The emergencies across the border will be solved thanks to the legal framework that we have built together throughout these fifteen months. But we have discovered other border obstacles concerning the certification of diplomas, which is a recurring problem for French doctors who want to come work at the Puigcerdá Hospital (located in Spain). They need to wait up to 6 months to obtain their certification from the Spanish Ministry.

So we think this first project could allow us to open the door and put around the table several levels of competences. Together, we have to start to work on a large crossborder health project.

Concerning emergencies, we have reached our objective: seeing ambulances crossing french and spanish borders will be a reality in the next future.

Some lessons learned:

·       In this kind of cooperation, it is not just a matter of funding; it is a question of human will, patience, and perseverance. That being said, working under the EC umbrella was very helpful;

·       Sometimes, it is not necessary to reinvent the wheel as some initiatives may already exist. In fact, when we started, we discovered that this kind of agreements have already been put in place between France and Belgium and between the Alsace Region and two German Landers (Bade Wurtemberg and Rhenanie Palatinat). It was unknown to the health people who worked on the day-to-day business. This is typical when they have never been involved in a cooperation project. They need cooperation experts to help and support them;

·       Border obstacles are always known in the field by local actors and rarely at the regional and national levels. To solve obstacles efficiently, we need time to analyse them, the preparation phase is crucial and from there, a competent partnership and consistent project can be built. The phases of obstacle detection and project building are certainly the most important ones.