The Partnership for Health System Sustainability and Resilience (PHSSR) was launched in 2020 as a project based on a collaborative partnership among the London School of Economics (LSE), the World Economic Forum (WEF), and other partners in industry with the objective of reviewing health systems in each country in response to Coronavirus Disease 2019 (COVID-19).

As healthcare systems around the world struggle to respond to COVID-19, PHSSR is a collaborative effort that spans national and regional borders to link people like researchers, governments, and policymakers in each country to assess the capacity of health systems to respond to pandemics and similar health crises. After examining health systems in 21 countries, this initiative has compiled the reforms that will be necessary to build more resilient, sustainable health systems.

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Contents

Executive summary
1. Introduction
2. Domain 1: Governance
3. Domain 2: Financing
4. Domain 3: Workforce
5. Domain 4: Medicines and technology
6. Domain 5: Service delivery
7. Domain 6: Population health and health promotion
8. Domain 7: Environmental sustainability
9. Case Study 1: A health system that can realise social inclusion in which no individual is left behind
10. Case Study 2: A social system that supports positive health throughout the life course
11. Acknowledgements
12. References

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To reinforce the sustainability and resilience of the healthcare system in Japan, HGPI and our partners at Keio University have hosted repeated discussions to identify issues in past actions taken to respond to COVID-19, to look back on the domestic COVID-19 response, and to identify necessary steps for preparing for similar and more frequent health threats we may encounter in the future.

Under a vision for enhanced healthcare system resilience and sustainability through “Better Co-being,” we have worked to improve society to enable all people to pursue better well-being in their everyday lives while providing mutual support throughout society to achieve well-being for all.

A summary of our past activities is provided below.

 

■Establishment of the advisory board

When launching the PHSSR Japan project, we first assessed the sustainability and resilience of Japan’s healthcare system in terms of seven domains: governance, financing, workforce, medicine and technology, service delivery, population health, and environment. In October 2021, we established an advisory board that included experts in each domain from academia, civil society, Government, and the financial sector. They are listed below. Based on the opinions and information gathered from the board, we outlined the vision of the PHSSR Japan project and formulated a proposal for realizing it.

Advisory board (At time of establishment in October 2021) (Titles omitted)

Domain 1: Governance

Ryozo Nagai (President, Jichi Medical University)
Keizo Takemi (Member, House of Councillors)

Domain 2: Health system financing

Kazumasa Oguro (Professor, Faculty of Economics, Hosei University)

Domain 3: Workforce

Yasuhiro Suzuki (Advisor, Ministry of Health, Labour and Welfare)
Ikuko Toyoda (Chair of Connecting Patients and Families to Medical Care, NPO Kakehashi)

Domain 4: Medicine and technology

Shinsuke Muto (President, Tetsuyu Institute Medical Corporation; Chair, Integrity Healthcare)
Takuko Sawada (Vice President, Shionogi & Co., Ltd.)

Domain 5: Service delivery

Satoko Hotta (Professor, Graduate School of Health Management, Keio University)

Domain 6: Population health and health promotion

Reiko Hayashi (Deputy Director-General, National Institute of Population and Social Security Research)

Domain 7: Environmental sustainability

Masahiro Hashizume (Professor, Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo)

 

■Hosting a non-partisan Diet Member briefing on health policy

After conducting surveys and research in the seven domains we examined with PHSSR Project members and our advisory board and forming a vision for enhancing the sustainability and resilience of Japan’s healthcare system, on April 4, 2022, we hosted a briefing with Diet Members, who are the parties responsible for creating policy, to receive their input on that vision.

The knowledge and insights we obtained on the necessary policies for achieving the PHSSR Project vision were compiled in the PHSSR Project policy recommendations and utilized to develop its content.

■Hosting a public symposium and presenting our policy recommendations

In May 2022, we hosted a public symposium titled, “Creating a Health System to Withstand Future Crises: Next Steps Toward Enhancing Sustainability and Resilience,” where we discussed the reforms needed to further reinforce the sustainability and resilience of Japan’s healthcare system with experts from industry, Government, academia, and civil society. Specialists in health systems also shared lessons learned through actions taken to respond to the COVID-19 pandemic in Japan and overseas.

At the symposium, we broadly disseminated the recommendations formulated by the PHSSR Project and advocated for the importance of achieving its goals for the future of Japan’s healthcare system to an audience with great interest in health policy.

Our policy recommendations include the following items as the first three steps in building and reinforcing healthcare data infrastructure for enhancing the sustainability and resilience of Japan’s healthcare system.

1) Develop infrastructure to make data collection and analysis more beneficial for healthcare providers and patients.
2) Create a new organization to facilitate multi-stakeholder collaboration on data-based policymaking.
3) Make effective use of data and reconsider the structure of authority within the healthcare system during times of crisis.

 

■Related content

[Event Report] Future of the Healthcare System Project – The First Media Seminar and Workshop for Promoting Healthcare Reform: Understanding Circumstances and Issues in the Domestic Health Sector Today (October 31, 2022)