In order for health services delivery to accelerate gains in health outcomes it must continuously adapt and evolve according to the changing health landscape. At present, the case for change is compelling. In the context of both new challenges and opportunities, initiatives to transform services delivery across the WHO European Region has emerged. This Compendium demonstrates the diversity in activity, describing examples of health services delivery transformations from each Member State in the Region. The initiatives vary greatly in their scope and stages of implementation, from early changes to initiatives at-scale. When taken together, these examples offer unique insights for setting-up, implementing and sustaining transformations. A summary of 10 lessons learned attempts to synthesize key findings and consolidate insights derived from experiences.