HHE HOPE 2019 | Page 25

• Making better use of data and digital technology. The NHS will provide more convenient access to services and health information for patients, with the new NHS app as a digital front door, better access to digital tools and patient records for staff, and improvements to the planning and delivery of services based on the analysis of patient and population data. • Getting the most out of taxpayers’ investment in the NHS. Working with doctors and other health professionals to identify ways to reduce duplication in how clinical services are delivered, make better use of the NHS combined buying power to get commonly used products for cheaper, and reduce spend on administration. Integrated Care Systems The NHS Five Year Forward View published in 2014 established Sustainability and Transformation Partnerships (STPs). STPs are now evolving into Integrated Care Systems (ICSs). Within the current legal framework, the NHS and its partners will be moving to create Integrated Care Systems everywhere by April 2021, building on the progress already made. ICSs bring together local organisations in a pragmatic and practical way to deliver the triple integration of primary and specialist care, physical and mental health services, and health with social care. They will have a key role in working with Local Authorities at place level, and through ICSs, commissioners will make shared decisions with providers on population health, service redesign and long-term plan implementation. ICS will deliver the aims set out in the NHS long-term plan. The Long-Term Plan articulates a new service model with greater emphasis on primary and community care, prevention, outcomes improvement, digital services and changes in the financial regime Moving care closer to people’s homes and communities Frimley STP’s North East Hampshire and Farnham Vanguard brought together primary, community, acute, mental health and social care service teams across the area to work as one. Closer working across traditional service boundaries helped to stimulate new services and initiatives, which support people, to manage their own health and care more effectively and to receive more care and support in their local community rather than in hospitals. This includes the Time Out café in Aldershot for people with mental health problems, run across geographical and organisational boundaries to offer an alternative to A&E for those in crisis. Service users can access the café seven days a week with no appointment needed, to get support from staff, learn self-management skills and use community resources such as peer support and mental health and wellbeing advice. The scheme has resulted in a reported 33% reduction in acute psychiatric admissions. Residents’ feedback shows they particularly value being able to access help when they need it and that the café has helped to avoid further crisis, self-harm and unnecessary A&E visits. Other examples include GPs in Erewash are supporting urgent care through an on-day service that has contributed to a 3.8% fall in non-elective admissions to hospital, despite overall rising A&E attendances. In Dudley, teams of doctors, nurses and other professionals have reduced the time people spend in hospital by the equivalent of 900 bed days in just over two years. Pharmacists, working alongside teams in local GPs’ surgeries, have helped reduced mortality from hypertension. • Further case studies and examples can be Could you present two/three elements on the impact of such reforms on hospital and/ or healthcare sectors that your organisation/ country has identified? Vanguards Following three years of testing alternative models in the Five Year Forward View through integrated care Vanguards and Integrated Care Systems, we now know enough to commit to a series of community service redesigns everywhere. The Vanguards received less than one tenth of 1% of NHS funding, but made a positive impact on emergency admissions, and demonstrated the benefits of proactively identifying, assessing and supporting patients at higher risk to help them stay independent for longer. found here. References 1 For more information on the Danish National Strategy for Personalised Medicine 2017-2020 click here. 2 For more information about the National Digital Health Strategy 2018-2022 click here. 3 The reply was provided in January 2019. The reform mentioned did not receive the approval on the Finnish Parliament and the Government resigned in March 2019. Ministério da Saúde (2018), Retrato da Saúde, Portugal. Available here. 4 Portaria n.º 71/2018. Available here. 5 For further information click on the following link. 6 Ministério da Saúde (2018), Retrato da Saúde, Portugal. Available here. 7 Estratégia Nacional para o Ecossistema de Informação de Saúde 2020 (ENESIS 2020). Available here. 8 Web-portal available here. 9 Mobile application MySNS available here. 10 Mobile application MySNS TEMPOS available here. 11 Mobile application MySNS CARTEIRA available here. 12 Decreto-Lei n.º61/2018 available here. UNITED KINGDOM Total current health expenditure as % of Gross Domestic Product (GDP) General government/compulsory current health expenditure as % of total current health expenditure Hospital current health expenditure, as % of total current health expenditure Household out-of-pocket health expenditure as % of total current health expenditure All hospital beds per 100,000 inhabitants Acute care hospital beds per 100,000 inhabitants Acute care admissions/discharges per 100 inhabitants Average length of stay for acute care hospitals (bed-days) Practising physicians per 100,000 inhabitants Practising nurses per 100,000 inhabitants 25 HHE 2019 | hospitalhealthcare.com 2002 6.6% 79.7% n.a. 11.4% 398.0 n.a. 11.2 7.5 210.0 865.0 2008 2016 7.7% 9.8% 82.8% 79.5% n.a. 41.7% 9.4% 15.1% 333.0 258.0 n.a. n.a. 12.9 12.5 6.3 6.0 257.0 278.0 867.0 788.0