integrated care in nsw presentation to nsw rural health & research congress dubbo, 9 september...
TRANSCRIPT
Integrated Care in NSW
Presentation to NSW Rural Health & Research Congress
Dubbo, 9 September 2014
Katherine Burchfield Director, Integrated Care Branch
NSW Ministry of Health
Various drivers are placing increasing pressure on our health system
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Increasing demands
on the health system
Increased demands from
people with complex needs
Increased number of people living
with chronic diseases
Growing and ageing population
Reduction in length of stay and
productivity targets
Increasing specialisation in
medicine and nursing
Societal changesRising consumer
expectations
The current system is episodic and fragmented, focused on patient outcomes by exception
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Current system tends to supports short term episodic care rather than long term health and functionality
Health promotion
Outpatient care close to
home
Unplanned hospital care
Residential aged care
Planned inpatient care
Planned care at home
“Systems designed to treat occasional episodes of care for normally healthy people are being used to deliver care for people who have complex and long term conditions.
The result is that they are passed from silo to silo without the system having the ability to co-ordinate different providers”
S Dorrell, NHS Health Service Journal, 2011
Why NSW needs integrated care
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Increase in chronic disease
Increase in hospitalisations and GP visits
Increase in need for health workforce
Increase in need for hospitals
• Prevalence of chronic disease expected to increase by 15-20% in 2030• Total number of chronic diseases to increase by ~1M (+33%) in 2030
• Length of stay has decreased but hospital separations have increased, resulting in an increase in bed days between 2006 and 2011
• Number of bed days to increase by 51% to 9.7m in 2030• Number of GP visits to increase by 64% to 56m in 2030
• Health workforce required to grow by 30-100% by 2030− 36% more nurses− 97% more physicians− 30% more allied health professionals
• An additional 10,000 beds or ~114 hospitals will be required in 2030
Ageing population• The NSW population is expected to grow by about 1% per annum • Over 65s will represent ~20% of the population in 2030 compared to 14% in 2006• Healthcare expenditure for over 65s is two to three times higher than under 65s
Better integration of care will help to achieve a more sustainable health system
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Today Tomorrow
?• Fragmented• Episodic• Inefficient• Unsustainable
Integration of care
Integrated, sustainable health system
Care is person centred
Care is a seamless continuum
Care is effective Care is efficient
Care is organised for, by and with the person by bringing
care to the person’s community or home rather than the person to the care
Care is organised across spectrum of care ranging
from social and preventative, to primary and acute, through to aged and end-of-life care
Care results in the outcomes that are desired by the
patient and reflect achieved health status, recovery
process and sustainability of health
Care makes efficient use of both financial and human
resources
What is integrated care?
Integrated Care meets a person’s needs by providing seamless, effective and efficient care, organised for, by and with the person, from prevention through to end of life.
Value-based healthcare
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• NSW State Health Plan launched in June 2014.
• Three clear directions for the future delivery of healthcare in NSW
Direction One: Keeping People Healthy
Direction Two: Providing World Class Clinical Care
Direction Three: Delivering Truly Integrated Care
NSW State Health Plan
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Jillian Skinner MP Minister for Health
Minister for Medical Research
MEDIA RELEASE
Thursday 20 March 2014
NSW GOVERNMENT COMMITS $120 MILLION TO INTEGRATED HEALTH CARE
The NSW Government will spend $120 million over four years to provide seamless care to people in an integrated way - from care in the community to acute care in hospital.
Health Minister Jillian Skinner was joined at Parliament House today by community providers including general practitioners (GPs) and non-Government organisations (NGOs) as well as representatives of the primary care sector including pharmacies and private hospitals as she launched the Integrated Care in NSW strategy.
Mrs Skinner described the NSW Government’s new focus on integrated care as a transformative step for health care in this state ….
Announcement
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The NSW Integrated Care Strategy has three components
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DescriptionDescription GoalGoal
Integrated Care
Demonstrators
LHD-led Demonstrators in Western NSW, Central Coast and Western Sydney focused on large-scale transformation of integrated local health systems and testing initiatives prior to extension across the State.
Develop system-wide integrated care approaches in three LHDs that are transferrable and scaleable
Statewide enablers
Focused on information technology infrastructure, outcomes measurement and patient feedback, capacity building and evaluation.
Establish key enablers of integrated care benefiting all LHDs and stakeholders
Planning and Innovation
Fund
Investment in individual initiatives and planning at the local level, including extension of successful integrated care approaches from the Demonstrators.
Support local planning, collaboration and innovation initiatives
Indicative % funding
Indicative % funding
$12
0M in
vest
men
t ov
er 4
yea
rs
Implementation will involve partnerships with primary care organisations, NGOs and private providers
42%
27%
31%
Expected benefits
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Better patient experience
Improved outcomes
Less waste
• Easier navigation of the system• Reduced waiting times• Increased satisfaction
• Better patient reported outcomes• Improved long term health outcomes
• Fewer avoidable hospitalisations and ED attendances
• Less duplication of services/tests
• Regional planning for health services and wider determinants of health
• Move beyond consultation & coordination to true partnerships with primary care, aged care providers, and Aboriginal Community Controlled Health Services (ACCHS)
• New funding and business models – particularly for community-based health services - that optimise workforce and funding streams
• Improve IT infrastructure and information flow, including outcomes monitoring and feedback
• Leverage MPS and service co-location ‘hubs’
• Further embed telehealth and m-health
• Greater use of telephonic solutions eg. HealthDirect
• Explore the most cost effective pathways for supporting ‘health’ of remote populations
• Promote prevention and early intervention
• Consumer/community engagement, health literacy and self management
Opportunities in rural NSW
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