A Movement for Change: Enabling People-Centred and Integrated Health and Social Care
The conference brought together researchers, clinicians and managers from around the world who are engaged in the design and delivery of integrated health and social care. They shared experience and the latest evidence about integrating Public Health, Health and Social Care and the New roles and Possibilities for Hospitals, producing Positive and Curative Integrated Mental and Physical Care, mobilising key enablers like policy making and Mobile and Digital Health Solutions, and investment in an Integrated Care Workforce, clinical leadership and coproduction with individuals, careers, communities and populations.
The conference was a partnership between The International Foundation of Integrated Care (IFIC), PIAISS of the Catalan Government, Hospital Clinic Barcelona (HCB), Forum ITESSS and the Tic Salut Foundation.
Theme 1. Integration Across the Care Continuum: Improving Population Health
- What is the rationale and evidence for integrating public health, health and care across the continuum of care?
- How can effective coordination between these sectors and other sectors can be achieved in practice? What are the key components of good practical examples? For example: How to distribute budgets? How to bring together the separate funding streams for health and social care? How to develop new professional’s roles and organizations? How to overcome differences due to public, social or private ownership? And different structure of incentives? How to align objectives? What can we learn from each other? How information is shared? What is the role of technology? What is the role of policy enabling or is it possible to make integration difficult?
- How can we transform current models of care that emphasizes the hospital, the specialist, and responding to ill health? How will we integrate public health, health promotion and primary, secondary and tertiary prevention, practice and perspective into traditional health care and social care service delivery?
- What are the most effective structural and organizational arrangements that support integrated care? How can we re-position traditional institutions? What are the future role of the hospital/hospital specialists; intermediate care; primary care/general practice/family medicine; social care/social workers; NGOs and the third sector; patient and community; and private sector organisations who can deliver care services?
- How will we support transitional care?
- How can we make sure that marginalised/deprived groups are included? How will we ensure there is a continued focus on reducing health inequalities?
Theme 2. Tackling the Challenge of Mental Health
- What is the rationale and evidence for integrating mental and physical health?
- How can we improve support for the psychological aspects of physical illnesses and long-term conditions; in particular dementia, depression and loneliness?
- How will we provide effective care and support to people with ‘medically unexplained symptoms’ that lie at the boundary of the mental and the physical?
- How to ensure people with severe mental illnesses receive integrated care and have their physical health needs met.
- How can we support evolving needs in management and prevention throughout the life course? For example adolescence, later life?
- How should we support care across organizational boundaries? For example, from institutions (hospitals, care homes, prisons, etc.) to home and workplace? What role can primary care play in supporting an integrated approach to physical and mental health? How can we support a community approach to physical and mental health integration?
- How will be support care across professional boundaries? For example, language, differing priorities? What competencies need to be developed in different professionals’ roles? How can we ensure that all health care professionals have sufficient understanding of mental health, and vice versa? How should we work in multidisciplinary teams?
- What does an empowered people mean in terms of mental health?
- How can ICT enable care?
- How should we address the distinct roles of people and carers from an integrated care perspective?
- How should we measure outcomes?
Theme 3. Advancing People-Centred and Integrated Care
- What does it mean to develop people-centeredness in health and care systems? What is the evidence?
- How do we empower, activate and engage citizens, families, carers and communities to co-produce health care services? How do we support participation, choice, rights and responsibilities and action on health determinants? How will we improve health literacy?
- How will we support informal carers, peers and volunteers to care for themselves and others?
- How can we support them to self-care, self-manage, engage in shared decision-making, and co-develop and implement personalized care plans?
- How should we support clinicians to better support the health needs and goals of people?
- What are the skill mix and competencies the workforce needs to support people-centred care?
- How can we evaluate patient reported outcomes measures? How can we measure patient and user experiences of integrated care?
Theme 4. Enabling Integrated Health and Care: Removing Barriers, Encouraging Adoption
- What do we mean by an enabling environment?
- What are the key policy strategies needed for care transformation?
What governance, regulations and accountability arrangements are most effective?
- Which financial arrangements and incentives have the greatest impact?
- How can devolution of power and budgetary control to local areas facilitate the implementation of integrated care?
- What are the skills and continuing education needs of the workforce? What new roles are needed? How can we support “old actors” to take on “new roles” in a people-centred integrated care paradigm?
- How do we manage transition and continuous improvement? What type of leaders and leadership should be encouraged? What are the successes and failures in enabling integrated care? Barriers, lessons learned?
- How can we support implementation, scalability, sustainability and transferability of good practices, research findings and policy making? How will we build a shared vision? What are the successes and failures in implementing new innovative processes, products and services? What are the lessons learned?
- Can it be done in an era of financial crisis?
- What is the relation between (EU and national) frameworks, local implementation and regional upscaling?
- How do we define outcomes of integrated care and how these outcomes may be measured? For example around the Triple Aim? How should we gather useful evidence? How can we assess integrated care practices? What is the role of Comparative Effectiveness Research and Big Data in the evaluation of integrated care from a population approach?
Theme 5. The Strategic use of Mobile and Digital Health and Care Solutions
- What are the most promising examples of technologies that support integrated care delivery? In planning? Organizing? Monitoring?
- How is patients and carers participation enhanced and empowered by technologies? For example in mental health and in people living with disabilities?
- What are the most successful strategies in incorporating mHealth and digital solutions to integrated care practices?
- How can we effectively assess the value of technologies? How can we deal with issues like wearable technologies, mobile phones in data capture, analysis, and communication?
- What are the current and future markets for mobile and digital health solutions?
- What are the changes in professional profiles needed in the future, regarding the introduction of ICTs?
- How can we use ICT’s to change the way that we work? How can technology support evaluation?
- From Claims to Electronic Medical Records: how can we accelerate the transition? How will we integrate Big Data?
Dr Nick Goodwin
International Foundation for Integrated Care (IFIC)
Nick was the co-Founder of IFIC in October 2011 and became its first Chief Executive Officer in March 2013. Nick is also the Editor-in-Chief of IFIC’s open-access and impact rated scientific periodical the International Journal of Integrated Care.
Nick holds a range of research, educational and consultation roles worldwide. These international commitments include several European R&D projects such as the EU FP7 Project INTEGRATE, the Horizon 2020 project SUSTAIN and the ICT-PSP projects SMARTCARE, BEYOND SILOS, and CAREWELL. Nick is an active member of the European Innovation Partnership on Active and Healthy Ageing B3 Action Group on Integrated Care.
Nick has also been working with the World Health Organisation to support the development of its Global Strategy on People-Centred Integrated Health Services and is on the Expert Advisory Team to WHO Regional Office for Europe’s Framework for Action Towards Coordinated/Integrated Health Services Delivery (CIHSD) leading work related to change management and adoption of integrated care in policy and practice.
Over the past year, Nick has also worked as an international consultant to the Agency for Integrated Care, Singapore; the Pan American Health Organisation, Washington; the WHO’s Western Pacific Regional Office; and to NHS England’s Better Care Fund Support Programme.
In previous roles, Nick worked as a Senior Fellow at the King’s Fund (2007-2013) leading key work on integrated health and social care as well as a two-year Inquiry into the quality of care in English general practice. Nick has also worked as a Senior Lecturer at the London School of Hygiene and Tropical Medicine (2003-2007) where he directed MSc and DrPH courses and worked as a lead academic for the National Institute for Health Research commissioning key studies into the service delivery and organisation of health care.
In January 2016, Nick received the Avedis Donabedian International Award for his contribution to Healthcare Excellence and Integrated Health and Social Care.
Dr Alonzo Plough
Chief Science Officer
Robert Wood Johnson Foundation (RWJF)
Dr. Plough became vice president for research and evaluation and chief science officer at the Robert Wood Johnson Foundation (RWJF) in January 2014. RWJF is one of the largest private funders of health and health care research in the nation with the aim of producing evidence that policy-makers and practitioners can use to build a culture of health. One of the cornerstones of RWJF’s mission is the support and evaluation of groundbreaking research aimed at solving the most pressing health issues facing Americans.
Dr. Plough came to RWJF from the Los Angeles County Department of Public Health, where he served as director of emergency preparedness and response from 2009 to 2014.In that role, Dr. Plough was responsible for the leadership and management of the public health preparedness activities protecting the 10 million residents of Los Angeles County from natural disasters and threats related to disease outbreaks and other public health emergencies. In this role he coordinated activities in emergency operations, infectious disease control, risk communication, planning and community engagement.
Prior to that position, Dr. Plough served as vice president of strategy, planning and evaluation for The California Endowment from 2005 to2009. He was responsible for the leadership of The Endowment’s strategic planning and development, evaluation, research, and organizational learning. Dr. Plough also served as director and health officer for the Seattle and King County Department of Public Health for 10 years, and professor of health services at the University of Washington, School of Public Health in Seattle. He previously served as director of public health in Boston for eight years.
Dr. Plough earned his PhD and master’s degree at Cornell University, and his master of public health degree at Yale University School of Medicine’s Department of Epidemiology and Public Health. He did his undergraduate work at St. Olaf College, where he earned a bachelor’s degree. He has held academic appointments at Harvard University School of Public Health, Tufts University Department of Community Medicine and Boston University School of Management. He has been the recipient of numerous awards for public service and leadership and is the author of an extensive body of scholarly articles, books and book chapters.
Albert Ledesma Castelltort
Pla interdepartamental d’atenció i interacció social i sanitària
Generalitat de Catalunya
Albert Ledesma Castelltort is a Family and Community Medicine specialist. Director of Inter-ministerial Health and Social Care and Interaction Plan, Department of Presidency. Generalitat de Catalunya, Government of Catalonia.
He is also Founding partner of the first entity of associative basis of Catalonia.Primary Care Team Vic, which manages the primary care services of health area in the city of Vic.
Juan Carlos Contel Segura
Institut Català de la Salut,
Generalitat de Catalunya
Juan Carlos Contel Segura works for the Chronic Care Programme and Integrated Health and Social Care Plan at the Department of Health, Generalitat de Catalunya, Government of Catalonia. He is a graduate of nursing from the University of Barcelona where he later taught in the same faculty. He has a master’s in public management from the ESADE Business School and a postgraduate diploma in health management from the same institution. He is the editor of several books including “Homecare organization and practice” and “Management in primary care”. He has also authored many articles related to home care, chronic care and integrated care.
Director of Global Initiatives
Informed Medical Decisions Foundation, Boston
Angela Coulter is a health policy analyst and researcher who specialises in patient and public involvement in healthcare. She is Director of Global Initiatives at the Informed Medical Decisions Foundation, Boston, and Senior Research Scientist in the Nuffield Department of Population Health, University of Oxford. A social scientist by training, Angela has a doctorate in health services research from the University of London. From 2000 to 2008 she was Chief Executive of Picker Institute Europe. Previous roles included Director of Policy and Development at the King’s Fund, and Director of the Health Services Research Unit at the University of Oxford. She is a Senior Visiting Fellow at the King’s Fund in London, holds Honorary Fellowships at the UK Faculty of Public Health and the Royal College of General Practitioners and is a Trustee of National Voices.
Angela has published more than 300 research papers and reports and several books including The Autonomous Patient, The European Patient of the Future (winner of the 2004 Baxter Award), The Global Challenge of Healthcare Rationing, Hospital Referrals, Engaging Patients in Healthcare (highly commended by the BMA), and Understanding and Using Health Experiences. She was the founding editor of Health Expectations, an international peer-reviewed journal on patient and public involvement in health care and health policy. She has won awards for her work from the Donabedian Foundation of Barcelona in 2012 and the International Shared Decision Making Conference in 2013.
Dr Jason Cheah,
National Agency for Integrated Care
Dr Jason Cheah graduated with a Medical Degree and Master of Public Health (with Distinction) from the National University of Singapore. After his clinical training in general internal medicine, he completed his Masters in Health Care Management from Wales University (Swansea) and a obtained a MBA from Warwick University in 1998. In 2001, he was awarded the Fellowship of the Academy of Medicine (FAM) of Singapore.
Dr Cheah has worked in the Ministry of Health Singapore, dealing with a variety of health policy and planning, health regulation and accreditation issues. He then spent a year in the private sector in charge of running Gleneagles Hospital, a 380 bedded acute care hospital. In 2000, Dr Cheah returned to the public sector and started the Clinical Project Management and Planning Office in the National Healthcare Group (NHG). Dr Cheah was appointed as Chief Projects Officer (CPO) and also concurrently as Director of Clinical Services at Alexandra Hospital. In Nov 2005, Dr Cheah was appointed as Chief Executive Officer of the National Healthcare Group Polyclinics (NHGP).
In July 2009, Dr Cheah was appointed by the Ministry of Health Singapore as CEO of a new National Agency for Integrated Care (AIC). This Agency is charged with integrating care for the numerous patients with chronic medical conditions across the continuum from acute hospitals to community hospitals, nursing homes and home care. In addition to his role as AIC CEO, in 2014, Dr Cheah was appointed to chair the planning committee to oversee the development of a new integrated healthcare campus in the northern part of Singapore.
Dr Cheah remains active in teaching at the Saw Swee Hock School of Public Health in the National University of Singapore. He was the Chair of the Organising Committee of the 1st Asian Conference on Integrated Care held in Singapore in February 2011 and the 1st World Congress on Integrated Care in 2013. He is also a member of the Editorial Board of the International Journal of Integrated Care (IJIC) since March 2011.
Dr. Josep M. Piqué
Chief Executive Officer
Hospital Clínic University of Barcelona
Dr. Josep M. Piqué was named Chief Executive Officer of Hospital Clínic University of Barcelona in February 2011. He is also acting as President of Council Management of Barnaclinic, President of the Governing Board of Clinic Foundation for Research & Innovation, and Member of the Board of Trustees of ISGlobal.
Other present appointments are President of MIHealth Forum, Barcelona, and Member of Barcelona International Medical Academy (BIMA).
Previously he was appointed as Deputy Managing Director (2008-2010) and Medical Director (2006-2008) at Hospital Clínic, University of Barcelona.
Dr. Piqué was graduated in Medicine at the University of Barcelona in 1974, and obtained his PhD degree at the same university in 1982. Specialized in Gastroenterology, he was Visiting Professor at UCLA in Los Angeles, CA (1986-1987) and Chief of Gastroenterology Department at the Hospital Clínic of Barcelona (1993-2006).
As gastroenterologist Dr. Piqué was member of the Research Committee of OMGE (World Organization in Gastroenterology) (1999-2002), President of Catalan Society of Digestive Diseases (1999-2001), President of Spanish Foundation of Gastroenterology since 2009, Editor of the Journal Gastroenterol Hepatol, and Chairman of the Joint Meetings between Spanish Gastroenterological Association and the American Gastroenterological Association. He has published above 280 original manuscripts which have generated more than 5.800 citations, and it has been editor of 15 books and author of 70 book chapters.
Professor of Health Policy
London School of Hygiene and Tropical Medicine
Nicholas Mays is Professor of Health Policy in the Department of Health Services Research and Policy at the London School of Hygiene and Tropical Medicine (LSHTM) where he has been since 2003. He also directs the Department of Health-funded Policy Innovation Research Unit. The Unit is a collaboration between LSHTM, the London School of Economics, Imperial College Business School, RAND Europe and the Nuffield Trust. It began in January 2011 and is aimed at involving a multi-disciplinary team of independent researchers in the very earliest stages of national policy development, and/or evaluation of innovative programmes and policies across health services, social care and public health.
Until March 2013, Nicholas was scientific coordinator of the Department of Health-funded Health Reform Evaluation Programme which aimed to evaluate the impact of two sets of major reforms of the English NHS: firstly, the market-related reforms of the period 2002-10; and secondly, the changes following the 2008 Next Stage Review, ‘High quality care for all’.
Nicholas has a background in social policy, policy analysis and health care policy evaluation.
He has experience as a policy advisor in government, having been principal health policy advisor in the New Zealand Treasury, 1998-2003. He continues periodically to advise the NZ Ministry of Health and Treasury on health system strategy. He was appointed by the Director-General of Health to the External Advisory Group for the refresh of the New Zealand Health Strategy in March 2015.
From 1994 to 1998 he was Director of Health Services Research at the King’s Fund, London.
He is co-editor of the Journal of Health Services Research & Policy which he established in 1995.
In all, he has 35 years’ experience in health services research and policy evaluation.
Senior Fellow in Health Policy
The King’s Fund
Chris is a Senior Fellow at The King’s Fund, an independent charity working to improve health and health care in England. He conducts research and policy analysis spanning a number of areas including integrated care, mental health, health system reform and public health. His recent work includes research projects exploring the role of acute hospitals in integrated care, and the integration of mental and physical health care. Previous publications include an analysis which estimated the cost of co-morbid mental and physical health problems to the English National Health Service.
Prior to joining The King’s Fund in 2007, Chris worked in research teams at the Institute of Psychiatry and the Sainsbury Centre for Mental Health, and has an MSc in public health from the London School of Hygiene and Tropical Medicine. He has also worked at the Public Health Foundation of India in New Delhi, where he was responsible for a review of research on chronic disease and integrated care in India.
Professor David Perkins
Director, Centre for Rural and Remote Mental Health (CRRMH)
University of Newcastle, Australia
David Perkins is Professor of Rural Health Research at the Centre for Rural and Remote Mental Health, University of Newcastle which is located in Orange New South Wales. He is editor in chief of the Australian Journal of Rural Health and an associate editor of the International Journal of Integrated Care. He has worked as senior health service manager in the UK and has held academic positions in England and Australia. He publishes in the fields of health service integration, service design and policy and is a member of the NSW Minster’s Advisory Committee on Rural Health. He is a Board Member of the International Foundation for Integrated Care.
Dr. Maria Chiara Corti
Director of Integrated Health Care
Veneto Health Service
Dr Maria Chiara Corti, MD, PhD, graduated as medical doctor from Padua University in 1985, later specialized in Rheumatology, acquired a Master in Health science (Chronic Disease Epidemiology) from the Johns Hopkins University in Baltimore, MD (U.S.). She holds a PhD in Gerontology from the University of Padua, School of Medicine.
Since January 2012, she has been appointed by the Veneto Region as a Director of Integrated Health Care in the Veneto Health Service. She is mainly involved in the management of Regional Programs of Primary Care, Home Care, Intermediate Care and Long Term Care, as well as in Innovative projects of health service integration (Implementation in Veneto of the Johns Hopkins ACG system (www.acg.regione.veneto.it) .
From January 2008 until December 2010 she served as Project Manager in a Grundtvig European Project named EHLE (Empowering Health Learning in the Elderly) involving partners from The Netherlands, France and Spain. The Project was designed to create, test and disseminate a training toolkit for Health Professionals involved in the Health Promotion of older persons living in the community.
From February 2008 until December 2011, she served as Director of the primary care department of Padua local health trust. Her work included the management of Primary Health Care delivery to approximately 110.000 persons, including the delivery of outpatient care, primary care, home care, palliative care and intermediate care in GP Practices, Community Hospitals, Hospice and Nursing Homes.
She authored and co-authored several peer-reviewed papers in the field of risk factors in connection with adverse events in older populations. She is serving in the Editorial Board of Journal of Gerontology and Aging Clinical Experimental Research. She is collaborating as a peer reviewer of JAMA, Journal of Gerontology and Journal of the American Geriatric Society.
Alfonso Lara Montero
European Social Network
Alfonso Lara Montero is Policy Director at the European Social Network, the European network of public social services, where he manages the research, policy and practice programme financed by the European Commission. Alfonso has more than 7 years professional experience on various social policy issues, including mental health, children’s social welfare, evidence and innovation, integrated care and the European Semester. He is the author and co-author of several publications, including ‘Mental Health and Wellbeing in Europe: A person-centred community approach’, ‘Looking ahead: Local social services priorities for the European Semester’, ‘Evidence-based social services: Toolkit for planning and evaluating social services’, and ‘Integrated social services in Europe’. Since 2013, Alfonso has led the project ‘Investing in children’s services, improving outcomes’ on organisation, coordination and implementation of children’s services in 14 European countries. His particular interest is in evidence-based social care and the role of social services in integrated care. He is currently advising the IESI project led by the European Commission’s Joint Research Centre on ICT-enabled integrated social services. Before joining ESN in 2010, he worked on information management in the private sector. He has an MA in European Governance Studies from the College of Europe and an MSc in Public Policy from University College London.
Resources from the conference
Date: 23-25 May 2016
Location: Barcelona, Spain
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