The members of the ERN Board of Member States met in Brussels on the 15th November where they addressed different aspects related to the European Reference Networks' expansion, from the perspectives of both geographical coverage and disease scope Contributions from different external stakeholders or initiatives brought relevant elements forward for reflection on how the ERNs define themselves in a broader context.

Member States first discussed the ongoing process of geographical enlargement through the recent inclusion of Affiliated Partners and the new call for healthcare providers to join existing Networks that will close on the 30th November. The designation of Affiliated Partners increased the number of Member States with healthcare providers within each of all the different ERNs. With Affiliated Partners the number of Member States having access to all 24 Networks increased from 3 to 10. The overall coverage at European level from 44% to 74%. Affiliated Partners can either be "Associated National Centres" which establish the link with one Network or "National Coordination Hubs" which can establish links with several ERNs at the same time. They aim to overcome the geographical gap where no ERN member is present from a given country, to allow patients' physicians to access the ERNs’ expertise. The designation phase of Affiliated Partners was closed on the 30th of September. Related to the new call for full membership, Member States and the Commission exchanged views on how to properly assess and endorse the national healthcare providers, how to manage an extended ERN system in terms of sustainability and governance of the Networks, as well as national referral systems and national networks creation.

The Member States also addressed the disease coverage of the ERNs. Orphanet was invited to the Board meeting to present its theoretical analysis on the overlaps and complementarities across the ERNs, as well as identifying certain gaps. Most ERNs had also mapped their overlaps themselves. Orphanet is currently reviewing some Orphacodes and looking to integrate new diseases and to establish a link with other disease classifications with certain ERNs.

Several presentations also allowed participants to discuss the link between the ERNs and other fields of actions, highlighting the necessity of networking and coordinating with other levels of action. The co-chair of the eHealth Network was invited to present the main activities and role of the eHAction, the 3rd Join Action on eHealth. The ERNs are very interested in the work conducted by the eHealth Network on interoperability and continuity of care abroad, as well as on the effort done to include Orphacodes within the European Health Record exchange Format.

The report of the feasibility study of establishing a European Expert Network on rare communicable diseases in the context of mobility and globalisation was presented. The objective of the study was to analyse the different options to address the treatments of those diseases (the surveillance being done by the ECDC). The creation of a new ERN in the future was one of the options illustrated.

Recommendations of the Joint Action on Rare Cancers (JARC) were presented. Four ERNs addressing Cancer (ERN EURACAN, ERN PaedCan, ERN EuroBloodNet and ERN GENTURIS) were involved in the project and the scope of many other ERNs may eventually also include rare cancers.