Abstract The Russian invasion of Ukraine in 2022 caused one of the largest population displacements in Europe since World War II. More than 6 million persons have sought international protection in other European countries, distributed in ways that take little account of the host countries’ population size, national income, or health system capacity. This workshop provides a platform to present and discuss findings of a health system impact assessment designed to anticipate the range of mid- to long-term impacts of this large-scale displacement on essential health system functions in refugee-receiving countries, identifying the challenges they face and opportunities to develop transformative policies and actions. This task is urgent given the risks of wider conflict in Europe. Objectives The workshop will 1) present the main findings from the health system impact assessment in seven refugee-receiving countries, 2) set out options for effective responses, considering policy and implementation perspectives, and 3) capitalise on the expertise of workshop participants to develop and refine policy options for structural reforms that not only help to sustain an effective response, but enhance the resilience of European health systems for the benefit of displaced populations and national residents alike. Format The workshop will comprise a panel with three speakers, followed by a roundtable discussion. Each panel member will make a short presentation (5 min) on different, but interrelated aspects of a transformative health system response to a protracted crisis scenario. These will highlight country and regional-level challenges arising during the Ukraine crisis, propose concrete policy options for transformation, and identify intersections between the health system response with other societal sectors and crises. The workshop objectives and rationales will be introduced by Kayvan Bozorgmehr, including a short pitch-presentation (3 min) highlighting the unequal distribution of displaced persons from Ukraine and the key-findings of the health system impact assessment. The panel will include follow-up presentations elaborating specific aspects in this context: 1. Healthcare models and needs for transformative response in a protracted crisis (Dr. Nino Berdzuli, WHO Special Envoy for Ukraine Emergency Response in refugee-receiving countries); 2. Supra-national health financing as transformative reform: pros and cons (Eilin Rast, Bielefeld University, Germany); 3. Regional Geopolitical Conflicts and Population Health in Caucasus, CIS and Ukraine (Prof. Akaki Zoidze, Ilia State University, Georgia). The subsequent roundtable discussion will be chaired by Martin McKee. It will focus on the proposed actions and considerations from a policy and implementation perspective, and workshop participants will be invited to contribute to a critical reflection regarding barriers and enablers, as well as required alliances and processes to translate the structural reforms into practice. Key messages • The ongoing conflict-related displacements from Ukraine have created a protracted crisis that will require structural transformations to enhance health system resilience. • Enhancing healthcare delivery, continuity of care, and effective health financing requires national and supra-national collaboration to sustain effective responses and prepare for future crises. Speakers/Panelists Nino Berdzuli Division of Country Health Programmes, WHO/Europe, Denmark Eilin Rast Bielefeld University, Bielefeld, Germany Akaki Zoidze Ilia State University, Tbilisi, Georgia