A Dutch model for bridging health, safety and government in crisis preparedness: lessons from GHOR

When a hospital loses power, a cyberincident disrupts regional coordination, or a prolonged crisis pushes care far beyond the emergency room, one question becomes urgent: who coordinates continuity and legitimate decision-making across health, safety and government under pressure? Across Europe, crises are becoming more prolonged, interconnected and system-disruptive. Power failures, cyber incidents and military or hybrid threats affect not only emergency care, but the wider care chain, public administration and crisis response. In 2025–2026, GGD GHOR Nederland and GHOR organisations in all 25 Dutch safety regions developed a shared resilience framework for GHOR, the statutory regional structure for emergency health preparedness, coordination and response. The framework clarified GHOR’s role at the interface of healthcare, public health and crisis management, and translated resilience into practical instruments for risk profiling, situational assessment, continuity planning, preparedness and exercises. The process produced a national framework with room for regional tailoring. It improved role clarity across preparedness and crisis phases, strengthened early risk interpretation, explicitly included non-acute care, and connected resilience to continuity tools, exercises, civil-military cooperation and stronger coordination with care partners. It also strengthened GHOR’s embedding within wider safety structures and governance under scarcity. Resilience is not only a healthcare issue but a public governance task. The Dutch model shows the value of a statutory actor positioned between health, safety and government. Key lessons are to build a strong information position, involve partners early, include non-acute care, align operational, tactical and administrative levels, and test escalation paths before crises occur. Care risk profiles, emergency coordination points and alternative care facilities help translate governance into practice.

Key messages

• Cross-sector resilience requires a public actor that connects healthcare, public health, with safety and government (governance) before and during crises.

• A shared 2025–2026 resilience framework across all 25 Dutch safety regions strengthened role clarity, risk interpretation and continuity planning in the face of future protracted crises.