Integrated Care in NSW
Presentation to NSW Rural Health & Research Congress
Dubbo, 9 September 2014
Katherine Burchfield
Director, Integrated Care Branch
NSW Ministry of Health
Content
Why Integrated Care?
What does it mean?
The NSW Integrated Care Strategy
1
Various drivers are placing increasing pressure on our
health system
Growing and
ageing population
Increased number
of people living
with chronic
diseases
Increased
demands from
people with
complex needs
Societal changes
Reduction in length
of stay and
productivity targets
Increasing
demands
on the
health
system
Increasing
specialisation in
medicine and
nursing
Rising consumer
expectations
2
The current system is episodic and fragmented, focused
on patient outcomes by exception
Health
promotion
Planned care
at home
Outpatient
care close to
home
Residential
aged care
Planned
inpatient care
“Systems designed to treat occasional episodes of care for normally healthy people are
being used to deliver care for people who have complex and long term conditions.
Unplanned
hospital care
The result is that they are passed from silo to silo without the system having the ability to
co-ordinate different providers”
S Dorrell, NHS Health Service Journal, 2011
Current system tends to supports short term episodic care rather
than long term health and functionality
3
Why NSW needs integrated care
Ageing population
• The NSW population is expected to grow by about 1% per annum
• Over 65s will represent ~20% of the population in 2030 compared to 14% in 2006
• Healthcare expenditure for over 65s is two to three times higher than under 65s
Increase in
chronic disease
• Prevalence of chronic disease expected to increase by 15-20% in 2030
• Total number of chronic diseases to increase by ~1M (+33%) in 2030
Increase in
hospitalisations
and GP visits
• Length of stay has decreased but hospital separations have increased, resulting in an increase in
bed days between 2006 and 2011
• Number of bed days to increase by 51% to 9.7m in 2030
• Number of GP visits to increase by 64% to 56m in 2030
Increase in need
for health
workforce
•
−
−
−
Increase in need
for hospitals
• An additional 10,000 beds or ~114 hospitals will be required in 2030
Health workforce required to grow by 30-100% by 2030
36% more nurses
97% more physicians
30% more allied health professionals
4
Better integration of care will help to achieve a more
sustainable health system
Today
•
•
•
•
Fragmented
Episodic
Inefficient
Unsustainable
Tomorrow
Integration of care
?
Integrated, sustainable health
system
5
Content
Why Integrated Care?
What does it mean?
The NSW Integrated Care Strategy
6
What is integrated care?
Integrated Care meets a person’s needs by providing seamless, effective and efficient
care, organised for, by and with the person, from prevention through to end of life.
Care is person
centred
Care is a seamless
continuum
Care is effective
Care is efficient
Care is organised for, by and
with the person by bringing
care to the person’s
community or home rather
than the person to the care
Care is organised across
spectrum of care ranging
from social and preventative,
to primary and acute, through
to aged and end-of-life care
Care results in the outcomes
that are desired by the patient
and reflect achieved health
status, recovery process and
sustainability of health
Care makes efficient use of
both financial and human
resources
Value-based healthcare
7
Content
Why Integrated Care?
What does it mean?
The NSW Integrated Care Strategy
8
NSW State Health Plan
•
NSW State Health Plan launched in June 2014.
•
Three clear directions for the future delivery of healthcare in NSW
Direction One: Keeping People Healthy
Direction Two: Providing World Class Clinical Care
Direction Three: Delivering Truly Integrated Care
9
Announcement
Jillian Skinner MP
Minister for Health
Minister for Medical Research
MEDIA RELEASE
Thursday 20 March 2014
NSW GOVERNMENT COMMITS $120 MILLION TO INTEGRATED HEALTH CARE
The NSW Government will spend $120 million over four years to provide seamless care to people in
an integrated way - from care in the community to acute care in hospital.
Health Minister Jillian Skinner was joined at Parliament House today by community providers including
general practitioners (GPs) and non-Government organisations (NGOs) as well as representatives of
the primary care sector including pharmacies and private hospitals as she launched the Integrated Care
in NSW strategy.
Mrs Skinner described the NSW Government’s new focus on integrated care as a transformative step
for health care in this state ….
10
The NSW Integrated Care Strategy has three components
Description
$120M investment over 4 years
Statewide
enablers
Planning and
Innovation
Fund
Integrated
Care
Demonstrators
Goal
Indicative %
funding
Focused on information technology
infrastructure, outcomes measurement and
patient feedback, capacity building and
evaluation.
Establish key enablers of
integrated care benefiting all
LHDs and stakeholders
27%
Investment in individual initiatives and planning
at the local level, including extension of
successful integrated care approaches from the
Demonstrators.
Support local planning,
collaboration and innovation
initiatives
31%
LHD-led Demonstrators in Western NSW,
Central Coast and Western Sydney focused on
large-scale transformation of integrated local
health systems and testing initiatives prior to
extension across the State.
Develop system-wide
integrated care approaches in
three LHDs that are
transferrable and scaleable
42%
Implementation will involve partnerships with primary care
organisations, NGOs and private providers
11
The Strategy seeks to build and link on existing initiatives
12
Expected benefits
Better patient
experience
•
•
•
Easier navigation of the system
Reduced waiting times
Increased satisfaction
Improved
outcomes
•
•
Better patient reported outcomes
Improved long term health outcomes
•
Fewer avoidable hospitalisations and
ED attendances
Less duplication of services/tests
Less waste
•
13
Opportunities in rural NSW
•
Regional planning for health services and wider determinants of health
•
Move beyond consultation & coordination to true partnerships with primary care, aged care
providers, and Aboriginal Community Controlled Health Services (ACCHS)
•
New funding and business models – particularly for community-based health services - that
optimise workforce and funding streams
•
Improve IT infrastructure and information flow, including outcomes monitoring and feedback
•
Leverage MPS and service co-location ‘hubs’
•
Further embed telehealth and m-health
•
Greater use of telephonic solutions eg. HealthDirect
•
Explore the most cost effective pathways for supporting ‘health’ of remote populations
•
Promote prevention and early intervention
•
Consumer/community engagement, health literacy and self management
14