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Pan-European Leadership Academy: Tier 3

Concept note

1. Background and context

The overarching goal of the Pan-European Leadership Academy (ELA) is to support Member States in achieving the goals and objectives of the current European Programme of Work 2020-2025: United Action for Better Health. World Health Organization. Regional Office for Europe (EPW). This includes aiding national health systems in preparing for potential risks and emergencies and ensuring the delivery of universal health coverage so that no one is left behind. In alignment with this overarching goal, this iteration of the ELA Tier 3 reflects insights gained from ELA Tiers 1 and 2 demonstration projects, evolving societal needs, and an understanding of the day-to-day realities faced by high-level public health officials, like general directors from European health ministries, and chief medical officers (CMOs).

2. About ELA Tier 3

ELA is envisioned as having a dual role, firstly supporting high-level public health officials and CMOs interested in implementing transformative change in their health systems, recognizing the significance of both strategic work and the day-to-day realities that can impact capacity and focus. These realities may include unforeseen events, such as new ministerial priorities or media reports, which demand immediate attention but also provide opportunities to leverage urgent matters for advancing strategic goals.

ELA aims to create a safe space for peer-to-peer discussions, sharing experiences and building the collective knowledge capital supported by WHO Regional Office for Europe technical experts as well as external experts. The academy recognizes the need for key decision-makers to possess a full range of transversal skills – including communication, crisis/risk management, time management and prioritization – to effectively manage daily pressures and sustain focus on long-term strategic objectives. By fostering these skills, ELA provides support to high-level decision-makers in navigating the complexities of their roles, particularly in the context of health system transformation and leadership during health crises.

ELA Tier 3 will support the development of high-profile educational and training initiatives in the field of health leadership. Building on previous initiatives, ELA Tier 3 will engage distinguished figures known as "transformers": experts selected for their extensive experience in leadership with a specific focus on the "how" that is, the practical aspects of implementing health system reforms, and the "what" which involves defining technical objectives.

Furthermore, leveraging the experience of existing European training initiatives, ELA will coordinate the creation of tailored courses to support capacity building for senior leaders in health systems transformation, with an emphasis on "upstream effectiveness": the ability to operate effectively outside traditional health-care systems in broader policy arenas, such as climate change, emergency response and One Health.

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Guiding principles

ELA will provide structured support by:

 creating a “safe space” for discussions and knowledge sharing:

o to facilitate the exchange of experiences among high-level public health officials and CMOs, and with seasoned health systems transformers on approaches, processes and challenges in health system transformation, with a focus on leadership during health crises and health system transformation;

 identifying specific skills and expertise:

o to help health leaders navigate complex situations and to provide opportunities for skills development; and

 stimulating exchange and mutual learning on how to confront particularly challenging leadership

scenarios: o identifying key scenarios in health system transformation and facilitating in-depth knowledge sharing

with leading experts in these areas – topics may include human resources for health, addressing noncommunicable diseases, transforming health care, leadership in health crises and more.

Other than as a convening body, it is not envisaged that the WHO Regional Office for Europe will have any individual contractual agreements with the participants of ELA Tier 3.

Objectives The primary objectives of ELA Tier 3 are:

 to reinforce leadership skills among high-level public health officials (targeting general directors of health ministries) and CMOs:

o empowering these key decision-makers with advanced leadership skills, particularly in navigating the day-to-day pressures and leveraging them to advance strategic health objectives;

o enhancing their ability to lead, make informed decisions and navigate the complexities of modern health environments;

o by equipping these leaders with robust leadership capabilities, ELA aims to ensure that health policies and strategies are effectively implemented to achieve optimal outcomes;

 to support strategy skills in European countries:

o a critical objective of ELA is to promote strategic thinking and planning skills among health leaders,

o this includes training in the development and execution of comprehensive health strategies that address both current and future challenges;

o by fostering a strategic mindset, ELA helps ensure that health systems are resilient, adaptable and capable of delivering high-quality care to all citizens; and

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 to promote collaboration among different countries to share good practices:

o ELA emphasizes international collaboration to share best practices, innovative solutions and successful initiatives, facilitating a collective approach to problem-solving;

o this collaborative effort aims to harmonize health-care standards, reduce disparities and drive continuous improvement in health delivery across Europe.

Structure The organizational structure of the ELA will comprise several key governing bodies:

 Academy Directorate: o the leadership of ELA will be entrusted to Professor Walter Ricciardi, School of Public Health of

Università Cattolica del Sacro Cuore (USCSC), Rome, Italy in coordination with a co-Director: Dr Hans Henri P. Kluge, WHO Regional Director for Europe;

o the Directorate will set strategic direction, oversee the implementation of initiatives and programmes and represent the ELA Tier 3 programme in external affairs;

o the Directorate ensures that the Tier 3 goals as set out above are achieved and maintains overall responsibility for its administration and governance;

 Steering Committee:

o this body will coordinate scientific directions, approve training activities and periodically assess progress;

o the Committee provides strategic guidance, ensures alignment with the mission of the WHO/WHO Regional Office for Europe, oversees major initiatives, and evaluates the impact of the programme;

o the Steering Committee will include high-ranking officials from the WHO Regional Office for Europe, former health ministers, and individuals with proven leadership roles in public health.

o The proposed composition of the Steering Committee is:  Bertrand Draguez - CMO of Belgium  Tony Holohan – former CMO of Ireland  Hans Henri P Kluge  Paolo Parente.  Walter Ricciardi

 Tier 3 Secretariat:

o the Secretariat will be supported by the School of Public Health of Università Cattolica del Sacro Cuore, and will play a crucial technical and operational support role for ELA activities;

o the Secretariat will be also responsible for coordinating communications, organizing meetings and events, and ensuring the smooth functioning of daily operations;

o the Secretariat's composition is as follows:  Carlo Favaretti  Maria Rosaria Gualano

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 Tommaso Osti  Paolo Parente  WHO Regional Office for Europe’s ELA Secretariat.

Together, these bodies will ensure that ELA Tier 3 functions effectively and achieves its mission of supporting Member States in reaching the goals and objectives of the European Programme of Work.

Tier 3 implementation The following points give an overview of the ELA Tier 3 activities.

 ELA’s activities will commence in the fourth quarter of 2024 with an information-gathering online event. The webinar will serve as an introduction to this Concept Paper and ELA Tier 3 activities, and as a promotion for future initiatives.

 In the first quarter of 2025 an in-person event will be held to allow for networking between participants and the determination of shared learning and exchange needs. The testimonies of several "transformers" will serve as a source of inspiration for discussions on health systems and for identifying specific critical skills (both technical and managerial) to be explored in subsequent activities and to determine key scenarios in which these can be applied and those which the group wishes to have in-depth discussions.

 Based on the crucial elements identified during the kickoff phase, the secretariat will facilitate several virtual skills building sessions and organize a second in-person event in which participants can meet with seasoned experts to explore specific scenarios, such as “leadership in health crises” and “leading health system transformation”.

 At the end of the cycle, a third online meeting will be held to comprehensively reflect on previous interactions and foster the creation of an ongoing community of practice/network through the ELA platform.

The organization of these initiatives will be coordinated by the Steering Committee and the ELA Secretariat. supported by the School of Public Health team of Università Cattolica del Sacro Cuore, which will serve as the Technical and Operational Secretariat of ELA Tier 3 in coordination with the WHO Regional Office for Europe’ ELA focal point.

The following activities will be undertaken as part of the initial phases of ELA Tier 3:

 In October 2024, an initial meeting of the Steering Committee and the ELA Secretariat will be held to: o identify needs and opportunities for training, with careful consideration of how these needs will

be measured to ensure that subsequent activities address shared and commonly understood needs; o formulate a list of “transformers” to collaborate with during the development of the academy's

activities and a list high-level public health officials and CMOs to whom the training initiatives will be addressed – a call-out for the selection should take place prior to the 74th session of the WHO Regional Committee for Europe; and

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o form the Working Group for Mapping Educational Models for Leadership in Europe and beyond, to serve as the foundation for establishing the work programme for the launch meeting of ELA Tier 3 activities:

 the Working group will be coordinated by the Steering Committee and supported by the UCSC Secretariat;

 the same working group will be responsible for the development of the ELA quality and evaluation framework.

 “Transformers” (the experienced consultants in delivering leadership training courses) will be engaged to support the initial phases of ELA Tier 3. Invitations for participation in the first planned activities will also be sent out at the same time.

 In December 2024 an information gathering online event will be held. The webinar will serve as an introduction to this Concept Paper and ELA Tier 3 activities and as a promotion for future initiatives.

 An in-person event for the launch of ELA scientific activities will be held in Copenhagen, Denmark in the first quarter of 2025 and will feature "transformers" sharing their expertise and insights, particularly in dealing with day-to-day realities and strategic opportunities in health leadership. During this event, the results of the information gathering event will be utilized to create an intensive 2-day programme aimed at capacity building.

 Online content and a series of webinars will be developed to further explore the issues, methodologies and experiences initiated at the ELA launch event.

 The second in-person meeting will be held in Rome in spring 2025 and will focus on the joint exploration of selected leadership scenarios, such as “leadership in health crises”, and/or “leading health system transformation”.

 The third ELA Tier 3 meeting will be held in the fourth quarter of 2025 and will focus on creating a community of practice/network of professionals through the ELA platform and ensuring its sustainability in the coming years.

These steps will ensure a robust foundation for ELA Tier 3, facilitating impactful leadership training and capacity building in health system transformation.

ELA Tier 3 organizational aspects

Duration of ELA Tier 3 Collaboration ELA Tier 3 will involve direct collaboration over a nine-month period, designed to facilitate intensive engagement and impactful interventions. This collaboration period will be further complemented by a long-term community of practice-style cooperation, ensuring sustained support and continuous professional development for participants. The long-term collaboration will enable participants to stay connected, share experiences, and access ongoing resources and expertise. Resource Requirements The successful implementation of ELA Tier 3 requires careful consideration of various resource needs including:

 travel costs and per-diem: o ELA will cover travel costs and per-diem expenses for Tier 3 experts who are supporting the

programme during in-person events; o participants will be responsible for their own travel expenses.

 meeting venue and catering:

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o adequate resources must be allocated for securing appropriate meeting venues and providing catering services, which includes ensuring that venues are equipped with necessary facilities and that catering meets the needs of all participants;

 remuneration of external experts, consultants and course directors: o ELA will provide remuneration to involve and retain high-quality external experts, consultants

and course directors; and

 dedicated support from the ELA Secretariat: o the ELA Secretariat will provide dedicated support to ensure the smooth operation of ELA Tier 3

activities including administrative support, coordination of events and addressing logistical challenges that may arise.

The Steering Committee will explore funding opportunities with key partners, including Belgium. Visas and Travel Logistics For in-person meetings that involve international travel, the ELA Secretariat will play a pivotal role in supporting participants with their travel arrangements. This includes:

 obtaining necessary documentation: o The Secretariat will assist participants in securing the required visas and travel documentation,

ensuring compliance with all relevant regulations;

 coordinating travel logistics: o the Secretariat will handle the coordination of travel logistics, including booking accommodation

and arranging transportation, to facilitate seamless participation; and

 ensuring smooth participation: o by managing logistical details, the ELA Secretariat ensures that participants can focus on their

engagement in the programme without the distraction of travel-related issues.

Evaluation

The evaluation of ELA Tier 3 will be aligned with the overall ELA quality and evaluation framework. This framework ensures that all educational interventions are assessed consistently, maintaining high standards of quality and effectiveness. As the Tier 3 concept is refined, specific evaluation strategies will be developed to measure its impact comprehensively. These strategies will include:

 clear objectives and outcomes:

o the evaluation will begin with the establishment of clear, measurable objectives and expected outcomes for Tier 3 interventions, providing a solid foundation for assessing whether the interventions achieve their intended goals. Formative and Summative Assessments: Both formative and summative assessments will be employed to evaluate Tier 3 interventions. Formative assessments will provide ongoing feedback during the implementation process, allowing for real-time adjustments and improvements. Summative assessments will measure the overall effectiveness of the interventions upon completion.

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 quantitative and qualitative methods: o a combination of quantitative and qualitative evaluation methods will be used to capture a

comprehensive picture of the intervention impact; o quantitative data will include metrics such as completion rates, participant performance scores

and measurable improvements in skills; o qualitative data will be gathered through interviews, focus groups, and surveys to capture

participants' experiences, perceptions, and the interventions' broader impacts on their professional practice;

 pre- and post-intervention analysis: o to determine the effectiveness of Tier 3 interventions, a pre- and post-intervention analysis will

be conducted involving the comparison of baseline data collected before the intervention with data collected after its implementation to assess changes and improvements;

 stakeholder feedback: o input from a diverse range of stakeholders, including participants, trainers and health-care

organizations, will be solicited and incorporated into the evaluation; o this feedback will provide valuable insights into the relevance, applicability and effectiveness of

the interventions; and  continuous improvement loop:

o the evaluation process will be iterative, with findings from each evaluation cycle used to inform and improve future iterations of Tier 3 interventions;

o this continuous improvement loop ensures that the interventions remain relevant, effective and aligned with the evolving needs of health-care leaders.

By integrating these evaluation strategies, the assessment of Tier 3 interventions will not only measure their immediate impact but also contribute to the ongoing enhancement of the ELA´s educational offerings.

Building sustainability for the future

Following the conclusion of the formal ELA Tier 3 period, sustainability of the programme will be supported by a community of practice fostered through the trust and networks established over the duration of the Tier 3 experience.

Proposed workplan The ELA has planned a series of meetings and initiatives to build a strong community of practice, identify training needs and enhance the competencies of high-level public health officials across European countries:

 first meeting: in-person – Copenhagen, Denmark, 26-27 February 2025:

o the initial meeting aims to foster the creation of a community of practice and determine capacity- building needs and opportunities;

 second meeting: in-person – Rome, Italy, spring 2025

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o the second meeting will span three days, with the areas of focus to be determined during the first meeting; and

 third meeting: online (to be confirmed):

o the third meeting will be held online with the goal of creating an implementation plan to ensure the sustainability of the community, network and the Academy in the coming years;

o this meeting could be with a much-reduced group.

Improvement areas The Academy will also focus on several key improvement areas:

 transversal skills: o enhancing communication, interpersonal approaches and emotional intelligence;

 health diplomacy: o strengthening skills in health diplomacy;

 technical knowledge and skills: o improving negotiation skills, interactions with other ministries and understanding the linkage

between health and finance, as well as developing robust health strategies; and  safe space:

o providing a secure environment to discuss, network and build an effective community of practice. These structured efforts aim to build a resilient network of health leaders equipped to address the dynamic challenges of modern health systems.

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First meeting of the governing bodies:

identification of the main areas of activities

Selection of high-level public health officials and

CMOs.

First meeting: Denmark, February 2025

Development of online content and a series of

webinars

Second meeting:

Italy, Spring 2025

Third meeting: online at the end of 2025

ELA Network

Engagement of a group of high-level

consultants/transformers

Mapping activity: Educational models for

leadership in Europe and beyond

ELA quality and evaluation fram

ew ork

ELA Platform

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Figure 1 - Tier 3 Programme development

Saatja: Pan European Leadership Academy <[email protected]>

Saadetud: 28.10.2024 16:09

Adressaat: <"Riina Sikkut">; <"Triin Uusberg">; <"Elen Ohov">

Koopia: Pan European Leadership Academy <[email protected]>; <=?utf-

8?Q?Helen_S=C3=B5ber?=>; <"Triin Uusberg">; <[email protected]>;

<[email protected]>; <[email protected]>;

<[email protected]>; KÖHLER, Kristina <[email protected]>

Teema: EST__Invitation to participate in the Pan-European Leadership

Academy: Tier 3, February 2025

Please see the attached correspondence sent from the World Health

Organization, Regional Office for Europe. One or more attachments may be

included.Veuillez- vous r¨¦f¨¦rer ¨¤ la correspondance ci-jointe du

Bureau r¨¦gional de l'Europe de l'Organisation mondiale de la sant¨¦. Une

ou plusieurs annexes peuvent ¨ºtre jointes.Mit der Bitte um Kenntnisnahme

der beiliegenden Korrespondenz (eine oder mehrere Anlagen),

Weltgesundheitsorganisation, Regionalb¨¹ro f¨¹r Europa.

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UN City, Marmorvej 51 Tel.: +45 45 33 70 00 Email: [email protected] DK-2100 Copenhagen Ø Denmark

Fax: +45 45 33 70 01 Website: https://www.who.int/europe

WORLD HEALTH ORGANIZATION ORGANISATION MONDIALE DE LA SANTÉ

WELTGESUNDHEITSORGANISATION ВСЕМИРНАЯ ОРГАНИЗАЦИЯ ЗДРАВООХРАНЕНИЯ

Date: 24 October 2024 Ms Riina Sikkut Minister of Health Ministry of Social Affairs Suur-Ameerika 1 10129 Tallinn Estonia

REGIONAL OFFICE FOR EUROPE BUREAU RÉGIONAL DE L’EUROPE

REGIONALBÜRO FÜR EUROPA ЕВРОПЕЙСКОЕ РЕГИОНАЛЬНОЕ БЮРО

Head office:

UN City, Marmorvej 51, DK-2100 Copenhagen Ø, Denmark

Tel.: +45 45 33 70 00; Fax: +45 45 33 70 01 Email: [email protected]

Website: https://www.who.int/europe

Our reference: Notre référence: Unser Zeichen: См. наш номер:

Your reference: Votre référence: Ihr Zeichen: На Ваш номер:

Dear Madam,

Invitation to participate in the Pan-European Leadership Academy: Tier 3

February 2025

Tier 3 of the Pan-European Leadership Academy (ELA) is a prestigious leadership development programme aimed at equipping senior health officials with the skills needed to address critical public health challenges. The programme focuses on enhancing leadership capabilities in health system transformation, crisis management and cross-sector collaboration, while fostering a peer-learning environment that encourages long-term collaboration and capacity building. I enclose for your kind information the concept note for ELA Tier 3.

In this regard, I am writing to formally nominate your country to participate in the upcoming launch of ELA Tier 3, which will take place on 26–27 February 2025, co-organized by the WHO Regional Office for Europe and the Università Cattolica del Sacro Cuore, Rome, Italy. Tier 3 is designed for Chief Medical Officers (CMOs), and officials of similar seniority across Europe including within the European Union, the European Economic Area, Switzerland and the United Kingdom.

The ELA event in February, held under the guidance of Professor Walter Ricciardi and myself, marks the formal launch of Tier 3 and will be a key opportunity to:

• strengthen leadership capacity: equipping senior health officials with the tools and skills to effectively lead and manage health crises and health system transformations simultaneously;

• engage in peer learning and networking: providing a “safe space” for open discussions, knowledge exchange and networking with peers from across the Region; and

• work towards collaborative solutions: engaging with senior public health figures and “transformers” who have successfully led health reforms, learning from their lived experiences.

The event will span a full day, with a working dinner the evening prior, and will include scenario- based discussions and practical training focused on real-world health leadership challenges.

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To support the preparations for the launch of Tier 3, we will be holding a virtual briefing in the morning of 6 December 2024. This session will provide an opportunity to elaborate on the specific offer of the Tier 3 programme and how it differs from other EU CMO networks and events. This briefing would ideally be attended by the CMOs themselves for them to gain a deeper understanding of the programme's unique value and to help ensure their full engagement.

We kindly request that you confirm the participation of your designated official by 18 November 2024.

We look forward to your country’s engagement in this transformative leadership programme and to collaborating on strengthening public health leadership across the Region.

Yours very truly,

Dr Hans Henri P. Kluge Regional Director Encls: Concept note: Pan-European Leadership Academy, Tier 3 Copy for information to: Ms Helen Sõber, Adviser, European Union Affairs and International Co-operation Department, Ministry of Social Affairs, Suur-Ameerika 1, 10122 Tallinn, Estonia Ms Triin Uusberg, Head, European Union Affairs and International Co-operation Department, Ministry of Social Affairs, Suur-Ameerika 1, 10129 Tallinn, Estonia H.E. Ms Riia Salsa-Audiffren, Ambassador Representative of the Republic of Estonia, Permanent Mission of the Republic of Estonia to the United Nations Office and other international organizations in Geneva, Chemin du Petit-Saconnex 28A, CH-1209 Genève, Switzerland H.E. Mr Andre Pung, Ambassador Extraordinary and Plenipotentiary, Embassy of the Republic of Estonia, Frederiksgade 19, 4th floor, 1265 Copenhagen K, Denmark Ms Kristina Köhler, Liaison Officer, WHO Country Office, Estonia, Paldiski Road 81, 10617 Tallinn, Estonia