European Patients Forum (EPF) organised a major European conference on cross-border healthcare in Brussels, Belgium. Patient leaders from across the EU and National Contact Points (NCPs) met together to discuss on the implementation of the Directive. 
The patient discussions reveal that both patients and their representative organisations play a key role in ensuring the Directive effectively “works”. Health Commissioner Vytenis Andriukaitis points out that while a large number of Member States have done a good job of transposition but there are still some that need to improve. He highlighted certain barriers including elaborate systems of prior authorisation; lower reimbursement tariffs; or difficult administrative requirements.
(In)Equity of access
It became evident during the conferences that the implementation of the directive by the member states was still uneven. A major threat to equity of access are financial barriers because many patients are unable to afford cross-border healthcare as they are required to make upfront payments and have to cover other related costs such as travel. Member states and National Contact Points need to work proactively on solutions to alleviate the financial burden on patients.
Information, the keystone
The lack of of information also came up during the discussions. It was highlighted that the establishment of NCPs for information was patchy and patients were faced with ‘a labyrinth of confusing, insufficient or too detailed information. 
“Implementing the Directive requires all stakeholders to create a culture of transparency and cooperation where they disclose information specifically on how they operate; the availability and cost of care and its safety and quality. This will in turn help patients who are already vulnerable due to the ill health and so may not have the capacity to battle bureaucracy to make use of their rights” said EPF Secretary General Nicola Bedlington.
There was a call for EU-wide guidelines on how NCPs should provide information to patients and how efforts need to be made to ensure patients have the information that meets their needs so that they are able to make informed decisions about cross-border healthcare. "Information BY and FOR the patient” as pointed out by Sinisa Bosnjak, the Slovenian Contact Point during the event.
Transparency, the changer
Transparency, the theme of EPF major campaign for 2015, could play a major role in patient empowerment. It will allow patients to compare standards between different countries and patient organisations will be able to use this information to advocate for better quality healthcare, both at home and abroad.
The Direction has no definition of quality or safety and this is an area where patient organisations can play a very important role. 
“A space has emerged for patient organisations to inform patients of their rights and how to go about exercising them; but also to help improve the patient journey overall by working more closely with competent authorities and NCPs. Patient groups now have a clearer view of the intention behind the words of the Directive and are already taking action to even become unofficial contact points in France or Bulgaria for instance” concludes Ms. Bedlington.
Image Credit: European Source of Patients 

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European Patients Forum, EPF, Directive, Cross-Border Healthcare, Inequity of access, Transparency European Patients Forum (EPF) organised a major European conference on cross-border healthcare in Brussels, Belgium. Patient leaders from across the EU and National Contact Points (NCPs) met together to discuss on the implementation of the Directive.