Opportunities for Collaboration

1. Slide 1Strictly Private & Confidential
Independent Hospitals Association of Ireland
National Healthcare Conference 2014, CEO Forum
Opportunities for Collaboration Between Public & Private
Catherine Whelan, Chief Executive
1st April 2014

2. Slide 2Strictly Private & Confidential
Agenda
 IHAI Introduction
 Current Collaboration
 Opportunities
 What’s Required?

3. Slide 3Strictly Private & Confidential
IHAI Introduction
Who We Are
 Representative group for the independent hospital sector in Ireland
 Our members operate almost one-third of Ireland’s acute hospitals
 Represent 20 independent hospitals providing acute & mental health services
 “A high performance health system should provide patients with a wide choice of quality and
innovative services at an affordable price”
 IHAI aims to help its members to deliver this vision to the patients they serve

4. Slide 4Strictly Private & Confidential
IHAI Introduction
Our Contribution to Patient Care Nationally
bed nights provided per annum
available hospital beds
patients cared for per annum (1 in every 5)
theatre procedures completed each year
diagnostic tests undertaken per annum
of all mental health care treatment
of all open heart surgeries
of all spinal surgery
people employed across Ireland
c1,000,000
1 in every 6
400,000
250,000
3,000,000
c22%
c50%
c65%
8,100+

5. Slide 5Strictly Private & Confidential
IHAI Introduction
Our Members

6. Slide 6Strictly Private & Confidential
 Each sector working independently to address key challenges
 Independent sector collaboration governed by competition law parameters
 Many differences in operating models but many common challenges exist
 Collaboration between sectors adhoc; no formal mechanisms to facilitate
 Independent sector invited to participate in some fora, e.g., NCEC, NCAG
 Opportunity being lost to share best practice, much duplication of activity
Current Collaboration

7. Slide 7Strictly Private & Confidential
❶ National Standards for Safer Better Healthcare
– Accreditation: Culture, Buy-In, Engagement
– Developing/evolving the Standards
❷ Quality/Audit Initiatives
– National Clinical Programmes
– National Guidelines, e.g. NEWS implementation
– Local initiatives, e.g., hand hygiene
– NOCA initiatives, e.g., INOR, IASM
– Training and implementation support
Opportunities for Collaboration
Patient Safety & Quality

8. Slide 8Strictly Private & Confidential
❸ Research, Education & Continuous Learning
❹ Joint Public Awareness Initiatives
– Chronic Disease Management initiatives
– Mental Health Awareness programmes
Opportunities for Collaboration
Patient Safety & Quality (continued)

9. Slide 9Strictly Private & Confidential
❶ Reimbursement
– Claims Processing
– Days Sales Outstanding
– Pended Claims
– E-Claims System
– Data Protection Issues
❷ Human Resources
– Haddington Road Agreement
– Medical Manpower Planning
– Training & Development Initiatives, e.g., Open Disclosure, Complaint Handling
Opportunities for Collaboration
Efficiency

10. Slide 10Strictly Private & Confidential
❶ National Service Planning
– Optimal use of all national resources, expertise, capacity (early adoption of UHI principle)
– Address Waiting List challenge & underutilised capacity
– Avoids duplication of capital spend
– Govern by agreed protocols/MoUs via Hospital Groups
– Integrate State service strategy with independent sector facilities, e.g., mental health services
❷ Technology & Innovation
– Joint approach to introduction of new technologies/treatments on a partnership basis
– Optimise choice/access for patients to innovation
Opportunities for Collaboration
Service Delivery

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❶ Licencing
– Accreditation “Licence to Operate”
– HIQA Standards & Regulation
❷ Hospital Groups/Trusts
– Corporate Governance/Board structures
– Alignment to optimise use of local resources/expertise
❸ Money Follows the Patient
– Similar to current payer model re private healthcare
– ICD 10 Coding
– Composition of Tariff
Opportunities for Collaboration
Universal Health Insurance

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❹ “Integration”
– Basket of Services, Values Framework
– Systems, processes, etc.
❺ Early Wins?
Opportunities for Collaboration
Universal Health Insurance (Continued)

13. Slide 13Strictly Private & Confidential
 Willing
 Established Structure/Mechanism
 Follow Through
 “Art of the Possible” approach
What’s Required to Make It Happen?

14. Slide 14Strictly Private & Confidential
 Many common challenges exist
 Efforts are being duplicated and best practice not shared as widely as possible
 Many reasons why collaboration has not been optimal to date
 Opportunities exist in many areas to collaborate for benefit of the entirety of the health system,
and especially for patients
 Moving towards “one tier” system – opportunity to move in that direction pre UHI introduction
Summary