Global Integrated Care, Diabetes Cardio-Vascular, Sanofi

Dr. Toni DEDEUDirector │AQuAS (Agency for Health Quality & Assessment – Ministry of Health of Catalonia)

@Toni_Dedeu

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Ageing society

Chronic conditions

Health workforce shortage

Financial unsustainability

HLY vs LEHealth

inequalities

INTRODUCTION

CHALLENGES TO

CARE DELIVERY

MODELS

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CONCEPTUAL FRAMEWORKS

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WHO World Health

Organisation

European Commission

National Regional

Level

Local level

INTRODUCTION

INTEGRATED CARE

BACKGROUND

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WHO

EUROPEAN

REGION

PERSPECTIVES

ON

PROMOTING

INTEGRATED

CARE IN

PRACTICE

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WHO

EUROPEAN

REGION

PERSPECTIVES

ON PROMOTING

INTEGRATED

CARE IN

PRACTICE

Researchers conducting key informant interviews

Languages used in the process of data collection

Countries engaged in the process

Pages of transcribed notes

Different experiences strengthening health services delivery

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WHO EUROPEAN REGION PERSPECTIVES ON PROMOTING INTEGRATED CARE IN PRACTICE

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Problem is clear and defined

• Measurable, well documented health burden

Solution is known

• Technically feasible solution aligned with values

Climate for change

• Gradual period of diffusing idea; ‘softening up’

It takes time• E.g. Norway 10 year period piloting

Requires good

advocacy

• E.g. personalised letters; conferences; site visits; roundtable discussions

Conditions for

creativity

• E.g. Trainings; study trips; research; time; resources; piloting

IMPLEMENTING INTEGRATED CARE

DRIVERS FOR CHANGE

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WHO EUROPEAN

REGION

PERSPECTIVES

ON PROMOTING

INTEGRATED

CARE IN

PRACTICE

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WHO

EUROPEAN

REGION

PERSPECTIVES

ON PROMOTING

INTEGRATED

CARE IN

PRACTICE

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WHO

EUROPEAN

REGION

PERSPECTIVES

ON PROMOTING

INTEGRATED

CARE IN

PRACTICE

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A new model of collaboration to facilitate innovation:• Ownership of key stakeholders

• High-level political commitment

• Very large-scale deployment & innovation

• Awareness and best-practice sharing across Europe

• Combining demand and supply sides of innovation

• Building on existing instruments and new ones

+2 Healthy Life Years by 2020Triple win for Europe

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EUROPEANCOMMISSION

EIP ON AHA

INTEGRATED CARE

Scale up

ReferenceSites

Twinning

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EUROPEANCOMMISSION

EIP ON AHA

INTEGRATED CARE

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REGIONAL

LEVEL

SCOTLAND

SYSTEMIC

INTEGRATION

Public Service Reform

Public Bodies (Joint

Working) (Scotland )

Act 2014

Reshaping Care for Older People

programme

Telehealth and Telecare Delivery

Plan for Scotland 2015

National Policy Drivers

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REGIONAL

LEVEL

SCOTLAND

SYSTEMIC

INTEGRATION

Before

Integration

After April 2015

32 Local Authorities responsible for social care, education, housing, transport

32 new “Health and Social Care Partnerships” jointly responsible for delivery of social care, community health / primary care and some hospital services

14 NHS Boards Acute, hospital, community, primary care health services

NHS Boards and Local Authorities will continue to provide a range of other health and care services

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REGIONAL

LEVEL

SCOTLAND

SYSTEMIC

INTEGRATION

Consultation on Regulations and development of

Guidance

MAY–AUGUST 2014

Regulations and guidance

complete

NOVEMBER 2014 – FEB

2015

Integration goes live locally

APRIL 2015

All integrated arrangements must

be in place

APRIL 2016

Timescales

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REGIONAL

LEVEL

SCOTLAND

SYSTEMIC

INTEGRATION

Cross party support

NHS support

Local authority support

Everyone (partners, stakeholders etc.)

agreed: A challenge exists

Something needs to be done

Having an agreed vision about what we

are trying to achieve

What has helped integration?

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REGIONAL

LEVEL

CATALONIA

PIONEER

TERRITORIESIntegrated &

Chronic Care

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REGIONAL

LEVEL

CATALONIA

PIONEER

TERRITORIES Inter-ministerial Programme for IC

HEALTH IN ALL POLICIES

PERSON CENTRED CARE

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REGIONAL

LEVEL

CATALONIA

PIONEER

TERRITORIES

Spider diagram

► Context of the findings

Different views (Health & Social Care) and breath

Useful tool to analyse sub-regional initiatives (County, Municipal, Providers level)

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REGIONAL

LEVEL

CATALONIA

PIONEER

TERRITORIES

Key drivers Chronic and integrated care policy-driven orientation

Introduction of stratification

Commitment of clinical leadership involved in design and implementation of

local integrated care pathways (ICPs)

Shared ICT between clinicians and between patients and professionals

Overcome of financial barriers introducing new joint cross-cutting targets

among different levels of healthcare

Promoting more care at home avoiding unnecessary emergency admissions

and institutionalisations and self-management policies

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REGIONAL

LEVEL

CATALONIA

PIONEER

TERRITORIES

ICT Readiness

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REGIONAL

LEVEL

CATALONIA

PIONEER

TERRITORIES

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REGIONAL

LEVEL

CATALONIA

PIONEER

TERRITORIES

‘My Health’

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REGIONAL

LEVEL

CATALONIA

PIONEER

TERRITORIES

Easier access

Strong passwordsystem

eConsultancy

Preventative & Health Promotion

Technology EnabledCare

2016

2017

2020

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REGIONAL

LEVEL

CATALONIA

PIONEER

TERRITORIES

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REGIONAL

LEVEL

CATALONIA

PIONEER

TERRITORIES

THANK YOU

Dr Toni DEDEUDirector │AQuAS (Agency for Health Quality & Assessment – Ministry of Health of Catalonia)

@Toni_Dedeu http://aquas.gencat.cat