Tallinn Charter 15th Anniversary Health Systems Conference, 12-13 December 2023

For the 2023 conference, it has produced a suite of five policy briefs in support of the key themes of trust and transformation. The key messages are collected in a summary document, while conference copies of the briefs are available for consultation before they will be revised and published in light of the conference discussions.

Trust

Trust is essential to health systems. The brief on trust shows how transparency, engagement with a wide range of stakeholders and effective communication support trust and help put a shared vision and values at the core of policy-making, strategy and practice.

From trust to transformation

Transformation cannot take place without trust and trust depends on transparency. It is essential that all stakeholders can see how a health system is performing, where its weaknesses are and how they are being (or might be) addressed.

• The HSPA brief shows policy-makers how to use the renewed global Health Systems Performance Assessment framework as a tool to identify weaknesses and test different policy options by working through plausible pathways from the roots of underperformance to impacts and goals.
• The brief on tracer indicators tests how selecting a small sub-set of HSPA policy relevant indicators and organizing metrics around real policy questions could transform the policy relevance of HSPA. It highlights the scope for collaborative work on data and a policy dashboard for a more useful HSPA.
  

Transformation

The Tallinn conference seeks ultimately to encourage transformation – transformation that includes and involves people, health and care workers, and decision-makers from health and other sectors in designing change so that health systems improve the health and the well-being of societies.

• The brief on financing for transformation recognizes the difficulties health policy-makers face making the case for health budgets and sets out the evidence that both efficient allocation of resources and more public spending on health are needed for transformation.

• The brief on transforming health service delivery shows how implementing real change needs policy leadership and vision as well as sufficient resources. It also demonstrates the importance of engaging stakeholders and of aligning governance mechanisms and resources at local level to facilitate change.
  

Together, the briefs support Tallinn conference calls for health system transformation through inclusive governance and co-creation, trust and transparency. The evidence they set out recognizes that health and stronger health systems are a political choice but offers health policy-makers conceptual framing, data and analysis to support their case. The briefs will help policy-makers ensure that health system transformation can be done and done well and will improve the health and well-being of European societies.