The document discusses improving home care provision in Ireland. It notes that home care is currently unregulated, dominated by the state as both purchaser and provider, and suffers from a lack of strategic engagement, funding silos, and transparency. It proposes adopting an internal reference price model to set standard home care prices while allowing flexibility for special cases, empowering clients to choose providers and negotiate customized care plans, and using commissioning policies to drive quality, efficiencies, and transparency without affecting care. The goal is to better integrate home care into the healthcare system and let funding follow individual needs and preferences.
24 February 2010: Survey commissioned by the National Consumer Agency shows that consumers in Ireland continue to be most likely to have switched mobile phone provider, car insurance provider or where they do their main grocery shop
This presentation by Elliott Scanlon was made at the workshop on Competition in Publicly Funded Markets (28 February 2019). Find out more at http://www.oecd.org/daf/competition/workshop-on-competition-in-publicly-funded-markets.htm
24 February 2010: Survey commissioned by the National Consumer Agency shows that consumers in Ireland continue to be most likely to have switched mobile phone provider, car insurance provider or where they do their main grocery shop
This presentation by Elliott Scanlon was made at the workshop on Competition in Publicly Funded Markets (28 February 2019). Find out more at http://www.oecd.org/daf/competition/workshop-on-competition-in-publicly-funded-markets.htm
Bill Taylor, Changing approach and behaviour in service delivery: a provider'...LandorLINKS
Bill is Managing Director of Ringway Jacobs Ltd, a joint venture company
delivery integrated highway services to a number of clients in England. Since 2009 he has combined this role with that of Managing Director of BEAR
Scotland a similar joint venture company delivering integrated services to the Scottish market since 2011, notably Transport Scotland’s 3G contracts.
He is a Chartered Civil Engineer with 28 years experience in roads design,
construction and maintenance. During the early part of his career he worked
in both contracting and local government. In 1996 he became General
Manager for the Tay Premium Consortium of local authorities from 1996 to
2001.
In 2001 Bill moved to the private sector and continued to specialise in
integrated services. Bill has extensive experience of highways term services which has included jointly developing new models working with clients such as the Transport for Buckinghamshire Alliance. He is responsible for nine term contracts in the UK including the prestigious TfL Central London Area contract.
Meeting the needs of tenants whilst operating within tighter constraints, requires a different way of operating and managing your business. To succeed, we need a new way of looking at how to operate in all areas of your business - consider a combination of best practice from both the public and private sectors (the best of both worlds approach).
Presentation delivered by Tim Anslee, The Wealth Care Partnership; Ruth Corden, West Sussex County Council and Lynda Ryan, Age UK West Sussex for TLAP's Information, Advice and Brokerage workshop for Care Act compliance.
Bill Taylor, Changing approach and behaviour in service delivery: a provider'...LandorLINKS
Bill is Managing Director of Ringway Jacobs Ltd, a joint venture company
delivery integrated highway services to a number of clients in England. Since 2009 he has combined this role with that of Managing Director of BEAR
Scotland a similar joint venture company delivering integrated services to the Scottish market since 2011, notably Transport Scotland’s 3G contracts.
He is a Chartered Civil Engineer with 28 years experience in roads design,
construction and maintenance. During the early part of his career he worked
in both contracting and local government. In 1996 he became General
Manager for the Tay Premium Consortium of local authorities from 1996 to
2001.
In 2001 Bill moved to the private sector and continued to specialise in
integrated services. Bill has extensive experience of highways term services which has included jointly developing new models working with clients such as the Transport for Buckinghamshire Alliance. He is responsible for nine term contracts in the UK including the prestigious TfL Central London Area contract.
Meeting the needs of tenants whilst operating within tighter constraints, requires a different way of operating and managing your business. To succeed, we need a new way of looking at how to operate in all areas of your business - consider a combination of best practice from both the public and private sectors (the best of both worlds approach).
Presentation delivered by Tim Anslee, The Wealth Care Partnership; Ruth Corden, West Sussex County Council and Lynda Ryan, Age UK West Sussex for TLAP's Information, Advice and Brokerage workshop for Care Act compliance.
Primary Care Trust perspective: Make or Buy - Paul Zollinger-ReadThe King's Fund
Paul Zollinger-Read, NHS Cambridgeshire Chief Executive, looks at whether GPs will be able to 'make' as well as 'buy' services from a Primary Care Trust perspective.
Better outcomes, better value: integrating physical and mental health into clinical practice and commissioning
Tuesday 24 June 2014: 15 Hatfields, Chadwick Court, London
What can be learned from the private sector and should housing become more commercial? What are your strategic goals over the coming years and what are your concerns for reaching them? A panel of industry experts will gather to answer your questions and debate how we can reduce costs and innovate sourcing methods to better develop procurement and meet strategic targets.
Panelists:
John Wallace, Head of Procurement & Purchasing at Anchor Trust Leisa Hewitt, Procurement Director at PfH
Mike Doyle, Assistant Director at NHS North West Procurement Development
John Durrell, Director for Private Sector at Inprova Group
Employee Engagement: Your Tool for Tackling Heath Care CostsDigital Measures
Everyone is concerned about increasing health care costs. This interactive session will review the various triggers that drive health care and insurance costs and cover the major communication and engagement strategies that companies use to reduce their trend. Case studies to be discussed include wellness, employee engagement and communication, benefit plan design and consumerism. Successful benefit incentive programs that support communication programs and have a quantifiable return on investment will also be discussed.
Similar to 1100 michael harty final hcci national healthcare conference 2015 (20)
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
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2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
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Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
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Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
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CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
VERIFICATION AND VALIDATION TOOLKIT Determining Performance Characteristics o...
1100 michael harty final hcci national healthcare conference 2015
1. How Can We Improve the Quality and
Efficiency of Home Care Provision in the
Absence of Regulation
National Healthcare Conference 2015
2. Social Care budget 2015 - €3B
Elder Care budget 2015 - €1.27B
Fair Deal Scheme - €948M
HSE Funded Home Care - €325M
Home Help - €195M
Home Care Package Scheme - €130M
Privately funded care - €20M
Older Persons Services
3. Home Care Market 2014
HSE
Not-For-
Profit
Private
Home Help Home Care
Packages
Private
Customers
€142m
€53m
€33m
€54m
€175m
€107m
€63m€43m
HSE Funded
€20m
€195m €130m €20m
€345m
4. Structural Issues Holding the Home Care Sector Back
Unregulated - Scandals
Dominated by State – Purchaser and provider
Strategic Engagement
Funding Silos
Poor cousin of Healthcare Sector – Lack of Confidence
Poor Transparency and Accountability
12. Examples of What is Wrong
5 Hour rule
Paying providers in advance of delivering care
One price for all cases
Regional monopolies - Lack of Choice and Clients not Empowered
Price based tenders
PHN’s over worked – assessors, supervisors, administrators, advocates
17. Internal Reference Price Model
Emphasises on quality
Licensing not contracting
HSE set internal price for home care
Justified
Per Lot
Latitude for special cases
PHN assessment
Outline
Hours
State contribution is ........
Tax relief
Private top up
18. Internal Reference Price Model
Client discusses with provider directly
Care Plan
Customised price
PHN role - supervision and support where needed
19. Internal Reference Price Model
Advantages
HSE know exact exposure
Promotes idea of contribution
Each individual case properly costed
Takes advantage of local conditions
Helps recruitment and retention
Drives quality through client choice
Promotes quality providers willing to invest
Move up acuity scale
Better integration with acute sector
20. Home Care Needs to Play a More Important Role
Let Money Follow the Patient – End Silos
Use Procurement as a Driver of Quality Provision
and Quality Providers
Commissioning Policy
Extensive
Transparent
Quality based
Summary
21. How Can We Improve the Quality and
Efficiency of Home Care Provision in the
Absence of Regulation
National Healthcare Conference 2015
Editor's Notes
Improving economic times but important we ensure we are getting max out of existing resources before looking for more
Overview of Elder care sector and give some context.
Looks complicated but actually gives a good breakdown of home care funding.
Interesting to see that private sector only accounts for about 18% of total market and only 13% of state funding.
Want to look at the issues I think are holding sector back from playing its full role within the overall health sector.
Most obvious obstacle
Primetime scandals
Should have been regulated before residential sector
Dept. of Finance not wanting to create further entitlements
Short term view as HC could bring significant long term savings
EPS report calculated savings of €2B over 8 years – running sector more efficiently and allowing hc play a fuller role
Another major obstacle
Both purchaser and provider
Not healthy
Expensive - 30%
Move towards how residential care sector looks 20/80
State should regulate and supervise not necessarily provide
Role for the state but questionable if it needs to be of order of 80%
Need strategic engagement with state
Connected to State dominance is lack of engagement with stakeholders
Threat to the sector
Recruitment / retention
Beaurocratic obstacle
State loves silos, HSE loves silos.
Allows them to channel funds how they want rather than in best and most efficient manner
Create false demands i.e. residential care
Protects poor providers
Takes power away from client
No difference between HH and HCP
Antipathy of money follows the patient
Issue providers need to address
HC seen as weak link in continuum of care – not safe pair of hands
Acute sector first reflex is for residential care / step down
Need to promote cohort of professional operators willing to invest
Move up acuity scale
Organisations need Clear future = Investment with confidence
HC underutilised
One of most Important structural issue
Lack of
Section 39 funding prime example – no procurement process - €18M out of €60M
Organisations receiving funds from multiple sources – no tracking
Primetime scandals – 50% wastage
Place for all types of organisations but no service is free Debunk myth of voluntary or NFP
Lack of transparency and accountability lead to waste
With increasing demand and scarce resources cant afford waste
Eliminate waste before we ask for more funds
5 hour rule – 2 providers per case, anti social hours, multiple providers, undermines continuity, silos issue.
Paying in advance – no accountability, cant assume army of Mother Theresas out there – Primetime
Single price – companionship to late stage dementia commodity type care, incentivises cutting corners. More nuanced approach needed
Regional monopolies – no incentive to provide great care, vulnerable people with low propensity to complain in first place. Competition good in health as people make decisions on quality not price
Price based tenders – pushed down price of HC which pushes down wages and causes problems of recruitment and retention. Bedrock of providing quality care. Look at UK example.
PHN’s – supervision should be primary role
To paraphrase Bill Clinton “It’s commissioning stupid!”
Most important tool available to shape sector
Too important for just procurement department
More input from ground staff and stakeholders – designed by stakeholders
Structure based on price fine for commodities but elderly aren’t a commodity
Last tender 100% price!!
Should be based on quality and client choice
Yes want value for money but more sophisticated and nuanced way to get there than just blunt price route
Not about knocking down prices and encouraging providers to cut corners
Trying to bring about efficiencies through a blunt instrument like price is a fools game
Providers that are bringing real value added to table
Transparency by ensuring all funding goes through a procurement process
Fairness promotes partnership and collaboration lacking at the moment
Why lock out good new providers?
Taking into account training, supervision etc.
Some providers may need to upskill to enable them to do proper assessments
Selection from Approved provider list
Price maybe taking into consideration that provider has work in the area already
Improving economic times but important we ensure we are getting max out of existing resources before looking for more
