseur:

What is EPSO?

What shall EPSO do? What are the aims of the organization?

This meeting represents the start of discussions and some activities – to explore subjects that reflect our problems.

The plan for day two involved proposals for statutes and working groups on relevant topics.

In 2004, the Netherlands shall chair the European Union. They are keen to put supervision of health services on the agenda.

The introductory session continued and ended with a round of introduction by the participants.

Friday 24 October

Proposal for Statutes

Dr Jan Vesseur asked the participants who will be responsible for signing the statutes in the different countries:

The Netherlands: Inspector General, Health Care Inspectorate

Belgium: Director General, Department of Health

Sweden: Director General, National Board of Health and Welfare

UK: Chairman, Commission for Health Improvement

Finland: Chief Medical Officer

or: Director General, National Authority for Medicolegal Affairs

Denmark: Chief Medical Officer, National Board of Health

Norway: Director General of Health, Norwegian Board of Health

The opinion of the members was that although the number of potential members is large, the aim should be to restrict the Platform to a small group. The members should represent central supervisory agencies that have similar problems. The strength of the Platform is that it is a small, intimate group that provides an arena for the discussion of common issues and problems. Participation in the Platform becomes of less interest for members if it becomes large and formal. The aim should be, not to address all the problems related to supervision, but to address the problems experienced by the participating organizations. It was agreed that the northern European countries have the most in common. The Platform should focus on how to get better at what the organizations do, rather than how they could do things differently.

The suggestions for changes to the draft statutes have been incorporated in the revised version of the statutes. The revised version will be offered to next the Chief Medical Officer (EU) meeting with the question to agree with it.

Topics for Future Work

The following topics for future work were identified:

1.  Risky health professionals

2.  Education of supervision personnel

3.  Overview of organizations involved in supervision and their responsibilities

4.  Development of supervision methodology

5.  The relationship between control and advising

6.  Root cause analysis of incidents

7.  Developing a web-site for EPSO

8.  Quality indicators

9.  Financial effectiveness of health care institutions

10.  Accreditation/certification of health care institutions

Four of these topics were chosen to be given priority:

1.  Risky health professionals
Describe the problem
Legal obstacles for solving problems such as health professionals who loose their authorization, but then work abroad
Responsibility: Per Haugum

2.  Education of supervision personnel
The comprehensiveness of training is variable in the different countries.
Responsibility: Norway

3.  Overview of organizations involved in supervision and their responsibilities
Who is responsible for the different elements of supervision? Who does what?
At what level are the different supervision organizations?
What level of independence do the different supervision organizations have?
How are they funded?
Responsibility: Jørgen Larsen

4.  Root cause analysis of incidents
Reports of accidents/incidents
Management of incident reports
Reporting systems. No blame systems, anonymous reporting.
Improvements made locally
How are complaints and insurance cases dealt with?
Responsibility: Ulla Fryksmark

It was decided that those who have responsibility for the working groups will take the initiative to the start the work of the group and to ensure its progress. They invite members and compile the group. EPSO member countries can indicate their interest to participate in a working group. The groups themselves are responsible for deciding how they will work. The working groups shall regularly report the status of work on the topics to the chair.

The four topics that have been given priority shall be presented at the 5th International Meeting of EPSO. A report from the working groups shall be sent to the members in advance, so that the members have time to assess the reports before the meeting.

Chair for the Next Meeting

The members were of the opinion that it is an advantage for EPSO if the Netherlands can continue as chair until the statutes have been approved and signed. It is also an advantage for the Netherlands to be chair when they become chair of the European Union in 2004. The Netherlands wishes to have supervision of health services on the agenda for the EU.

Dr Jan Vesseur shall clarify the matter of chair for EPSO with Dr Herre Kingma.

The meeting closed with lunch at 1200.

List of Participants

The Netherlands

Dr Jan Vesseur

Senior Inspector of Health Care

Public Health Supervisory Service of the Netherlands.

Health Care Inspectorate

Pels Rijckenstraat 1

P.O. Box 9013

6800 DR Arnhem

The Netherlands

Tel: +31 26 352 8250

E-mail:

Prof dr J. Herre Kingma (not present at the meeting)

Inspector General

Public Health Supervisory Service of the Netherlands.

Health Care Inspectorate

P.O. Box 16119

2500 BC The Hague

The Netherlands

Tel: +31 70 3405655

E-mail:

Belgium

Dr Hilde de Nutte

Ministry of Flemish Community

Markiesstraat 1

1000 Brussel

Belgium

Tel: + 32 2 553 36 41

E-mail:

The United Kingdom

Mr Matt Tee

Director of Communications

Commission for Health Improvement (CHI)

10th Floor, Finsbury Tower

103-105 Bunhill Row

London EC1Y 8TG

England

Tel: +44 20 7448 92222

e-mail:

Denmark

Dr Jørgen Hansen

National Board of Health

Denmark

e-mail:

Finland

Dr Pirjo Pennanen

Senior Medical Officer

National Authority for Medicolegal Affairs

P.O. Box 265

00531 Helsinki

Finland

Tel: +358 9 7729 2121

e-mail:

Sweden

Dr Ulla Fryksmark

Director

National Board of Health and Welfare

Regional Office, Gothenburg

Mail Vasagatan 45

SE-411 37 Gothenburg

Sweden

Tel: +46 31 759 59 00/06

e-mail:

Mr Gunnar Östling

Senior Administrative Officer

National Board of Health and Welfare

Division of the Regional Supervision Authority at Jönkjöping

P.O. Box 2163

SE-550 02 Jönkjöping

Sweden

Tel: +46 36 30 94 00/14

e-mail:

Norway

Mr Per Haugum

Director

Norwegian Registration Authority for Health Personnel (SAFH)

P.O. Box 8053 Dep

N-0031 OSLO

Norway

Tel: +47 22 24 90 35

e-mail:

Ms Linda Grytten

Adviser

Norwegian Board of Health

P.O. Box 8182 Dep

N-0032 OSLO

Norway

Tel: +47 22 24 88 47

E-mail:

Ms Astri Teien

Adviser

Norwegian Board of Health

P.O. Box 8182 Dep

N-0032 OSLO

Norway

Tel: +47 22 24 89 75

E-mail:

Ms Jo Kittelsen

Assistant director

Norwegian Board of Health

P.O. Box 8182 Dep

N-0032 OSLO

Norway

Tel: +47 22 24 90 32

E-mail:

Mr Jostein Ingulfsen

Adviser

Norwegian Board of Health

P.O. Box 8182 Dep

N-0032 OSLO

Norway

Tel: +47 22 24 89 85

E-mail:

Prof Lars Hanssen

Director General of Health

Norwegian Board of Health

P.O. Box 8182 Dep

N-0032 OSLO

Norway

Tel: +47 22 24 88 00

E-mail:

Dr Geir Sverre Braut (not present at the meeting)

Deputy Director General of Health

Norwegian Board of Health

P.O. Box 8182 Dep

N-0032 OSLO

Norway

Tel: +47 22 24 88 02

E-mail:

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