The large numbers of migrants arriving from North Africa and the Middle East to Mediterranean countries pose new challenges to the recipient health systems, which must adapt and respond to the needs of both migrants and residents. This requires an efficient policy dialogue between the main stakeholders to share experiences and identify best practices. The WHO Regional Office for Europe provides advice and technical assistance through the Migration and Health Programme. This was established in 2012 as the Public Health Aspects of Migration in Europe project in response to the 2008 World Health Assembly resolution WHA61.17, the 2010 Global Consultation on Migrant Health and Health 2020. A joint assessment mission in Spain in 2014 involved all relevant stakeholders with the aim of strengthening the country’s capacity to address public health implications of large immigration flows. The WHO toolkit was used during interviews and field visits. This report summarizes the results under the six functions of the WHO health system framework.