Preventing hospitalisation in Europe: what needs to change?
16 September 2026
Every winter, European health systems face increased pressure as respiratory infections rise. Influenza, RSV and COVID-19 contribute to hospitalisations, ICU occupancy, workforce pressures and delays in care. But how much of this pressure could be avoided?
This question has been at the centre of a series of discussions convened by the EHMA and Sanofi since May 2026. Across two roundtables, clinicians, public health experts, researchers, patient representatives and health system stakeholders looked at the lessons from the latest winter season and, importantly, at what is already working in practice.
The starting point was clear: many of the tools to reduce avoidable hospitalisation already exist, but they are not reaching everyone who could benefit from them.
At the first roundtable in May, participants examined the 2025/26 winter season, and the burden respiratory infections continue to place on health systems. The discussion highlighted differences between countries and settings. Where immunisation is easily accessible, embedded into routine care and supported by appropriate coverage, health systems appeared better equipped to manage winter pressures and maintain continuity of care.
The discussion also challenged how respiratory infections are understood. Influenza, for example, is not simply a respiratory illness. Participants highlighted its links with cardiovascular events and functional decline, particularly among older adults. Prevention therefore needs to be considered as part of healthy ageing and health system resilience, rather than as a separate public health activity.
The second roundtable in July moved from the scale of the problem to a more practical question: what works?
Participants pointed to examples from across Europe. Pharmacy-based vaccination has improved access and uptake in several settings. Call-and-recall systems can help reach eligible populations. Primary care can integrate prevention into routine care. In France, an early-stage pilot at CHU Besançon is exploring vaccination reconciliation within a cardiology pathway. Portugal was also cited as an example of how family doctors, community connections, pharmacies and healthcare centres can work together to reach different groups.
These examples point to an important conclusion: the challenge is not simply a lack of evidence or potential solutions. It is making effective approaches part of the way health systems routinely work.
Participants identified structural barriers that can prevent successful approaches from being scaled, including procurement and reimbursement bottlenecks, fragmented governance, inconsistent vaccination pathways and limited data infrastructure. They also highlighted the need to plan across the full vaccination schedule rather than treating vaccines and disease areas separately.
Communication is another part of the challenge. Current campaigns can focus heavily on disease risk and may primarily reach people who are already willing to be vaccinated. Participants called for communication that connects prevention with what matters to people in everyday life such as staying independent, avoiding hospitalisation, remaining active and being there for family , at the same time remaining evidence-based and avoiding overstatement.
And prevention cannot sit with immunisation programmes alone. GPs, pharmacists, cardiologists, nurses, patient organisations, local authorities, social care providers, community leaders and other actors all have a role to play in reaching people who are currently underserved.
The discussions have therefore brought the series to a practical point: Europe already has approaches that can help prevent avoidable hospitalisations. The challenge is creating the conditions for these approaches to reach more people and be sustained at scale.
That will be the focus of the final event in the series, taking place on 13 October 2026 at the European Parliament. The recommendations emerging from the two roundtables will be brought to policymakers for discussion and validation, with the aim of translating the lessons from evidence and implementation into concrete policy action ahead of the next winter season.
The lessons have been gathered. The next step is to turn them into action.
Join us in October for the final discussion on preventing hospitalisation in Europe.
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I have been active in EHMA since the first years of the '90s and I have seen its evolution from a small association of members interested in sharing knowledge on health management practices to the current status of reference and advisory key player for EU, health systems and organisations, stakeholders associations, industry and universities. EHMA is now a unique knowledge hub, policy advisor, community of practice and network of best in class organisations involved in health policy and management. A place where health managers can build their competences, policy-makers and stakeholder associations envision how to implement and sustain change through health management, industry leaders understand how to engage more effectively with health organisations and systems. The right place to nurture and grow health management capabilities and capacity for every stakeholder of health systems.
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Prof Sandra C. Buttigieg, MD, University of Malta, Malta
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