Improving health sector coordination for resilient healthcare systems: European lessons from the COVID-19 pandemic

Introduction The COVID-19 pandemic highlighted the importance of integrating the concepts of Public Health Emergency Preparedness (PHEP) and health system resilience, emphasizing the role of coordination across sectors, which is essential for ensuring that systems can respond effectively to public health threats and manage resources efficiently. This paper aims to summarize the lessons learned from the COVID-19 pandemic among European Union Member States, focusing on gaps and improvement areas within coordination of healthcare services. Methods The study analyzes the experience of Croatia, Finland, Germany, Italy, and Spain during the initial phase of the pandemic. These countries were selected for their diverse organizational structures and varying responses to COVID-19. The research involved literature reviews, analyses of pandemic preparedness plans, and interviews with national focal points and experts. Key areas of public health emergency capabilities were examined using the ECDC PHEP Logic Model, with a particular focus on coordination of health services. Results The analysis focused on four capabilities in the health services domain. Among them, coordination of population-based medicine emerged as a key element in integrating public health and primary care during pandemics and to ensure consistent and coherent response within the whole health system. Common challenges included organizational fragmentation and communication barriers, which hindered effective coordination across healthcare services. Conclusions The COVID-19 pandemic revealed, at national, regional and local levels, several gaps in coordination between hospitals, primary care, and public health services. At the same time, it provided lessons on measures that countries can implement to enhance public health emergency preparedness and thus resilience of health systems, for future health emergencies. By fostering collaboration between services and addressing systemic barriers, healthcare systems can enhance coordination and deliver high-quality, patient-centered care​. More than anything the pandemic underscored the importance of effective leadership and system adaptability strongly aligned with comprehensive emergency plans that clearly outline in advance tasks, responsibilities and procedures. Furthermore, creating effective communication channels and tools, can significantly improve information exchange between healthcare providers and emergency responders, ensuring timely and efficient responses to emerging health threats.