1. Helena Silfverhielm, Chair PPHS EG Arnoldas Jurgutis, ITA PPHS EG NDPHS EXPERT GROUP ON PRIMARY HEALTH AND PRISON HEALTH CARE SYSTEMS Activities to implement goal 5

2. Goal 5: Inequality in access to qualified primary health care in the ND area is reduced OT 1: Differences in the accessibility of qualified primary healthcare in countries of the ND region are assessed I 1: A report outlining the differences in the accessibility of qualified primary health care in partner countries and recommending further actions is developed. OT 2: Mechanisms for promoting an equitably distributed and good quality primary care, which corresponds to changing society health needs in the region, are defined. I 1: A jointly developed paper presenting population health care needs in the ND region is in place. I 2: A position paper on tomorrow’s role of primary health care professionals in the context of changing society needs is in place. I 3: Jointly developed conclusions for education and professional development of primary health care teams with particular attention to PHC nurses and patient empowerment are in place. I 4: Models of good practices in different countries are demonstrated and policy conclusions for dissemination are in place. OT 3: By 2013, the advantages of e-health technology are better known and appreciated by policy makers and healthcare professionals. I 1: Pilot project on tele- mentoring for career development of health professionals in remote primary health care. I 2: Pilot Project on tele- consultation for improved Professional cooperation and quality in remote primary health care. OT 4: By 2013 a review of policies and practices for primary health care services for migrants will be presented and disseminated to inform and mobilize ND States and other stakeholders on migrant health issues I 1: A report on policies and practices for primary health services for migrants developed and disseminated I 2: Consultations in/within the ND Region held and a workshop organized

3. Goal 5: Inequality in access to qualified primary health care in the ND area is reduced OT 1: Differences in the accessibility assessed I 1: A report on the differences in the accessibility Imprim reports: Funding Primary Health Care in the Baltic Sea Area (Joint Transnational Synthesis report for Imprim Countries) (Blekinge Competence Centre (Sweden) – developed Transnationally valid incentive payment scheme attracting health professionals to PHC and increasing performance of PHC particularly towards disease prevention and health promotion in the community (piloted in the framework of the project) - final in September 2012 Operational and tested system of evidence-based and recognized quality indicators for PHC performance (piloted in the framework of the project) (Klaipeda University, Latvian National Health Agency, Gomel Health Care Adminstration, Estonian MOH) – finalised in September, 2012 Future needs actualised during PPHS EG 4 th Febr 2012 Survey to assess accessibility to health services for exprisoners, migrants and other vulnerable population groups

4. Goal 5: Inequality in access to qualified primary health care in the ND area is reduced OT 2: Mechanisms for promoting primary care, which corresponds to changing society health needs I 1: Report on population health care needs in the ND region is in place. I 2: Policy document on tomorrow’s role of primary health care professionals in the context of changing society needs. I 3: Jointly developed conclusions for education and professional development of primary health care teams with particular attention to PHC nurses and patient empowerment are in place. I 4: Models of good practices in different countries are demonstrated and policy conclusions for dissemination are in place. Materials for policy document on Tomorrow’s Role of Primary Health Care Professionals have been collected since 2009 Developed project proposal planned to be submitted to NDPHS grant application to EC support through ENPI: Improvement of competences of PHC nurses and other PHC team members in community based health promotion, prevention and management of NCDs with particular focus on vulnerable population groups and patients with high comorbidity Contribution to ADPY-project on WP Development alcohol and drug prevention cooperation model.

5. Goal 5: Inequality in access to qualified primary health care in the ND area is reduced OT 2: Mechanisms for promoting primary care, which corresponds to changing society health needs I 1: A jointly developed paper presenting population health care needs in the ND region is in place. I 2: A position paper on tomorrow’s role of primary health care professionals in the context of changing society needs is in place. I 3: Conclusions for education and professional development of primary health care teams with particular attention to PHC nurses and patient empowerment are in place. I 4: Models of good practices in different countries are demonstrated and policy conclusions for dissemination are in place. Imprim reports: Strategy for professional development of primary health care professionals with particular attention to interaction between doctors and nurses and patient empowerment are in place. Final version October 2012 During PPHS EG 5 th Meeting in Stockholm September 12-13 th, agreed that it should partly cover Indicator 2 of OT2 on “Tomorrows role…”

6. Goal 5: Inequality in access to qualified primary health care in the ND area is reduced OT 2: Mechanisms for promoting primary care, which corresponds to changing society health needs I 1: A jointly developed paper presenting population health care needs in the ND region is in place. I 2: A position paper on tomorrow’s role of primary health care professionals in the context of changing society needs is in place. I 3: Jointly developed conclusions for education and professional development of primary health care teams with particular attention to PHC nurses and patient empowerment are in place. I 4: Models of good practices in different countries are demonstrated and policy conclusions for dissemination are in place. NDPHS project proposal to the DG REGIO: Subproject: Development of Transnational Policy Conclusions on Best Model Solutions for Local Hospitals to support High Quality Primary Care in the Baltic Sea Region Activities of this subproject have started in December 2011. Background material for a project proposal on the future role of local (district, rayon, etc.) hospitals as a structure covering the interface between primary health care and specialist care have been collected in Latvia, Lithuania, Finland, Russia and Belarus Broadening scope of the future project: TO ADDRESS THE COMPREHENSIVE RANGE OF SERVICES TO OLDER PEOPLE – TOWARDS A JOINT PROJECT ON INTEGRATED CARE

7. Goal 5: Inequality in access to qualified primary health care in the ND area is reduced OT 3: By 2013, the advantages of e-health technology are better known and appreciated by policy makers and healthcare professionals. I 1: Pilot project on tele- mentoring for career development of health professionals in remote primary health care. I 2: Pilot Project on tele- consultation for improved Professional cooperation and quality in remote primary health care. Activities of the Project PrimCare IT have started in the very end of 2011: The kick-of Meeting of the Project PrimCare IT was in Seinajoki (Finland) 22-23 February 2012 The Transnational Meeting of Project PrimCare will be in Karlskrona (Sweden) 24-27 April 2012 Every country has to present literature review on teleconsultations and telementoring eHealth acceptance conference 2012 Nov In Brussels, in panel Aigars Miezitis

8. Goal 5: Inequality in access to qualified primary health care in the ND area is reduced OT 4: By 2013 a review of policies and practices for primary health care services for migrants will be presented and disseminated to inform and mobilize ND States and other stakeholders. on migrant health issues I 1: A report on policies and practices for primary health services for migrants developed and disseminated I 2: Consultations in/within the ND Region held and a workshop organized Survey to explore existing gaps in ND countries should be performed: accessibility of health services to vulnerable population groups (migrants, ex-prisoners, unemployed, elderly ) appropriatness /existance of migrant sensitive /or appropriate health related services and policies Seed money needed