Quality of care in an era of global challenges: a transformational vision for WHO European Region and beyond.

Health systems today face overlapping pressures-from demographic shifts, workforce shortages, climate change, and geopolitical and economic instability. This strains their ability to deliver effective and equitable care and erodes public trust. Traditional approaches to quality of care, often focused on service volumes or process compliance, are proving insufficient to address these system-wide challenges. In response, this paper proposes a transformational vision for quality of care that moves beyond traditional models. This vision is rooted in two interconnected pillars. First, a focus on outcomes that truly matter to people and populations, prioritizing health and well-being over service volume. The second pillar is a whole-systems perspective that embeds quality across all levels of governance, policy, and financing. This transformation is made possible through three key enablers. First, an empowered workforce and accountable leadership are needed to drive change. Second, data must be used transparently to build trust and guide results-focused work. Finally, innovative solutions and tools must enhance quality and be aligned with equity. Drawing on practical implementation examples, this paper outlines a roadmap for system-wide alignment of health systems-to rebuild trust, improve resource use, and advance health equity. This makes quality a lasting foundation for resilient, sustainable, and equitable healthcare.