While the need for integrating palliative care (PC) services into heart failure (HF) care has been well recognised, as of yet this integration lacks behind, especially when compared to cancer care. Currently, only 5-7% of patients with HF utilise PC services, due to a focus on optimising therapy and an unpredictable disease trajectory with exacerbations which hampers prognosis. As a result, many symptoms and concerns that are not directly related to HF are not recognised and undertreated and patients are often referred to PC services only at the very end of their lives. The RAPHAEL consortium sets out to take the next big step in integrating PC into HF care by integrating the RAPHAEL palliative care approach in existing HF care pathways. This flexible and patient centred approach starts with the identification of multidimensional symptoms and concerns, prioritise needs with patient and informal carer and formulate a proactive care plan. The symptoms and concerns will be monitored by the patient at home using the PAL@HEART application. The app can be used to evaluate interventions, support communication and earl identify new or increasing needs. As a result, the care needs of each individual patient with HF are addressed faster and better, improving their quality of life and autonomy. Moreover, this will lead to a reduction in emergency hospitalisations, unburdening the healthcare system and reducing costs. The RAPHAEL project sets out to adapt the RAPHAEL approach to HF care within a European context and test and validate its (cost-)effectiveness via a feasibility and large-scale evaluation study performed in 7 EU countries, the UK and Switzerland. It brings together experts in palliative care, cardiology, and primary care as well as professional organisations and patient representatives. Together the RAPHAEL consortium is uniquely situated to demonstrate the (cost-)effectiveness of the RAPAHEL approach and launch its implementation in Europe and beyond.

One of the lessons learnt from the Covid-19 pandemic is the importance of flexibility in funding and organization of health systems. European countries responded quickly to this extreme event, by expanding the amount of financial resources available for health care and reallocating financial and human resources. However, there are several other challenges for health care systems that require efficient and flexible financing mechanisms to be successfully addressed. This project undertakes a comprehensive analysis of health care financing mechanisms in Europe, by focusing on the two key stages of the process: i) budget allocation (e.g., among managing authorities, clinical areas), ii) financing of health services within a specific budget, through the definition of contracts and payment rules. We identify and examine the most prominent mechanisms underlying the relationship between the main challenges faced by health care systems (demand shocks, ageing, budget pressure) and their financing. By employing a wide range of methodological approaches, we provide evidence on the ability of existing financing mechanisms and contracts to address such challenges and study new solutions to achieve more effective, efficient and equitable health care systems.

PALLIAKID is an interdisciplinary project aiming to evaluate the feasibility, effectiveness, and cost-effectiveness of novel interventions for children, adolescents and young people (AYA) with palliative and end-of--life care needs in different healthcare systems across Europe, with a focus on those factors that influences the active patients' and family caregivers' engagement. PALLIAKID responds to several needs or gaps identified by the consortium clinical partners, grouped into three cornerstones of paediatric palliative care: 1) Early identification of children and AYAs with palliative and end-of-life care needs, 2) Comprehensive assessment of children and their family caregivers' needs, 3) A comprehensive, personalised, interdisciplinary care plan including Advance Care Planning. The proposed solution entails three main results: PALLIAKID Eary Detection System, PALLIAKID intervention (Needs assessment, Advance Care Planning and Patient Journey digital platform); and PALLIAKID XR-based capacity-building program for professionals. In addition, the project will develop policy recommendations, guidelines and standards for patient-centred communication, together with a scale-up strategy to guarantee the project result's’ sustainability and impact. In this sense, PALLIAKID aims to reduce taboos and misunderstandings of paediatric palliative care with its activities and the planned Public Engagement Strategy. The consortium is composed of 19 entities with the needed and complementary expertise and knowledge to respond to the proposed objectives, including the triad perspective (child-family-professional): five clinical sites to co-design and test the PALLIAKID solutions, two European networks, four experts in the needs assessment and ACP tools to be adapted (HexCom and IMPACT), three technological partners, one expert in evaluation, three experts in SSH and one expert in data and ethical issues.

It is clear that critical pandemic decisions need to link rapid, reliable testing with comprehensive modelling of potential impacts. Currently, Europe lacks a comprehensive One 1) A diagnostic point of care instrument (PANPOC) for rapid detection of respiratory RNA viruses with pandemic potential: Influenza A (human, avian and swine), influenza B and beta-CoV (SARS-CoV-2 variants and emerging beta-coronaviruses) (the Target Viruses). PANPOC will be validated by testing animal, environmental and clinical samples (one health approach). 2) A prognostic AI-based platform (PANRISK) to predict the spread of the Target Viruses and contribute to public health by giving an alarm once an outbreak exceeds a given threshold. The platform is based on a pathogen genomic drifting model to predict the risk of animal pathogens drifting to become human pathogens and an epidemiological model to predict geographical and temporal outbreaks of zoonoses. The portable PANPOC equipment will be validated and demonstrated at end-users: hospitals, General practitioners, competent veterinary authorities, health authorities, border controls, airports, refugee camps, etc. The aim of PANRISK is a syndromic surveillance framework for diseases, for targeting directed surveillance in concentrated periods of time and areas. The advantage of the PANRISK model is targeted towards zoonotic diseases, with high precision data that allows high precision in the surveillance for trends. The contribution of social sciences and humanities (SSH) is integral to the project. An SSH partner will focus on social and health inequities in the pandemic preparedness and aims to provide indications for the implementation of the PPP to support the involvement of stakeholders as well as public trust. A policy development partner will align the projects output to the key policy development and implementation processes within the EU. A dissemination and communication partner will ensure efficient communication, dissemination and engagement of the stakeholders.