In 2011, eight hospital clown organizations created a federation and agreed upon a common set of goals. They became the founding members of the European Federation of Healthcare Clown Organizations (EFHCO).
Today, EFHCO has 22 full and associate members from 15 European countries.
All are professional organisations, driving the European association, being active in the healthcare, social care sector interfacing with the cultural side of humanities. Beside in hospitals for patients of all ages, today the clowns work with young people, demented or elderly people in needs as well as in camps for refugees or in crisis areas (war, earthquakes).
The federation aims are developing common standards on competence and good practice within healthcare clowning, affirmed by an own efhco Quality Label. All full member organisations are audited every 5 years by qualified artistic and administrative auditors.
The federation organises workshops, nose2nose and virtual conferences on different topics around healthcare clowning and helps to explore and develop.
efhco is fully funded by membership fees.