How paediatric primary care is organised across Europe has changed substantially over the past decade. A new EAP-led study published in Acta Paediatrica provides the most comprehensive comparative overview to date, examining how children and adolescents access primary care in 42 European countries and how these systems have evolved since 2010.
One of the most striking findings is the growing move away from exclusively paediatrician-led or GP-led systems. The study shows that 45.2% of countries now operate mixed models, where both paediatricians and general practitioners/family doctors provide primary care to children. This represents a significant shift compared with earlier surveys, with 28.6% of comparable countries having restructured their primary care model between 2010 and 2024.
For clinicians, this trend raises important questions about role definition, continuity of care, and how responsibilities are shared between providers with different training backgrounds.
A key concern highlighted by the study is the mismatch between clinical responsibility and paediatric training, particularly for GPs and family doctors involved in child health care. While some countries require several months of paediatric training, others mandate only 1–3 months, and in a small number of cases no paediatric training at all is required for providers delivering routine care to children.
This variation is especially relevant in mixed-care systems, where children may be seen by clinicians with very different levels of paediatric expertise depending on age, location, or service structure.
Across Europe, the study identifies a consistent gap in adolescent primary care. As children grow older, paediatric involvement decreases and care shifts increasingly to general practice. In some countries, routine preventive visits for adolescents are limited or absent altogether.
For paediatricians, this finding reinforces long-standing concerns about continuity, preventive care, and the transition from child- to adult-oriented health services, particularly for adolescents with chronic conditions or complex needs.
Despite widespread digitalisation of health systems, only 35.9% of countries reported fully interoperable electronic health records across primary care settings.
Limited interoperability continues to hinder continuity of care, information sharing, and coordinated follow-up, an issue felt directly in day-to-day clinical practice.
This study does more than describe system differences. It provides a shared evidence base for discussions on training standards, workforce planning, adolescent care, and digital health, at national and European level.
For the European Academy of Paediatrics, the findings support ongoing work on:
strengthening paediatric input into primary care systems,
aligning training requirements with clinical responsibilities,
and advocating for improved adolescent-focused services.
For individual paediatricians, the data offer context for challenges encountered in practice and a clearer picture of how colleagues across Europe are navigating similar issues within very different systems.
New ways to test high-risk medical devices.
Manufacturers of medical devices need to test their products before being allowed to market them. Specifically, they require clinical data showing their medical device is safe and efficient. In this context, the EU-funded CORE-MD project will translate expert scientific and clinical evidence on study designs for evaluating high-risk medical devices into advice for EU regulators. The project will propose how new trial designs can contribute and suggest ways to aggregate real-world data from medical device registries.
It will also conduct multidisciplinary workshops to propose a hierarchy of levels of evidence from clinical investigations, as well as educational and training objectives for all stakeholders, to build expertise in regulatory science in Europe. CORE–MD will translate expert scientific and clinical evidence on study designs for evaluating high-risk medical devices into advice for EU regulators, to achieve an appropriate balance between innovation, safety, and effectiveness. A unique collaboration between medical associations, regulatory agencies, notified bodies, academic institutions, patients’ groups, and health technology assessment agencies, will systematically review methodologies for the clinical investigation of high-risk medical devices, recommend how new trial designs can contribute, and advise on methods for aggregating real-world data from medical device registries with experience from clinical practice The consortium is led by the European Society of Cardiology and the European Federation of National Associations of Orthopaedics and Traumatology, and involves all 33 specialist medical associations that are members of the Biomedical Alliance in Europe.
