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Taru Koivisto: Integration of Health and Social Care


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Integration of health and social care – predicting the quality, costs and consequences 17.4.2018

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Taru Koivisto: Integration of Health and Social Care

  1. 1. Integration of Health and Social Care 17th April 2018 Taru Koivisto, Director Ministry of Social Affairs and Health 24.4.20181
  2. 2. - The health, social services and regional government reform • One of the largest reforms of administrative structures and practices ever undertaken in Finland • Will affect the work of hundreds of thousands of people and the services provided for every citizen in the country • Also an impact on the financing, management and taxation of health and social services • Organisation of health and social services and other regional services transferred from the municipalities to the new counties as of 1 January 2020 24.4.20182
  3. 3. - We need the reform because • the ageing population needs a variety of more individual services • at present people do not have equal access to health and social services across the country 24.4.20183 • the economic situation is difficult and the public sector debt is increasing • services are financed through tax revenue, which is declining • at the same time the cost of health and social services is increasing • health and social services have inefficient practices, and new good practices should be introduced across the country • digital services are scarce and more are needed
  4. 4. - One in ten healthcare and social welfare customers need tailored help People of working age need services on an occasional basis and are able to use online services. One in ten customers need help frequently and for a range of problems. They need integration of services 10% of customers 80–90% of healthcare and social welfare resources 24.4.2 018 4
  5. 5. 24.4.20185
  6. 6. - Integration in the reform • One objective of the health and social services reform is to integrate health and social services into a client-oriented package • This integration of health and social services is one of the key elements of the health and social services reform and is aimed at improving the effectiveness of services • The integration of health and social services means that all services will be collected under the authority and organisation responsibility of the counties • In addition, all financing will flow through the counties to service providers • The information systems of counties and service providers will also be integrated 24.4.2018
  7. 7. - Counties will be responsible for integration of social and health services • Integration of organization • all services under the management of a single structure, the county, responsible for the service provision structure and its steering, official activities, evaluation of regional impact, cost- effectiveness and quality of services as well as supporting the users’ freedom of choice • Integration of financing • all financing goes through the organiser, who has an overall view of the financing (a single budget and single financial management) • Integration of information • in a client/care relationship and the related analysis, information flows between providers through national registers and interoperable information systems • Integration of service chains • care and service packages are organised ensuring that different services and service providers can effortlessly liaise with each other • Integration of provision • will take place in a network-based structure that consists of several service providers. Public, private and third-sector services work seamlessly together, and the services meet quality criteria 24.4.20187
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  9. 9. - Service integration in counties: need to… • recognise clients, who need a wide range of integrated services, who are frequent users of services or who need special support • define service chains or service packages for client or population groups • use client care plans to integrate individual level services • utilise client/patient data with different service providers • use preconditions or incentives to promote service integration with multiple providers • develop information systems to support integration • monitor and analyse implementation of integration 24.4.20189
  10. 10. - Counties organise all health and social services for children and families and coordinate the services of different providers into efficient and customer-oriented care and service chains. Intensive specialised child protection services Child protection Intensive psychiatric services for children and adolescents Services for people under criminal sanctions Intensive services for immigrants and asylum seekers Intensive preventive substance abuse services Services for persons with disabilities Specialised medical care Family centre model Welfare clinics, family work Early childhood education Digital services Services provided by organisations, parishes and peers Services for couples considering divorce Support for wellbeing of children and adolescents at school School and student health care Psychologists and school social workers Prefects and tutoring The KiVa Koulu antibullying project Integration of services for families with children Customer-centered collaboration, efficient flow of information, interoperable systems
  11. 11. - Conclusions • Integration is the key element in the Finnish social and health care reform • Integration is a tool both for client-orientation and cost-containment • BUT… • Our knowledge about impacts of integration is still scarce • More evidence is needed for the new counties, national governance and academia 24.4.201811
  12. 12. Division of duties: municipalities, counties, stateMunici- palities Communities of local involvement, democracy and vitality that manage the duties of municipal self-government as decided by the residents and local duties defined by law. • Skills and education • Health and wellbeing • Sports and culture • Youth work • Local industrial and business policy • Land use and construction Counties • Health and social services • Expert in promoting health, wellbeing, and safety and security • Rescue services • Environmental healthcare • Regional development • Steering of regional land use and construction • Employment and business services • Transport system planning, regional public transport planning • Rural development and farm relief services State • Maintaining and developing the rule of law • Safeguarding and assessing fundamental rights • Safety and security • National and international duties • Public guardianship 24.4.2018 12
  13. 13. Thank you! 24.4.201813