Exploring National Support Mechanisms for European Reference Network Centres
Vojtěch Šimka1, Jana Jedličková1, Nela Navrátilová1
1Centre for Paediatric Rheumatology and Autoinflammatory Diseases ERN-RITA, Department of Paediatrics and Inherited Metabolic Disorders, General University Hospital and 1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
European Journal of Medical Genetics
|August 7, 2026
Summary
Integrating European Reference Networks (ERNs) into national health systems requires addressing inconsistent support. Enhancing national recognition, funding, and staffing is vital for sustainable rare disease care.
Area of Science:
- Health Policy
- Rare Disease Management
- Healthcare Systems Integration
Background:
- European Reference Networks (ERNs) are essential for rare disease care.
- Integrating ERNs into national health systems faces significant challenges.
- Inconsistent national support structures hinder ERN effectiveness.
Purpose of the Study:
- To evaluate national support structures for ERN centres across six key domains.
- To identify barriers and facilitators for embedding ERNs into national healthcare systems.
- To inform policy recommendations for strengthening ERN integration.
Main Methods:
- A multi-stakeholder survey was conducted between 2024-2025.
- Participants included ERN clinical centre leads, hospital administrators, and national health authorities.
- The survey assessed support across staffing, education, recognition, funding, quality assurance, and strategic planning.
Main Results:
- Inconsistent legal frameworks and major staffing deficits were identified.
- Dedicated funding for ERN activities and strategic planning for rare disease networks were limited.
- Institutional support for quality assurance and continuing education was low, impacting sustainability.
Conclusions:
- Formal policy recognition, consistent funding, and stronger institutional backing are crucial.
- Structured support mechanisms are needed to address workforce and quality gaps.
- Long-term sustainability of collaborative rare disease networks depends on addressing these systemic issues.


