Health professionals, researchers, patient organisations and policymakers gathered in Brussels on 21 & 22 November for the 4th European Reference Networks Conference. The well-attended and lively event featured two full days of presentations and debate, driven by plenary sessions and eight parallel workshops.

The event highlighted progress to date in establishing the networks and discussed challenges and opportunities that lie ahead as the ERNs develop. The networks now connect 900 healthcare units in 313 hospitals across 26 countries. More than 250 patients have directly benefited from virtual consultations by the network and this number is expected to grow.

The conference focused on the need to consolidate the networks and examined some of the challenges that lie ahead. One of the priorities for 2019 is the integration of ERNs into national health systems. The role of Member States and hospital managers will be central in this regard, and both parties were well represented at the event. Improving the geographic coverage of the networks was a recurring theme: the networks have very strong representation from high GDP countries but less participation among lower GDP Member States as the smaller population countries will, due to their size, see a smaller number of rare or highly complex cases. A new call for affiliated members may help to redress the balance.