6.I. Workshop: Assessing health system resilience to future shocks: a new tool for policy making
Authors:   Organised by: European Observatory on Health Systems and Policies, Organisation for Economic Co-operation and Development, European Commission,   Chair persons: Steve Thomas (Ireland), Jonathan Cylus (UK)
Published: October 2023

The COVID-19 pandemic has highlighted the importance of health system resilience, the ability of a health system to prepare for, manage and learn from a shock. Other recent adverse events, such as economic crises, conflict, migration and extreme weather have demonstrated how a wide range of shocks can challenge health systems. Health systems vary in their ability to respond to shocks and other challenges, mitigate adverse impacts, and learn from previous experience. While emergency preparedness and planning is a well established component of health system governance in many countries, no methodology currently exists to systematically test the resilience of a health system to a broad range of shocks. In this workshop, the European Observatory on Health Systems and Policies (OBS) and the Organization for Economic Cooperation and Development (OECD) share learnings from an ongoing project with the European Commission (EC) to help EU Member States assess and understand the resilience of their health system to a wide range of future shocks. The resilience testing methodology draws on two conceptual frameworks: the Health System Performance Assessment Framework for Universal Health Coverage (HSPA Framework for UHC) and the Shock Cycle. A specific shock scenario is chosen from a broad range of possible shocks to hypothetically challenge a given health system to its limits. This highlights key structural strengths and weaknesses of the health system. The country-led process culminates in a resilience test workshop that brings together policy makers, civil servants and other relevant experts. The test day is supported by an expert facilitator and research team, who provide background knowledge and structure the test day. Results of the resilience test include an understanding of the health system strengths and vulnerabilities specific to the shock. The test day may also anticipate spill-overs effects to other health system functions, and contribute towards a participatory approach to improve preparedness going forward.

The objectives of the workshop are to:

- present the new methodology for resilience testing;

- showcase country examples that have piloted the methodology;

- engage workshop participants in discussion towards a common approach to health system resilience strengthening.

The workshop consists of presentations (40 minutes) and audience interaction (20 minutes). The presentations will cover the methodology, pilot countries’ experience, and an EU view of the resilience testing process. The audience interaction will consist of moderated discussion with an element of a digital feedback and Q&A (if settings allow). Discussion will reflect on usability, potential adaptations to suit various national settings, and operationalisation for policy makers so that countries can prepare more systematically for future shocks and long-term challenges.

Key messages

• Resilience testing is a novel and systematic method to engage policy makers, understand health system vulnerabilities and identify weaknesses requiring action.

• Country-led pilots show that shock scenarios can be employed to reveal structural vulnerabilities, which can be addressed to enhance health system resilience.