The European Commission launched the “2019 call for membership to the existing European Reference Networks (ERNs)” (https://ec.europa.eu/health/ern/consultations/2019_call_membership_en) with the aim to allow Healthcare Providers (HCPs) to join the already existing 24 ERNs, following the adoption of the Commission Implementing Decision (EU) 2019/1269 of 26 July 2019 amending Decision 2014/287/EU.

The application process consisted in the application and the self-assessment forms and included the following documents to be uploaded by the applicant HCP:

• Letter of endorsement from its National Authority;
• Declaration form signed by the CEO or Director of the Healthcare provider;
• Declaration form signed by the Representative of the Healthcare provider.

After the call ended, the evaluation process started and it consists in the following steps:
1. Eligibility check by the European Commission (up to 45 days)
2a. Assessment by the ERN Board of the Network to deliver an opinion (up to 90 days)
2b. In case of unfavourable opinion, the applicant will be allowed to reply and provide additional information (up to 30 days) and then the ERN Board of the Network will formulate the final opinion (up to 30 days)
3. Assessment by the Independent Assessment Body (nominated by EC) to deliver an assessment report (up to 180 days)
4. Final approval by the Board of the Member States (up to 60 days)

After the eligibility check by the European Commission, ERN BOND received a total of 28 application to be evaluated.
The ERN BOND Management Committee during the network midterm face-to-face meeting held in November 2019, elected the ERN BOND Steering Committee, plus 2 BOND ePAGs non-member of the committee as the Evaluation Board for the application assessment. Therefore, in the evaluation process will be applied all the governing rules of the Steering Committee already in place, including for instance the voting procedure in case of disagreement. In particular, a two-thirds majority of the Evaluation Board members is required for the opinion. Each board member counts for one vote.

The Evaluation Board will compile the form provided by the European Commission and express the favourable / unfavourable opinion to be uploaded within 90 days into the EC devoted platform. The applicant will be automatically notified through the EC platform.
HCPs applying for full membership are expected to actively contribute to the mission of ERN BOND, including availability of their medical staff to provide expertise to the CPMS panels and active participation into network activities.

The following criteria of the self-assessment form will be evaluated by the Evaluation Board, the same applied for current full membership:
• detailed self-assessment, with comments in all items;
• presence of supporting documentation (if applicable);
• caseload volume (paediatrics plus adults pts) above n. 150 patients/year, according to the EC scope, criteria and thresholds of the diseases https://ec.europa.eu/health/sites/health/files/ern/docs/specificcriteria_en.xlsx
• number of specialised rare disease groups and sub-groups
• number of diverse types of services covered