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Recommendations for future sustainable health-care services

The policy report is structured by five policy issues that were recognized as particularly important at the national workshops, with related policy options and recommendations (summarized in Table 7.2 below).

Technology is considered an important element in future health care by many actors, such as the EU and national or regional authorities all over Europe. The stakeholders involved in the PACITA project support this, but they stressed the importance of broadening the debate and to also look at social and organizational innovation.

Broadening the knowledge base for policy making

Societal challenges that involve new technology can often be perceived as complex and difficult to grasp. The experience from the PACITA project on ageing clearly shows that involving a broad group of stakeholders in discussions can help identifying opportunities, challenges and barriers related to the future of health care and the implementation of new technology. The stakeholders' hands-on knowledge and diverse areas of expertise provided important insights that would not necessarily have been identified by the homogenous expert groups traditionally involved in policy-making processes.

table 7.2 Policy recommendations produced by participating stakeholders

Involvement of carefully selected diverse stakeholder groups is also a way to make policy decisions more democratic, robust and socially acceptable. Involving relevant stakeholders in the process can give them ownership of the process and increases the chances for both adapted policy prescriptions and the development of relevant products actually meeting users' needs. This in turn can make implementation processes easier.

Cross-European stakeholder involvement

The method of scenario workshops has until now mainly been used in national contexts. Using the method in a cross-European manner proved challenging to some degree, but it was also beneficial to the project results and the embedded potential of the method.

In the preparation of the scenarios, it proved challenging to write scenarios that were both general enough to feel relevant for all participating countries and at the same time specific enough to provoke discussion.

Scenarios that are too general would not have contributed to the desired discussion, while making them too specific would have made it difficult to relate to the range of ethical and social dilemmas to be dealt with. But the cross-European approach proved to give significant added value compared with the more common alternative, which is a series of isolated, national debates taken without much synchronicity. The scenarios created discussion that had the same starting point but that moved in different directions based on national differences in experience, organization and financing of health-care services and national/regional culture, policy preferences and worldviews. The national reports describe dilemmas, barriers and solutions that are grounded in a specific national or regional context but that are highly relevant for policy makers all over Europe.

Realizing that all countries face the same challenge, learning from each other, exchanging experiences and identifying European examples of best practices are starting points for the future of knowledge-based policy making within and across Europe. The method of scenario workshops proved suitable to a cross-European context, and the format of separate national activities that were linked by taking the scenarios as a common starting point for discussion created a common frame for the dialogues which ensured the comparability of the results that were collected at the regional or national level. The PACITA workshops produced important insights for national and regional, as well as European, policy making. But it also highlighted the importance of independent and diverse policy advice, an opinion that was emphasized by all the involved participants. The coming together of stakeholders facilitates not only a knowledge exchange but also knowledge production for the future.

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