Transforming Integrated Care in the Community
Priority AxisTechnological and Social Innovation
Lead partnerThe Health and Europe Centre
Project budget8 022 824 €
ERDF amount4 813 694 €
The 2Seas area faces clinical, social & financial challenges in health and social care as the population ages & public funding decreases. Recruitment & retention of the health and social care workforce in the 2Seas area is challenging & the situation will further deteriorate as the existing workforce ages. This has an impact on quality as perceived by patients. A number of initiatives have been highlighted as innovative but rarely get transferred from one country to another. The causes of these blockages need to be identified & a method developed for overcoming the barriers to transferability. The systems that have developed in the 2Seas region over the last 20 years have led to the fragmentation of care & a task driven, activity based approach & remuneration.
TICC will enable countries in the 2Seas area (& later, beyond) to implement successful health & social care innovations
quickly in a cost effective, sustainable way.
TICC will create systemic change in health & social care, providing services better suited to our ageing population addressing holistic needs. It will present a methodology to overcome blocking points in transferring socially innovative service models from 1 area to another. This will be tested via the implementation of the Buurtzorg integrated care at home model (http://bit.ly/2bCQRLG: self-managing teams of 12 staff working at neighbourhood level handling every aspect of care & business, significantly reduced back office, simple IT & coaches rather than managers, providing better outcomes for people, lower costs/unplanned hospital admissions & consistent care) into new geographic & cultural contexts. TICC will enable other health/social care organisations to implement new ideas; increase staff productivity/recruitment/retention/patient satisfaction & decrease costs/emergency admissions/staff absence & will aim to postpone the moment when residential/end of life care is needed.
Blueprint for successful transfer of social innovative service models in health & social care from 1 country to another benefitting all public/private services 3 new countries adopting integrated neighbourhood care (BE, FR & UK) – neighbourhood based self-managing teams providing holistic person-centred care.
Changes to existing patient-data gathering systems using the Omaha logic for better communication between nurses, care
workers & citizens Publications to stimulate entrepreneurs & leaders to create new organisations or transform existing organisations,
ensuring this is not solely an institutional response.
- Patients: improved services – possibility to introduce new practices quickly & effectively
- Health & social care providers: able to be more reactive in care provision, increased staff retention from higher job satisfaction
- Public purse: costs of providing care decrease
Cross border approach
PP2 has developed a radical & highly successful model for providing home care nursing which has generated much interest in the 2Seas area. However front-line care providers are blocked by constraints within existing state health structures & have not yet been able to duplicate the model elsewhere in Europe. TICC PPs bring expertise to identify barriers blocking innovation transfer & will design a methodology to ensure successful innovative practices in health & social care can be easily implemented across borders. The 2Seas programme gives the opportunity for a regional European test before a wider roll-out the health & care systems in the 4 countries are all very different & cover the majority of models used across Europe & PPs cover public private & 3rd sector. As such our collaboration will ensure transferability across the whole EU. By working in partnership across 4 countries the TICC implementation will highlight barriers individual partners may not encounter in isolation
TICC has continued to perform well in 2019, with growing collaboration between partners, and an improved sense of common purpose.
Two two-day meetings were held (including Steering Groups), and one further one-day meeting, all involving all PPs.
Output 2.1 - Implement changes to existing patient data gathering systems following the Omaha logic for better communication between nurses/care workers/patients - was delivered on schedule earlier in the year, in practice manifesting itself in different ways across the delivery partners due to their varying starting points and local needs. This part of the project is not over, in that opportunities to go further in terms of systems changes are likely to present themselves in future, and will be taken wherever possible.
Output 1.1 - the implementation of a TICC model incorporating Buurtzorg learning - is now well under way in all delivery partners. It continues to prove challenging - but it represents a major organisational and cultural change, and even where positively sought, this is always difficult. The learning feeds Output 3.1 - the Blueprint - and the process for collecting and analysing learning is now well embedding. Evaluation partners work closely with other PPs at all times, working towards Output 4.1, the evaluation reports.
Other highlights mentioned by one or more partners include:
- Delivery partners increasingly developing their own experience of Buurtzorg/TICC, and exchanging/learning from each other
- Successful team launches, with accompanying recruitment and staff training
- Successful conferences and events, for example at the House of Lords, promoting teams and the TICC project
- Press mentions, including BBC television
- Sending staff to shadow Buurtzorg nurses, providing significant motivation
- Increasing self-management, with balanced, independent teams
- Professionalisation of the back office in support of the front-line teams' new missions
- National recognition, notably in France, where a three-year pilot programme has government support
- Evaluation has become more real and meaningful, taking into account differing local contexts, increasing delivery partners' motivation
- Reaching out beyond the immediate partnership, to act as a catalyst for other self-organised teams within the 2Seas area
- Positive progress on the Blueprint, showing the similarities as well as the challenges partners face