IFIC Ireland Annual Conference (AICIC23)
People-centred Integrated Care:
The right care, in the right place, at the right time
IFIC Ireland in association with the International Foundation for Integrated Care (IFIC), the Health Service Executive (HSE Ireland), Health and Social Care Northern Ireland (HSC NI) and Sláintecare presented “People-centred Integrated Care: the right care, in the right place, at the right time” on Thursday, 23 March 2023 in O’Reilly Hall University College Dublin.
This conference focused on how integrated care is the solution to many of Ireland’s health and care challenges, particularly the urgent care crisis and improved hospital admissions and discharge approaches. Over 250 delegates attended the conference from across the island of Ireland and will include Health and Social Care Services Managers, Clinicians and System leads, Academics leading in the field of integrated care, and a wide range of not-for-profit patient representative organisations and private sector providers of care services.
Keynote presentations and best practice examples will consider:
- What needs to happen across the island of Ireland to reduce pressures on hospitals and increase levels of health and care support in the community and closer to home?
- Will the new structures and system transformation across the island of Ireland support a more people-centred, integrated service for all?
- How taking an asset-based approach to care service models can improve multi-disciplinary working and deliver real co-design with patients, caregivers, and communities?
- What kind of leadership is required across all levels of health and care to make real improvements for people, their families and the communities where they live?
- What are the drivers of integrated care, and how can we ensure the right resources are in place to support the development of these important enablers?
A whole system response is required
In January a record number of patients waited on trolleys across Ireland. Interim HSE CEO Stephen Mulvany, speaking about the recent crisis said that the HSE has initiated a “whole system response” to the ongoing hospital overcrowding crisis. Talking to Morning Ireland, he said “The key thing is we can’t assume that any one part of this will solve it, so additional acute hospital beds have to fit into an overall integrated system and the processes have to work well.”
While the media has focused on under resourced hospitals, those who are designing and delivering care services realise the solution to the crisis is driven by an integrated care approach. An integrated approach which sets patients at the centre and provides a continuum of care across the whole life course, with care delivered in the most appropriate settings.
An emergency department is designed for short-term care and should only be used for emergency and urgent incidents. People who need more support or longer-term treatment, particularly those who are old and frail, are better cared for in another type of place such as a community hospital or step-down facility, residential care or in their own home. The latest crisis in emergency care across both Ireland and the NHS has highlighted the continued gap in care services that are community based and primary care led. Those in leadership positions must come together to enable the shift in resources that will lead to people getting the right treatment, at the right time, in the right setting − doing whatever we can to avoid unnecessary deaths from ambulance and emergency department-related delays.
A climate of change
At the same time, Ireland is going through a climate of change as systems in the North and South go through transition. With continued pressures on frontline and service delivery staff, now more than ever policy makers and system leaders need to focus on the best use of existing resources and make smart strategic and financial decisions to ensure that those at the receiving end of health and care services are provided with a continuum of care, delivering life-long services for individuals, their families, and the communities they live in. This transition involves a long-term programme of change and improvement for health and care services and will involve people at every level of the service. Now more than ever, enablers such as the alignment of financial approaches, health intelligence data, leadership development at all levels, and innovative digital and ICT solutions are required to support the workforce to deliver integrated care.
Introducing the Regional Health Authorities (RHAs)
In April 2022, the Government approved the next steps for setting up 6 Regional Health Areas (RHAs) within the HSE. Each RHA will be able to plan, resource, and deliver health and social care services for the needs of its unique population. This will result in improved accountability and governance in terms of finance and performance. It will also empower frontline staff and bring decision-making closer to the frontline. RHAs will enable staff to provide services that are:
- Integrated, locally planned and delivered
- Easier to access and navigate for patients and their families
- Available closer to patients’ homes when they need them – right care, right place, right time
There will be a phased introduction of the new bodies in 2023 and they will be fully operational from 2024.
A new Integrated Care System (ICS) for Northern Ireland
A new Integrated Care System (ICS) is currently being developed in Northern Ireland. This system signals a new way of planning and managing health and care services that will harness the strengths of the health and social care sector but look beyond traditional organisational boundaries to include partners in areas such as the voluntary and community sectors, local government, and service users and carers.
ICS NI will seek to empower local providers and communities to come together to plan continuous integrated care for their local populations with specialised services planned on a regional basis.
The new model will be underpinned by a population health approach and subject to legislation, will be launched in April 2024.
Providing a safe space for connecting and sharing
To make these changes happen, it is important that those at the forefront of taking integrated care forward are enabled to share their experience, success and failures with others. Spread and sustainability can be accelerated if innovators and leaders are supported to work together through which information and intelligence can be shared. This helps to avoid the same mistakes being made, can avoid unnecessary duplication of effort and can help build commitment by enabling leaders to work together in a community of practice.