European Reference Networks


Imagine if the best specialists from across Europe could join their efforts to tackle complex or rare medical conditions that require highly specialised healthcare and a concentration of knowledge and resources. That's the purpose of the European Reference Networks and it's becoming a reality.

Health systems in the European Union seek to provide high-quality, cost-effective care. This is particularly difficult in the case of conditions requiring a concentration of resources or expertise, and even more so with rare or low-prevalence complex diseases or conditions.

EU healthcare policy has furthered cooperation between EU countries, including networking. Some networks benefit from the EU's public health  and research programmes, especially in the areas of rare diseases , paediatric cancer and neurological complex diseases.

Such cooperation has been based mainly on bilateral agreements or joint projects in specific fields. Moreover, healthcare access varies widely across the EU. More efficient and coordinated sharing of resources and expertise was thus needed, and can be achieved through the creation of European Reference Networks (ERNs). Read more…

Legal background

  • Directive 2011/24/EU  on patients’ rights in cross-border healthcare;
  • Commission delegated decision  (annex) listing the criteria and conditions that healthcare providers and the ERNs should fulfil;
  • Commission implementing decision  (annex) containing criteria for establishing and evaluating ERNs, including the exchange and dissemination of information about the ERNs.

Networks implementation

The Directive on the application of patients' rights in cross-border healthcare requires the European Commission to support Member States in the development of European Reference Networks (ERN) and the Commission Implementing Decision establishes the process and criteria for setting the complete lifecycle of the Networks  from the call for proposals to the assessment, establishment and evaluation.

The Board of Member States

The Board of Member states  is the formal body in charge of the approval and termination of  Networks and  memberships as provided in the Commission Implementing Decision. The Board is constituted by representatives of the 28 EU Members States and the EEA countries. 

ERNs & centres of expertise

Several EU countries already have national models and systems  for identifying and designating highly specialised healthcare providers as centres of expertise or reference. This enables them to concentrate expertise and patient numbers in one place to tackle rare or complex diseases and conditions more effectively.

ERNs - projects & activities

The EU has funded pilot networks and projects  focusing on groups of rare, low-prevalence or complex diseases. A number of studies have been, or are being conducted on ERNs and the provision of highly specialised care.