Plenary 2016 - Flash report
The ECIBC Plenary 2016 focused on the transfer of science into policy.
The ECIBC Plenary 2016 focused on the transfer of science into policy. Key points were the launch of the first four recommendations of the European guidelines for breast cancer screening and diagnosis (European Breast Guidelines) and the exchange and collection of feedback from countries on the possible implementation of the European Breast Guidelines and the voluntary European Quality Assurance scheme for Breast Cancer Services (European QA scheme).
Attended by over 150 participants, the 2016 ECIBC Plenary (in Varese, Italy) was an opportunity to proactively engage with and collect feedback and suggestions from breast cancer policymakers, national accreditation bodies, the scientific community, citizens and patient representatives on ECIBC projects and developments.
Day 1 – Science for policy development
The Plenary opened with welcome messages from JRC Deputy Director General Charlina Vitcheva and JRC Directorate F Director Elke Anklam. In a moving testimony, writer and breast cancer survivor Marja Aarnipuro then spoke of the fear she experienced upon diagnosis of breast cancer, and how a lack of information added to that fear. Her touching words, together with former MEP Zofija Mazej Kukovič’s account of how and why the request for evidence-based guidelines and cancer care performance measurement came to be part of the 2008 Council Conclusions, were appropriate reminders of the reasons for launching the ECIBC in 2013.
The opening was followed by the launch of the first four evidence-based recommendations from the European Breast Guidelines addressing whether breast cancer screening should be offered to women based on their age.
In tune with the scope of the first day (Science for Policy Development), Josep Figueras from the European Observatory on Health Systems and Policies advised the audience on strategies for the successful transfer of science into policy. Success requires systematic knowledge dissemination, including policy briefs and individual exchanges with policymakers and national stakeholders, going beyond the "usual suspects" involved in Commission projects.
Updates on the status of ECIBC projects then informed participants about the work in progress of the two nominated ECIBC working groups, the Guideline Development Group (GDG) and the Quality Assurance Development Group (QASDG). The next set of European Breast Guidelines recommendations is expected in February 2017, while the requirements and indicators for the European QA scheme will be finalised by 2018. The scheme is expected to be piloted later that year.
For the Guidelines Platform, which will bring together existing evidence-based guidelines on breast cancer treatment, the collection of documents – including those not publicly available – has been completed. External contractors are evaluating collected guidelines against rigorous criteria for evidence that would make them eligible for inclusion in the platform.
In the afternoon, implications of the European QA scheme operating within the context of the European legal framework on accreditation were explored in more depth. Breast cancer services seeking certification under the European QA scheme will be certified by conformity assessment/certification bodies that are accredited for this task by the respective national accreditation body under ISO 17065. Furthermore, testing activities (laboratories, pathologies and imaging services) related to these breast cancer services will need accreditation under ISO 15189 or equivalent standards. All other clinical processes in breast cancer care will be certified according to requirements currently under development within the QASDG. To highlight better what accreditation under ISO 15189 means, experts spoke of their experiences with this standard in Italy and the Netherlands.
Day 2 – Policy for science implementation
Moving from progress to eventual implementation, the second day was dedicated to countries' views on implementing the European Breast Guidelines and the European QA scheme. Countries had prepared posters on ECIBC implementability which were presented the first day, while presentations on breast cancer care and possibilities for ECIBC implementation were provided by Scotland, the Netherlands and Romania.
Participants were brought together around ‘country tables’. Twenty-seven countries were represented, out of the 35 participating in the initiative. Following dynamic discussions on how the recommendations and European QA scheme could fit with the health system and care arrangements within their country, each national delegation completed a questionnaire.
Not only did the ‘country tables’ provide the JRC with valuable feedback on the readiness of countries for implementation, but they also informed the JRC as to which additional national stakeholders could be approached (beyond the "usual suspects") to facilitate ECIBC implementation.
On the European Breast Guideline age-range recommendations published the previous day, some country tables reported potential issues for implementation, in particular for the 45-49 age group, but few saw real barriers. Comments ranged from calls for more awareness-raising on the recommendations, to a reminder that any changes would require a political decision. Some participants highlighted their countries’ current alignment with the recommendations, and emphasised their value as a useful basis for dialogue with policymakers.
Turning to the European QA scheme, most respondents were happy with the modules proposed. How the European legal framework for accreditation will be applied requires further explanation for some, and seven countries expressed doubts about their country’s readiness to adapt to the scheme. Most appreciated the fact that the European QA scheme will allow comparisons between EU countries, while some highlighted the extent of realignment that would be required in their country, and the resources that would be needed.
This feedback fed into a round table discussion that touched upon the voluntary nature of complying with the recommendations, and the need for balancing flexibility in applying the European QA scheme (on account of differences between health systems) with ensuring it provides for the highest possible quality of care for breast cancer patients around Europe. The discussion also addressed who should be contacted in order to ensure the European Breast Guidelines and the European QA scheme are considered – and eventually implemented – nationally.
The plenary was closed by Member of the European Parliament Alojz Peterle, President of ‘MEPs Against Cancer’ (MACs), who welcomed the meeting of minds between science and policy. Now that there is a basic and shared understanding of the relevance of the European Breast Guidelines and the European QA scheme, the next step is to create an even more favourable political context to ensure both are implemented, he said.
The next plenary will take place after the rollout of the European QA scheme. While the working groups behind both this and the European Breast Guidelines continue to formulate requirements and recommendations, the JRC will be speaking to representatives from each participating country and addressing incentives and barriers as agreed during 2016 ECIBC Plenary.