Photo: In May 2024, the directors of the five hospitals signed the agreement to establish the Nordic University Hospital Alliance (NUHA). From left to right: Matti Bergendahl from Helsinki University Hospital, Bjørn Atle Lein Bjørnbeth from Oslo University Hospital, Rasmus Møgelvang from Rigshospitalet, Patrik Rossi from Karolinska University Hospital, and Runolfur Palsson from Landspítali – University Hospital, Reykjavik.

The combined population of 30 million people in the Nordic region is a significant leverage point that makes it easier to develop healthcare systems for the benefit of all patients. This is the Danish assessment following the establishment of the Nordic University Hospital Alliance (NUHA) in May 2024. In the first months, the focus has been on strengthening collaboration on clinical trials, increasing data sharing, and shaping leadership roles in the future that university hospitals are heading towards.

The alliance includes leading university hospitals in the capitals of Denmark, Sweden, Norway, Finland, and Iceland. The hospitals face challenges that transcend national borders, and all Nordic countries experience a demographic double pressure—where more elderly people require treatment while the workforce is shrinking, and demand for increasingly individualized and specialized treatments is growing.

According to Deputy Director Thomas Høi-Hansen from Rigshospitalet, there is good reason to explore the possibilities of connecting Nordic hospitals more closely.

"In many contexts, a population of 30 million provides a better foundation than Denmark's six million when it comes to developing our healthcare system and helping patients. In the first few months, we have discussed a range of Nordic collaboration projects, and I see great potential in identifying areas where thinking more collectively as a Nordic region will benefit patients," he says.

Thomas Høi-Hansen himself is part of a benchmarking group within NUHA, where they compare data from hospitals across a wide range of areas, such as cancer treatment and hip surgeries.

"We can use our benchmarking analysis as a mirror for our own organization—to assess how we are performing, how patient quality is progressing, and whether we are using resources efficiently," he explains.

A Nordic treatment community

According to Thomas Høi-Hansen, the hospital alliance aims to take advantage of the cultural cohesion and proximity of the Nordic countries, which makes it more manageable for patients to travel to a neighboring Nordic country rather than, for example, Belgium or the United States. For healthcare professionals, collaboration can also be smoother due to similarities in culture, values, and organizational structures.

Over the years, departments at Rigshospitalet have had individual cases of collaboration with Nordic hospitals on specific patient treatments. Most recently, a Finnish child with a heart condition was operated on at Rigshospitalet. Moving forward, hospitals should be better equipped to support such cases, according to Thomas Høi-Hansen.

"The treatment went well for the patient, but the process also revealed several bureaucratic challenges when transferring patients across national borders. The Nordic alliance aims to systematize these types of cases to make them run more smoothly," he says.

According to Hospital Director Rasmus Møgelvang, the hospital alliance is taking the first steps toward a treatment community where patients could potentially access the best possible care across national borders.

"We are working with the idea of a shared Nordic treatment responsibility in certain areas—for example, by centralizing the treatment of extremely rare diseases at a single hospital. This also means that we must be prepared to transfer specific treatment areas to, for example, Stockholm or Oslo if it benefits patients," says Rasmus Møgelvang.

Clinical trials across the Nordic region

In the field of research, the NUHA collaboration can provide Nordic hospitals with better opportunities to apply for EU funding, where patient volume can be a decisive factor. The ambition to attract more clinical trials and industry collaborations could also receive a boost, as a Nordic population base of 30 million makes it possible to conduct more clinical trials independently within the region.

One concrete joint initiative is a collaboration on platform trials—an ongoing test structure where multiple treatments are tested simultaneously and continuously within a particular patient group. Research Director Malene Fischer from Rigshospitalet explains:

"By sharing data and resources, we can conduct larger and more comprehensive studies. Initially, we are exchanging knowledge about platform trials, but the next step will be to involve patients from other Nordic countries in our trials. The goal is to establish a shared NUHA platform unit, where we conduct multiple joint platform trials across the Nordic region," says Malene Fischer.

She adds that the trials can be initiated either by hospitals themselves or in collaboration with industry partners.

Read more about the vision for the hospital alliance.