operating grant title european health management

Operating Grant Title European Health Management Association FY2010

Operating Grant Acronym EHMA FY2010

Type of funding Scheme Health Programme 2008-2013

Grant agreement number 2009 31 01

Technical and Financial Midterm Report

2 EHMA FY2010| Technical and Financial Midterm Report

Table of Contents

Summary ........................................................................................................................................................................ 3

Chapter 1: Background and Context on the EHMA FY2010 Programme ....................................................................... 5

Chapter 2: Quality and Equity: Collaboration Mechanism ............................................................................................ 8

Chapter 3: Innovation: European Mental Health Network ........................................................................................... 9

Chapter 4: Sustainable Health Systems: Cross Border Healthcare in Practice Simulation .......................................... 11

Chapter 5: Leadership .................................................................................................................................................. 13

Chapter 6: Dissemination ............................................................................................................................................ 17

Chapter 7: Financial report .......................................................................................................................................... 21

This report arises from the operating grant EHMA FY2010 which has received funding from the European Union, in the framework of the Health Programme. Sole responsibility lies with EHMA and the Executive Agency is not responsible for any use that may be made of the information contained herein.


Summary

The European Health Management Association (EHMA) is delighted to report on the activities in the first

half of 2010 (M1-6) that were supported by the EHMA FY2010 Operating Grant. EHMA’s core values,

innovation, quality and equity and sustainable health systems are clearly reflected in the work that has

been carried out successfully so far.

The EHMA FY2010 Operating Grant successfully enables EHMA to maintain the Chief Executives’

Network (CEOs’ network) and the thriving Transitional Countries Network (TCN), which saw its members

meet in March - for the third time since the launch of the network in 2009 (supported previously by

PHETEHM). The network and its initiatives are still growing, therewith confirming the need for this

platform. A promising CEOs’ network meeting planned for April has now been rescheduled for later this

year. The Operating Grant also supports EHMA in launching new initiatives; the European Mental Health

Network, work on the feasibility of a cross-border care simulation and on a Collaboration Mechanism.

These initiatives take place in the second half of 2010, but early preparations have already been

undertaken.

Although the majority of events still have to take place, EHMA is happy with the progress achieved

within the first half year of 2010. One successful event has been held so far. In addition, substantial

effort has already gone into planning and preparing the new initiatives to allow for successful

implementation of activities in the coming months.

The EHMA FY2010 Operating Grant also supports the everyday functioning of the EHMA office, which is

necessary to implement the work programme and the association as a whole. Office support,

dissemination, governance and evaluation are core themes which improve the quality of EHMA’s

activities and events.

Conservative financial management assures that the budget provided for executing the work plan will be

sufficient. Currently EHMA succeeded in executing its tasks very economically, leaving sufficient budget

for the second half of 2010.

In conclusions, EHMA is delighted with the successes achieved so far and strongly believes that the

activities supported by the Operating Grant will continue to flourish in the second half of 2010.


Overview of deliverables

Deliverable Title Delivered Yes/No/Expectancy

1 Discussion paper based on results of the CM meeting (11)

No, expected M11 in line with work programme

2 Policy and discussion paper based on the EMH Network meeting (11)


3 Launch of a discussion forum for EHMN members and other stakeholders (M6)

Yes, delivered in M6 in line with work programme

4 Report summarising results and outcome of the cross border healthcare simulation feasibility meeting (M12)


5 Digest of EU Health Policy news with brief analysis: monthly from month 1

Yes, Delivered since M1 and ongoing

6 Report on the discussions and results of the TCN meeting (M6)

Yes, Delivered in M5 in line with work programme

See also http://www.ehma.org/?q=node/597

7 Discussion paper based on the outcomes of the CEO Network meeting (M6)

No. Planned for M6, but postponed until M11 due to exceptional circumstances

8 Internal Evaluation report (M8) Yes, delivered in M8 and added to this interim report ( please see file of deliverables)

9 Final technical and financial report (M12+2) No, expected M12+2 in line with work programme

http://www.ehma.org/?q=node/597


Chapter 1: Background and Context on the EHMA FY2010 Programme

1 European Health Management Association (EHMA) in 2010

1.1 Background & Objectives of EHMA

The European Health Management Association (EHMA) is a membership organisation with more than

150 institutional members across more than 30 countries. It was founded in the 1960s, and is registered

as a charity in Ireland. EHMA is funded through membership subscriptions, project funding, sponsorship

and event income. In 2010, EHMA legal status changed to being a not-for-profit company with limited

guarantee.

EHMA's aim is to improve quality and build capacity of health management across the European region.

As EHMA's statutes declare: we seek to "improve health management and health policies through the

development and exchange of both ideas and practices among academics, researchers, managers,

clinicians, policy makers and consumers throughout Europe” (extract from the Statutes of the European

Health Management Association, also available at www.ehma.org).

EHMA’s visions can be categorised in three main areas – all underpinned by leadership:

Quality and Equity: We want to see high quality healthcare and reduced health inequalities, led

by outstanding managers, supported by appropriate policy frameworks and backed by the best

available research.

Innovation: We want to see innovative health management and research with original ideas

about service provision and public health for the good of all citizens.

Sustainable health systems: We want to see health systems equipped to respond to current and

future challenges in a way that guarantees health for all.

More information on EHMA is also available on our website – www.ehma.org .

1.2 Governance

The Board plays an essential role in EHMA’s governance structure. They retain overall oversight of the

work programme and are involved in the monitoring, evaluation and quality control of EHMA activities.

The Board is made up of elected and co-opted members.

The Board comprises 10 members: President, President-Elect or past-President, Honorary Treasurer, 5

members at large, Annual Conference host (co-opted) and SAC chair (co-opted). In addition, the Director

will be co-opted onto the Board to act as secretary.

http://www.ehma.org/



Board members hold office in their individual capacities - they do not represent the institutions to which

they belong. Two Board meetings took place in 2010: They took place on 19 January (Dublin), 12 April

(phone conference) and 30 June (Lahti). The last Board Meeting of 2010 will take place on 19 October

(Brussels).

The Annual Report and the audited annual accounts are presented to members at the Annual General

Assembly (AGA) in June of each year. EHMA’s Board is also elected/ appointed at the AGA following an

open call for nominations among EHMA’s members. EHMA statutes, the annual reports as well as details

on the board members and funding are also available on our website at

http://www.ehma.org/?q=node/7.

The EHMA team is headed by the Director. The Senior Management Team (SMT) consists of the

Director, the Deputy Director and the Office Managers. The Office Managers manage the Office

Administrator. The Deputy Director line manages the Policy & Projects Manager, Policy Officer and

Projects Officer. The Policy & Projects Manager line manages stagiaires. The full EHMA team meets

regularly. The SMT meets as well to oversee the management of the secretariat and day-to-day

expenditures.

1.3 Membership

EHMA Membership is open to all institutions that support the Association's aims. Individuals may also

become members at the institutional rate. Membership applications are reviewed by the Director and

confirmed by the Board. EHMA currently has over 150 member institutions across 30 countries. An

updated list of members is published regularly online at www.ehma.org .

http://www.ehma.org/?q=node/7



1.4 Description of the work programme

1.4.1 Strategic Objectives and Specific activities for the year in question

The work programme is summarised under EHMA’s three activity areas, with Leadership as a cross-

cutting theme.

(i) Quality and Equity: Collaboration Mechanism

For a more detailed description of achievements linked to the Collaboration Mechanism, please see

chapter 2.

(ii) Innovation: European Mental Health Network

For a more detailed description of achievements linked to the European Mental Health Network, please

see chapter 3.

(iii) Sustainable Health Systems: Cross border Healthcare in Practice Simulation

For a more detailed description of achievements linked to the Cross border Healthcare in Practice

Simulation, please see chapter 4.

(iv) Leadership: Transition Countries Network (TCN) and Chief Executives’ Network (CEO’s Network)

For a more detailed description of achievements linked to the TCN and CEOs’ Network, see chapter 5.

(v) Supporting the general operations of the association, underpinning the specific activities

described above:

The EHMA FY2010 Operating Grant also partially covers the costs of office and management costs

(including administrative support), essential for the implementation of the work programme and vital

for the functioning of the organisation. The office team has been responsible for all of the financial,

administrative and legal processes related to EHMA FY2010.


Chapter 2: Quality and Equity: Collaboration Mechanism

2.1 Introduction

The aim of the Collaboration Mechanism (CM) is to build capacity through facilitating the exchange of

expertise and information on maximizing health gain between key health investment funders and

Member States/regions utilizing and applying for these funds.

The CM meeting will be organised in November 2010. The target group is 15 key stakeholders, including

major health funders, experts, MS and regional governments, with a focus on stakeholders from EU 12

Member States.

2.2 Deliverables

The deliverable following from this activity within the framework of the EHMA FY2010 Operating Grant

is a discussion paper based on results of the CM meeting (Deliverable 1, planned for M11). This

discussion paper will be disseminated electronically to both members and key stakeholders.

2.3 Outcomes and achievements

The expected outcome is enhanced capacity to access investment for health and intelligence for funders

on the experience of applicants for funding.

2.4 Self-sustainability

The collaboration mechanism is expected to be the start of a round table cycle in which EU health

stakeholders join forces.

2.5 Budget

No direct costs were made in relation to the implementation of the Collaboration Mechanism. However,

indirect costs and related staff costs (preliminary preparations) were already incurred in relation to the

activity.

2.6 Conclusion

As the CM will take place in November, only preliminary preparations have taken place. However, EHMA

is dedicated to make the Collaboration Mechanism a success and expects it to add substantial value to

our work on quality and equity of health.


Chapter 3: Innovation: European Mental Health Network

3.1 Introduction

EHMA is devoted to promoting equitable access to mental health services, and to best practice in their

management. This commitment resulted earlier in the flagship study ‘HealthQuest’ (available at the

EHMA website) and the ensuing Health Access seminar that took place on 22 April 2009 (supported by

the PHeTEHM Operating Grant made available by the EU in the framework of the Health Programme).

The European Mental Health Network (EMHN) will build on these initiatives in an effort to promote

innovative health management and research with original ideas about service provision and public

health for the good of all citizens. More specifically, the objective of the EMHN is to provide a unique

European forum for policy makers, managers and researchers looking at mental health care delivery

from a system perspective. The network will meet to look at implementing the evidence on effective

and high quality mental health care, including moving care out of hospitals and somatic care for people

with mental disorders.

The network's target group will be 20 senior mental health policy makers, managers and researchers,

from both old and new Member States.

3.2 Deliverables

Two deliverables will result from the EMHN. A discussion forum for EHMN members and other

stakeholders is launched in M6 (deliverable 3). The forum will be promoted through email to EMHN

members and other stakeholders. This target has already been met. Secondly, a Policy and discussion

paper based on the EMH Network launch meeting scheduled for 9-10 December 2010 will be published

and disseminated to all network members, all EHMA Members and to defined key stakeholders

(deliverable 2, planned for M11). The discussion paper will link to the launch event, scheduled for

December 2010.

3.3 Outcomes

It is expected that the outcome of the network will be strengthened European capacity to implement

the evidence on effective mental health systems and a strong peer network to solve common problems.

3.4 Self-sustainability

The EMHN is currently in its initial stage. Supported by the FY2010, EHMA will (financially) support the

set-up of the network. The underlying aim is that it will continue to run for the next years following its

set up in order to encourage long-term growth and development in mental health systems in Europe.


At the end of the year, EHMA will critically review the network and possibilities for self-sustainability will

be assessed.

3.5 Budget

Costs in relation to the implementation of the European Mental Health Network have been limited so

far as the launch event has not yet take place. However, indirect/admin costs and staff costs (preparing

the virtual forum, early preparations) were made in relation to the activity. Moreover, costs related to

the dissemination and evaluation of the initiative has also been incurred.

3.6 Conclusion

Behind the scenes EHMA started preparations for the launch of the European Mental Health Network,

scheduled for 9-10 December in Brussels, Belgium. EHMA is currently strengthening its position in the

EU Mental Health policy field, while stakeholders and target organisations have received notification of

this initiative. Initial discussions with key experts have taken place and it was strongly advertised during

the EHMA Annual conference in Lahti. The online forum has also been delivered. Substantial interest for

the network has already been recorded, which suggests a high added value for the European mental

health policy and practice community. EHMA is positive to be able to make this initiative a success.


Chapter 4: Sustainable Health Systems: Cross Border Healthcare in Practice Simulation

4.1 Introduction

Cross Border Healthcare is a ‘hot’ topic at EU level, especially since a new political compromise has been

reached by EU ministers of health and social affairs on the new proposed Directive on patients’ rights in

cross border healthcare. The agreement is an important step for the future of the Directive - which has

been discussed for more than two years now at EU level.

Supported by the FY2010 Operating Grant, EHMA will hold a simulation feasibility meeting that will

explore the feasibility of holding a cross-border care simulation in practice that could model and discuss

reactions and implications of managing cross border care. The objective of the simulation would also be

to model likely impacts of future patient mobility.

The target group for the simulation is 25 national and regional policy makers and health managers, with

representation from Southern, Eastern, Central and Northern Europe.

4.2 Deliverables

The Simulation has one deliverable, namely a feasibility report on the cross border healthcare simulation

(Deliverable 4, M12). This report would give important insights into the feasibility and potential impact

of a simulation. This would be an important first scoping step planned for the year 2010 that is essential

before holding an actual simulation at a later stage could be considered. Outcomes shall be

disseminated to all EHMA Members, to the full non-member contact list and to key pre-defined

stakeholders.

4.3 Outcomes

The expected outcome will be valuable intelligence on the scope of a simulation, the potential impact of

cross border care on European health systems through its impact on management practice, published as

a discussion paper.

4.4 Self sustainability

The feasibility report will be an important first step that will feed into EHMA’s ongoing policy work on

cross border healthcare, and could potentially lead to the consideration of a simulation in later years.


4.5 Budget

The feasibility report will be drafted later this year. So far, admin/indirect costs and staff costs related

the activity has been incurred. An initial meeting to highlight cross-border care and receive feedback

from stakeholders was held as part of the EU policy session during the EHMA annual conference in Lahti.

4.6 Conclusions

New developments in cross border healthcare show that the topic is still high on the EU agenda

therewith emphasizing the importance of gaining more insights on patient mobility. EHMA has been

closely following he debate on cross-border care and will continue to do so in the coming months. EHMA

believes that we are well positioned to successfully deliver the feasibility report on a cross-border

simulation by M12.


Chapter 5: Leadership

5.1 Transitional Countries Network

5.1.1 Introduction

In March 2009, EHMA launched a peer network across Central and Eastern Europe, the Balkans and

other transitional countries for senior health managers and health policy makers. Its main aim is to build

health management capacity across transitional countries and to address common health management

challenges as health systems in Central and Eastern Europe face challenges in reducing health

inequalities and modernising systems. Key stakeholders within EHMA’s membership identified a

significant need for an international network focusing on building capacity in this area. In 2010 EHMA

aims to expand the network (counting over 30 members at the end of 2009) to maximise the value of

the meetings and mentoring opportunities.

The network is free to join and becoming a member of the network gives participants and their

institution several advantages, including access to EHMA's wider networks and at least one year of free

EHMA Membership. The target for 2010 is to recruit an additional 15 senior managers and policy

makers. Currently the network counts 45 members.

Part of the TCN is a dedicated women network for senior health managers and health policy makers.

Women often still encounter a “glass ceiling” or barrier to advancement into the management ranks of

organisations. With the network EHMA aims to bring together women in management to discuss gender

and leadership issues in transitional countries.

5.1.2 Deliverables

The first event (“On Health Politics and Health Management – Transitional Countries Network”) was

organised as part of the EHMA/MCI (Management Centre Innsbruck) European Winterschool on health

politics and health management in Innsbruck, Austria on 11-12 March. The European Winterschool

sessions were a unique experience for TCN members to learn about core health management and policy

issues in an international atmosphere. TCN members benefited from a tailored programme, which ran

from Thursday afternoon 11 March until Friday evening 12 March including a meeting of the TCN

Women’s Network. A fourth gathering of the TCN is scheduled for 24-25 November 2010 and is likely to

take place in Krakow, Poland.

The first meeting for 2010 in Innsbruck was attended by 19 network members. This number of

attendance is similar to the previous two TCN meetings that took place in May 2009 (Budapest,

Hungary) and November 2009 (Bucharest, Romania). A meeting report, presentations and pictures from

the third meeting are all available on the EHMA website.


Every month EHMA EU Shortcuts is sent to TCN members (and others), which provides a digest of EU

Health Policy news with brief analysis (Deliverable 5, from M1). EU shortcuts will also continue to be

sent in the following months until the end of 2010.

All deliverables scheduled for the first half of 2010 and linked to TCN have thus been successfully

delivered.

5.1.3 Outcomes

The expected outcome is increased health management capacity in transition countries and improved

connections between management practice and policy. Considering the current developments EHMA

believes that these outcomes are feasible as within the framework of the network members are able to:

(1) receive mentoring from mentors within/outside transitional countries or to mentor “emerging”

leaders themselves, (2) share knowledge and expertise through the website or newsletters, (3) host

future TCN meetings and raise the profile of their institution, (4) network with other TCN members and

(5) enhance their leadership and management skills.

5.1.4 Self sustainability

In 2010 the Transitional Countries Network keeps evolving and growing at high speed. The network grew

almost by 50% in the first 6 months and the events are well visited while satisfying the participants.

However, EHMA’s primary goal is to keep expanding the network , while the financial vulnerability of the

target group has to be kept in mind.

5.1.5 Budget

Costs of the third TCN meeting were covered by both EHMA and the Management Centre Innsbruck.

Expenses covered by the grant related to travel costs of speakers and staff, and venue and catering

costs. For more information, please consult chapter 7 on financial matters.

5.1.6 Conclusions

In only 14 months time, EHMA’s has built up a sustainable network in Central and Eastern Europe of

some key health representatives from 14 transitional countries. All network meetings (two in 2009, one

in 2010) were attended by around 20 participants, which comprise half of the network. Given the

current financial and economic situation in most of the transitional countries this number is relatively

high. The TCN provides opportunities to network members both within and outside the network. A

fourth gathering of the TCN is scheduled for November 2010 and will take place in Kraków, Poland.


5.2 Chief Executive’s Network

5.2.1 Introduction

The objective of the Chief Executives’ Network (CEOs' Network) is to build capacity for health leaders

across Europe, with a particular emphasis on international exchange and learning from other sectors.

The network will meet once in 2010, with additional mentoring, briefing papers and virtual contact.

The target group will be 15 CEOs of health planning and delivery organisations, including both new and

old MS.

5.2.2 Deliverables

EHMA organised a meeting for 15 and 16 April with the title “Reducing variation – improving quality”.

This meeting aimed to provide an intensive and highly interactive knowledge transfer based on the

action-learning approach which allows participants to explore their individual approaches through the

process of examining the particular situations and issues that they each face. The learning set would

have addressed individual and group responsibility for resolving issues and problems.

However, EHMA decided to postpone the meeting until 4-5 November as keynote guest speaker

Professor Stephen Prosser died suddenly only a few days before the event was bound to take place. The

participants who already booked their travel arrangement will be offered complimentary registration for

the next event to ensure their continued participation in the network. The related deliverable, a

discussion paper based on the outcomes of the CEO Network meeting (deliverable 7), was planned for

M6 but will now be delivered in M11, following the event in early November.

5.2.3 Outcomes

The expected outcome of the network is a greater European perspective for health leaders and a strong

peer network across Europe for finding solutions to common problems.

5.2.4 Self sustainability

After a slow start in its first year EHMA will (financially) support the CEO Network for the upcoming year

in order to encourage growth and development. At the end of the year the Network will be critically

reviewed.

5.2.5 Budget

Most expenditures that were made could be claimed back due to the nature of the cancelation, which

has provided sufficient budget for rescheduling the event for November 2010. Preparations have been

taken place, and admin costs and staff time was invested in both meetings.


5.2.6 Conclusions

Both EHMA and the registrants were highly disappointed with the sudden loss of Professor Prosser, who

had made the event particularly attractive. Fortuantely, members appeared to be still interested in both

the network and the topic (patient-centred care). Therefore preparations for an event in M11 have now

started, and the network’s members received an early notice of the date with full registrations to be

opened in autumn.


Chapter 6: Dissemination

This chapter outlines different efforts taken in the first half of 2010 by EHMA to circulate findings and

achievements linked to our work programme. Dissemination of different EHMA initiatives and results is

considered of great importance.

6.1. Dissemination activities

This section describes all of EHMA’s dissemination activities that are linked to the implementation of the

FY2010 work programme. They are grouped by dissemination channel (e.g. printed, face-to-face,

electronic, etc.). In addition to ongoing communication with EHMA’s members and networks, EHMA also

attended internal and external events, provided publications on the EHMA website, in journals and via

other information sources and linked with the networks of other stakeholders and civil society

organisations.

As one of the largest membership organisations in Brussels, EHMA members include service delivery

organisations, health insurers, universities, research institutes, consultants and ministries of health.

Open to all organisations committed to health management improvement, EHMA works together with a

wide variety of stakeholders at international, European, national and local level. For example, the

weekly EHMA newsletter as primary source of information and dissemination is sent to approximately

400 individuals in at least 30 countries across the WHO European region and beyond.

6.1.1. Published outputs

EHMA exploits a number of different dissemination channels resulting in the following published

documents:

The Annual Report gives a fair overview of EHMA’s recent and current activities and programmes for

those who are familiar with EHMA and those who are not.

The weekly send EHMA News keeps members informed on activities, developments and published

material. It provides links to more information including briefings, shortcuts, and other sources on our

website.

EU Shortcuts is a monthly digest on EU health policy, organisations and developments of the European

Union (in a broad sense) as well as news from a member state. It is advertised via the EHMA news and

has been particularly beneficial to TCN members.

Policy briefings are published regularly and timely and offer a to-the-point analysis of health policy

developments at European level, including briefings Review of the Working Time Directive, the

Communication on the EU’s role in Global Health and briefings on Cross Border Healthcare.


In 2010 subscription to EHMA’s official journal – the Journal of Management and Marketing in

Healthcare – formed part of EHMA's member service. This quarterly journal for all those directly

involved in, or concerned with the organisation, delivery, management, and marketing of healthcare

services at a strategic and operational level added additional value as a source of information and

exchange and allowed a wider dissemination of EHMA activities.

All publishable outputs from the EHMA work programme are or will be published on the EHMA website

(including presentations of relevant events), are promoted face-to-face and via virtual means (when

applicable).

A number of standard EHMA materials – including references to EC funding – were produced and

disseminated widely in 2010. In particular, the “Getting Connected 2010” folder became a useful frame

for any dissemination, information or publication event and has been distributed among a large

community of health stakeholders. The Annual Report has also been revised and provides detailed

information on EHMA’s activities in a clear and concise manner. Examples for both publicatison have

been enclosed with this report.

6.1.2. Electronic Access

In addition to EHMA’s newsletter and website, EHMA launched in partnership with the King’s Fund a

new initiative in 2009, named “Global Emerging Leaders” (GEL), an international online community of

clinical and non-clinical leaders in health care providing new ideas, stimulus and support for people

building their careers in health. GEL maintains to offer an excellent opportunity to promote EHMA

activities and achievements.

The Management in Practice Database, which arose from the project ‘PHeTEHM – Promoting Health

through Excellence in Health Management’ and which has received funding from the European Union, in

the framework of the Health Programme, is gradually becoming more popular as more EHMA members

and non EHMA members register. The Database provides a platform for sharing good practices.

6.2.3. Face-to-face dissemination

Numerous efforts were undertaken in 2010 to disseminate EHMA activities face-to-face by participating

in a variety of different events, both in Brussels and other European countries. In particular, EHMA’s

attendance, participation and contribution to key forums in the field of European Health Policy have to

ensure adequate representation and dissemination of EHMA activities (including TCN, CEOs, EMHSN

etc.).


Regular and diverse dissemination efforts are of strategic importance to the organisation. A few selected

initiatives are outlined below:

February EHMA’s Projects & Policy Manager Britta Baer and Deputy Director Elisabeth Jelfs attended the launch

of a simulation on regional cooperation in cross border care, run by the International Healthcare

Management Masters programme at MCI Innsbruck. Elisabeth Jelfs presented on the role of cross

border care, looking at the patient journey and at the importance of cross border healthcare at EU

level as a lightning rod for other debates, such as quality in healthcare. Discussion after the

presentation focused on the questions of reimbursement mechanisms across social insurance and

Beveridge systems, assuring healthcare quality, and the possibility of sharing health system capacity.

The meeting also provided EHMA with additional insights into cross- border care and the technicalities

of holding a simulation.

March On 11-12 March EHMA’s Transitional Countries Network (TCN) convened for the third time in

Innsbruck, Austria. The event took part within the framework of the EHMA/MCI (Management Centre

Innsbruck) European Winter School. A tailored programme was prepared for TCN members and

focused on EU Health Policy and EU Funding Opportunities to improve health outcomes and

infrastructure. Invited speakers included: Rostislava Dimitrova (European Commission, DG SANCO),

Ourania Georgoutsakou (Assembly European Regions), Paul Rübig (Member of the European

Parliament), and Ursula Plassnik (Former Foreign Minister of Austria).

In March EHMA's Deputy Director Elisabeth Jelfs taught on EU Health Policy for the three groups of

students attending the MSc course for the Graduate Management Training Scheme in the UK. The

sessions focused on the impact of EU health policy on the devolved NHS in the United Kingdom, with

an emphasis on workforce, patient safety and cross border care, and a detailed case study on debates

on the EU's remit on quality of care.

April EHMA attended the first meeting of the European Parliament Interest Group on Mental Health of the

new parliamentary term on 28 April in Brussels. The interest group is a means of building dialogue on

mental health between parliamentarians, the European Commission and health stakeholders, and

linked well to EHMA activities in the field, in particular the European Mental Health Systems Network.

May On 19 May EHMA Director Jeni Bremner and EHMA Policy Officer Annemie Coëme taught on EU

Health Policy for a group of MBA health executives from Gothenburg at the Västra Götaland Region

Brussels Office. The session focused on the impact of EU health policy on member states, with an

emphasis on workforce, patient safety and cross border care, and a case study on debates on the EU’s

remit on quality of care. The executives appeared to be very interested in EHMA and its activities and

this might provide important follow up for the CEO’s network.

On 21 May EHMA Director Jeni Bremner spoke on the feasibility of developing a European wide

system for the accreditation of health managers at a one day conference designed for Fellows of the

Institute of Healthcare Management (IHM) in the UK – a network of senior managers who have

demonstrated excellence in practice at the highest levels. The conference also looked at the future of

the NHS and compared best practice in the areas of operational management, benchmarking and

delivering good leadership, and quality compliance. It was an excellent opportunity for EHMA to

disseminate our initiatives for 2010, including the CEO network.


June On 3-4 June EHMA attended the fifth International Conference on Patient Safety after receiving an

invitation from the Spanish Presidency of the EU. In Madrid the main topic discussed was “Healthcare-

Associated Infection and Antimicrobial Resistance”. EHMA approached several attendees for both the

TCN and CEOs network, while the content was researched for the next TCN meeting to be held in

November 2010.

The EHMA Annual Conference “Managing radical change in health: quality, efficiency and equity” took

place between 30 June and 2 July in Lahti in Finland. The Conference provided ample opportunity to

showcase EHMA’s work, to spark further interest and disseminate our initiatives and discuss potential

next steps, for example for TCN, CEOs, the Mental Health Systems network, EU policy work etc. The

Conference also provided room for additional internal meetings such as the Board meeting and SAC

sessions, the 2010 Annual General Assembly etc.


Chapter 7: Financial report

This chapter gives an overview of expenditures made for the implementation of the work programme

during the period 1 January – 30 June 2010.

Having taken advices from accountants, legal advisors and tax consultants, EHMA changed the nature of

its legal status. With effect from 1 March 2010 EHMA is operating through the European Health

Management Association Limited (a not-for-profit company limited by guarantee), whereas previously it

operated through the European Health Management Association.

As a consequence of implemented changes, EHMA last audit period covered 1 January 2009 to 28

February 2010 – a financial year of 14 months. Hence, the first two months of the working programme

have already been audited. The other 10 months will be covered during the audit of the current financial

year 2010. Numbers presented in this report should therefore be considered as provisional until the

final audit report has been submitted (provisionally scheduled for February 2011, i.e. M12+2).

Section 7.1 gives an overview of the money currently spent compared to the sum budgeted under the

specific titles. The second section provides an overview of staff days spent on implementing the work

programme, while the third part goes into detail of the money spent on administrative expenditures and

the costs of implementing the work programme.

7.1. Overview of the EHMA FY2010 budget

This section provides an overall view of the EHMA FY2010 budget and expenditures made so far. The

overall expectancy is that at the end of the year actual expenditures will be partially covered by the FY

2010 Operating Grant.

As the table below shows, expenditures on staff and general administrative expenditure promise to be

much higher than the contribution of the operating grant. The expectancy is that adjustments will be

made in the second half of the programme and transfers will be made between the different budget

titles. However, it is not likely that these changes will surpass the 20% receiving line and therefore will

not require any official amendments of the budgetary annex. Although expenditures under the title

‘Expenditure linked to the Beneficiary’s normal operations’ are not very high, the bulk of the costs will

be made in the second half of the duration of the operating grant.

BUDGET CURRENT EXPENDITURES/INCOME LINKED

TO THE OG’S TITLES

Title

Expenditure title 1

Staff 58.590,00 66.612,86

Expenditure title 2

General Administrative Expenditure 7.630,00 20.452,96

Expenditure Expenditure linked to the Beneficiary’s normal 50.850,00 35.016,35


title 3 operations

Total Expenditure 117.070,00 122.082,17

Income title 1 Operating income 47.070,00 101.985,00

Income title 2 Beneficiary’s own contribution 0,00 0,00

Income title 3 EC contribution (received pre financing) 70.000,00 21.000,00

Income title 4 Other external contributions 0,00 0,00

Total income 117.070,00 122.985,00

7.2. Staff costs

Time spent by the EHMA staff has been recorded in time sheets. By using time sheets a fair overview of

effort spent on the implementation of the work programme can be provided, while double charging

with other projects is evaded. The total number of days and the expected days involved in the

implementation can be found in the table below.

Please notice that both the functions of Events and Network manager have largely been covered by Ms.

Annemie Coeme (EHMA’s Policy officer), who is full-time engaged with OG 2010 activities. Additional

support for these two functions has been provided by Ms. Sonia Bowen and Hilde Bilgic (EHMA’s office

managers) and for this reason they have been included in the implementation of the work programme.

This is the result of internal developments within the EHMA staff structure since the Operating Grant bid

was accepted and might result in minor changes in the total number of days to be claimed in 2010 (to be

confirmed in the final report).

EHMA Deputy Director Elisabeth Jelfs spent already 63 staff days on Operating Grant related activities.

In order to ensure that the value of the project will be maximized EHMA would like to increase the

number of days to 120. It should be noted that Ms. Jelfs, who is linked to EHMA as an associate (i.e.

interim staff) for legal reasons, has not provided all her invoices yet for M1-6. As a result, costs linked to

Elisabeth Jelfs included in this report might be not representative of the actual effort put in. Revised and

final numbers will be available in the final financial report due in M12+2.


FUNCTION NAME ACTUAL DAYS

INVOLVED JANUARI – JUNE

ACTUAL STAFF COSTS1 EXPECTED NO. OF DAYS TO BE CLAIMED IN 2010

Director Jeni Bremner 15 11.250,00 17

Deputy Director Elisabeth Jelfs 75 10.810,11

(22.500) 110

Network/ Events Manager Annemie Coeme 108 19.903,53 200

Events / Office Manager Sonia Bowen/ Hilde Bilgic

45 24.649,22 90

7.3. Expenditures linked to administrative expenditures and the Beneficiary’s normal

operations

This section elaborates the general administrative expenditures. The available budget is compared with

the money currently spent on each of the titles. As a result it becomes clear that the Operating Grant

partially supports EHMA general expenditures.

Title 2 BUDGETED BY OG FY2010 CURRENTLY SPENT (M1-6)

212 Rent and charges of offices 4.300,00 23.703,45

219 Other building and associated costs 240,00 1.760,75

TOTAL BUILDING AND ASSOCIATED COSTS 4.540,00 25.464,20

Chapter 23

233 User support 275,00 1.047,69

239 Other telecommunication and computer costs 45,00 149,59

TOTAL TELECOMMUNICATION AND COMPUTER COSTS 320,00 1.197,28

Chapter 24

241 Office supplies 340,00 1.890,46

TOTAL ORDINARY ADMINISTRATIVE EXPENDITURES 340,00 1.890,46

1 As she is involved in multiple projects and avoid any risk of double charging, EHMA Director Jeni Bremner staff

costs are calculated by multiplying the staff days spent in the period 1 January 2010 – 30 June 2010 with her daily rate. As full time Events and Network manager of this operating Grant, Annemie Coeme’s actual staff expenditures are used. Please note Deputy Director Elisabeth Jelfs has not provided all of her invoices yet (though time records exist), which results in lower actual expenditures than expected actual costs in the period 1 January 2010 – 30 June 2010. Therefore a fair indication has been given in brackets by multiplying her daily rate with the number of days spent on the Operating Grant activities so far.


Chapter 27

272 Telephone, fax, internet and email 280,00 4.050,15

TOTAL ADMINSTRATIVE COSTS 280,00 4.050,15

Chapter 28

281 Accounting fees 1.320,00 907,50

282 Audit fees 830,00 0,00

TOTAL EXTERNAL SERVICES 2.150,00 907,50

TOTAL ADMINISTRATIVE EXPENDITURE 7.630,00 33.509,59

The work programme contains a wide range of meetings, conferences and workshops in line with

EHMA’s core principles. Current expenditures only relate to the third TCN meeting deliverable 6). Future

expenditures will relate to deliverables 1 (Collaboration Mechanism), 2 (EMHN meeting), 4 (Cross border

healthcare feasibility meeting) and 7 (CEOs meeting). Although expenditures are relatively low, the

majority of events will take place in the second half of 2010. This will result in an increase of

expenditures in those budget lines.

EHMA’s travel policy is based on both the reimbursement of travel costs and daily allowances (per

diems). Daily allowances were introduced to control costs while travel costs are only reimbursed when

the most economical option is chosen. In EHMA’s accounts both numbers are integrated – in other

words ‘travel costs’ consists of both the cost of travelling and the daily allowances. For an overview of

EHMA’s travel costs (both staff and external invitees) please consult annex 2.

Title 3 COVERED BY OG FY2010 ACTUAL EXPENDITURE

311 Meetings, conferences, workshops 12.000,00 1.842,60

TOTAL MEETINGS, CONFERENCES, WORKSHOPS 12.000,00 1.842,60

Chapter 32

321 Travel costs of staff 7.500,00 3.027,18

322 Subsistence allowances of staff 2 7.000,00

323 Travel costs of external invitees 9.000,00 2.404,72

324 Subsistence allowances of external invitees 9.000,00

TOTAL MISSION COSTS 32.500,00 5.431,90

Chapter 35

351 Studies, Consultancy, Translation & Interpretation and other

6.350,00 27.741,85

TOTAL EXPENDITURE LINKED TO THE BENEFICIARY’S NORMAL OPERATIONS

50.850,00 35.016,35

2 For a full overview of staff costs please consult Annex 2


7.4 Income

The costs for implementing the operating grant are covered by both EHMA’s membership contribution

and an EC contribution (€70.000). Based on membership invoices/numbers for 2010, EHMA projects a

total income from membership subscriptions of EUR 144.072,50.

At the end of June 2010, transfers of a total amount of EUR 101.985,00 have been received for 2010.

The outstanding amount from unpaid invoices for 2010 membership is at approximately EUR 42.087,50.

Chapter 11

CONTRIBUTION TO OG FY2010 RECEIVED

111 Membership contributions 47.070,00 101.985,00

At the same time, it should be noted that EHMA has received a pre-financing from the European

Commission of EUR 21.000,00, i.e. 30% of the total EC contribution. It is expected that following

acceptance of this interim report, a second instalment of approximately EUR 28.000 will be paid by the

Commission.

A request for payment of the balance together with the final report will be submitted 2 months

following completion of the Operating Grant (M12+2) and will also be accompanied by an external audit

report for 2010.

operating grant title european health management

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