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Now is the Time to Protect Patients and Safeguard Access to Care

8 April 2020

The COVID-19 pandemic is now affecting all countries and all communities. Patients with chronic diseases – numbering at least 150 million in the EU – are among the most vulnerable, as many are at much higher risk of serious illness and death from COVID-19, but also because patients are directly exposed to disruptions in healthcare provision.[1] Treatment delay and discontinuation are very real concerns for certain groups of patients such as cancer patients for example. Clarity on what is happening in terms of access to ongoing treatments, therapies and procedures in place is urgently needed for many chronic disease patient communities.

Building upon our first statement on the pandemic one month ago, EPF still feels that protecting this particularly vulnerable population in many countries has for the large part been forgotten in the public discourse. EPF continues its calls on Member States to put in place effective strategies to protect the health of chronic patients andrecommends authorities to work with their country’s patient organisations to identify best possible solutions, ensure effective flow of information.

Ensuring access to timely treatment and care

Health system responses to the crisis have in some locations already resulted in changes that patients have hoped for many years would happen – such as virtual consultations[2], patients and professionals using online tools to communicate information, physicians’ access to health records from offsite as well as home delivery of treatment and medications or local pharmacy access.[3]

“In Germany, for example, finally video consultations are increasingly practised and this experience in the time of crisis may change care providers’ and patients’ future views on this kind of service.  This applies also to electronic prescriptions and the electronic health record which have been legally allowed as of 2021. However, e-health services must guarantee all, people with disabilities included, full access as well as provide adequate data protection.” Said Birgit, a patient living with cystic fibrosis from Germany.

“In Cyprus, electronic monthly prescription for all chronic patients is in place, doctors during this crisis are also accepting telemedicine consultations,” said Nicolas, a patient representative from Cyprus.

This is unfortunately not yet the norm and too few patients with chronic conditions are benefitting from these alternative solutions.

“In Bulgaria, unfortunately there is currently no way for patients to be followed at a distance. Telemedicine is currently not an option in our country, and it is even forbidden by the law. All patients are still obligated to go to hospitals and pharmacies to get their treatment and medication,” said Stanimir, a patient representative from Bulgaria.

“In Latvia, the further development of ehealth solutions has recently been discontinued.[4] With a rapid switch to telemedicine, brought about by the COVID-19 situation, we fear that only private clinics will be able to adapt quickly enough. All patients cannot afford private care however,” said Baiba, a patient representative from Latvia.

Many national patient organisations have reported challenges in both accessing treatment and medical consultation and have proposed solutions to their governments.

“In Spain, the president of the Madrid community has rapidly decided to allow home delivery and local pharmacy access to treatments, following our request. Despite this positive development, this accessibility is not applied to the whole of Spain as the Spanish health system is divided into 17 different autonomous regions. This will no doubt lead to increased health inequalities between patients of a same country,” said Elena, a patient representative from Spain.

In keeping patient safety as a top priority, EPF calls on Member States to facilitate both local pharmacy pickup and home delivery of treatment and medication for patients and ensure that accessible and affordable telemedicine services are made available.

In a probable situation where the current restrictive measures will apply for a longer time, access challenges faced by patients with chronic conditions will become even more alarming. Similarly, how will continuous protection of patients be ensured when lockdown measures end? This will require serious thought.

Patient organisations as partners in solutions

Patient organisations are connected to their grass-roots communities and can support healthcare services and governments in developing adequate solutions for patients’ continuing access to care at a time when crisis threatens to overwhelm them – for example by using telemedicine. Similarly, patient organisations are invaluable partners in ensuring information flows and good communication.[5] Meaningful patient involvement becomes a reality when the power of the patients’ voice is supported by health experts, the media and listened to by our health authorities.

To date, we have unfortunately not seen a systematic collection or sharing of “best practice” alternative access solutions (for example virtual consultations, automatic prescription renewals etc.). This is one area, among many, where the European Commission can support Member States, with the involvement of patient organisations.

EPF highlights the fact that Patients’ organisations are an essential resource for health services in identifying and implementing the best possible solutions to continued access to quality care and treatment.

 

 

Conclusion

The COVID-19 crisis is revealing already existing gaps and weaknesses in our health systems, exposing the flaws of our fragmented health and social systems and a lack of common effort and European harmonisation and cooperation.

Once the immediate pandemic situation has been overcome, attention must be turned towards enhanced European collaboration and common thinking for strengthened health systems. Health is not only a national matter – it is an urgent European and global health policy priority.

This statement has been endorsed by EPF’s internal working group on universal access to healthcare.[6]

 

ABOUT EPF:

The European Patients’ Forum (EPF) is an umbrella membership-based organisation that works with patients’ groups in public health and health advocacy across Europe. Our 74 members represent specific chronic disease groups at EU level or are national coalitions of patients. https://www.eu-patient.eu/



[3] The views of patients and the public should be included in policy responses to covid-19 , the bmj opinion: https://blogs.bmj.com/bmj/2020/03/30/the-views-of-patients-and-the-public-should-be-included-in-policy-responses-to-covid-19/

[6] For more patient perspectives collected by EPF: https://www.eu-patient.eu/COVID-19/patient-perspectives-covid/