Cross-border cooperation

HOPE has worked for many years on the topic of cross-border cooperation and identified and contributed to several activities in this field.

Co-operation in border areas has a positive impact on patients, providers, those who pay for health insurance and the whole healthcare system. The areas of cooperation are very diverse, involving local resources with the aim of better serving the needs of the local community, for example, emergencies, care, telemedicine, sharing of equipment, research, human resources, networking/sharing practice, funding or common structures.

Some of HOPE activities in recent years included a mapping exercise, organisation of conferences and participation in EU co-funded projects and tenders.

European Reference Networks (PACE-ERN)

ERNs aim to bring together the best specialists from across Europe to tackle complex or rare medical conditions that require highly specialised healthcare and a concentration of knowledge and resources. Under the Directive 2011/24/EU on the application of patients’ rights in cross‐border healthcare, the development of European Reference Networks (ERNs) was seen as a primordial area for cross‐border cooperation among Member‐States.

HOPE has been involved in the activities of the Partnership for Assessment of Clinical Excellence in European Reference Network (PACE-ERN), awarded to a consortium led by the European Organisation for Rare Diseases (EURORDIS).  PACE-ERN developed a manual and toolbox for assessing ERNs addressing all the stages of the process from the call for Networks and providers to the approval of the Networks. A first draft of such documents was presented at the second conference of ERNs which took place in Lisbon (Portugal) on 8 and 9 October 2015 and completed before the launch of the call in March 2016.

Additionally, HOPE regularly follows developments of the ERNs and reports about them to its members and its network.

Hospital Network for Care Across Borders in Europe

The EU co-founded project HoNCAB set up of a pilot network of hospitals, allowing members from different EU countries to share practical experiences, problems and solutions related to cross-border healthcare. The Hospital Network for Care Across Borders in Europe brings together a first pilot group of hospitals interested in the issue of cross-border healthcare and the European Hospital and Healthcare Federation (HOPE) as permanent secretariat, which ensures visibility and dissemination of Network’s activities at European level.

The participating hospitals share data but also good practices related to the management of patients crossing borders, which is key in order to adapt their activity to a future growing demand for cross-border healthcare services.

More information on the Network is available at


HOPE set up in 2001 a working party on cross-border cooperation to work on a mapping of all hospital projects in border regions. Two questionnaires were designed, one for individual hospitals, one for health authorities at a regional level. The replies were compiled in the paper “Hospital co-operation in border regions in Europe” published in June 2003.


HoNCAB Final Conference, 18 February 2016, Brussels (Belgium)
HoNCAB project Final Conference represented the opportunity to present project’s main results and discuss them with the audience, including policymakers and health stakeholders. During the event one of the project’s outcomes, the Hospital Network for Care Across Borders in Europe, was also launched.

Cross-Border Territories: Day-To-Day Europe, 8-9 November 2007, Lille (France)
This conference was co-organised by HOPE and the Mission Opérationnelle Transfrontalière (MOT) with the objective to discuss the political and operational issues of cross-border cooperation. The 12 workshops provided opportunities for topic-by-topic debates and share of projects, good practices, etc., leading to concrete proposals in the form of recommendations, which were collected early in 2008 in a white paper addressed to national and European institutions. The two plenary panel discussions showed that cross-border territories meet real needs, are an effective means of boosting Europe and must receive greater support from national and European authorities. More than 800 people from all European borders participated to the event.

Cross-Border Cooperation in Border Regions, 25 October 2005, Venice (Italy)
This workshop was co-organised by HOPE, Veneto Region and the Local Health Authority of Feltre (Italy), gathering participants representing local authorities and healthcare institutions involved in cross-border activities in border regions. The workshop presented best practices as well as obstacles faced in the concrete work of cross-border actors. All types of cooperation were presented from collection of medical data to organized mobility of patients.

An important part of the workshop was devoted to the work done on Italian borders (Italy-Austria, Italy-France). Experiences from other border regions such as the Republic of Ireland and Northern Ireland, one or the Euregio Meuse-Rhine (Germany, Belgium and the Netherlands) were presented as well as cooperation between Germany and Austria, Portugal and Spain. Finally, also the innovative first steps for a “cross-border hospital” on the Spanish (Catalan region) and France were described.

Free Movement and Cross-Border cooperation in Europe: Practical experiences in hospitals, June 2003, Luxembourg
During this workshop various areas of cooperation were discussed, e.g. emergencies, care, telemedicine, sharing of equipment, research, human resources, networking/sharing practice, funding or common structures. The event gathered a wide range of professionals – nurses, managers and doctors – from different European countries.

EU projects

Support creation of a pilot network of hospitals related to the payment of care for cross-border patients

Evaluation of cross border activities in the European Union

Solutions for improving health care cooperation in border regions

Mapping Health Services Access: National and Cross-border Issues

Europe for Patients

Methods of Assessing Response to Quality Improvement Strategies

EURopean wide Innovative Procurement of Health Innovation