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A National Health Systems Strategy for Malta 2014-2020
June 2013
Securing our health system for future generations
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Why a new NHSS?
� Health Vision 2000 (1995)
� Fast changing environment � (demography, epidemiology, financial)
� Challenges for sustaining the health system� EU Country Specific Recommendations
� Requirement for application for future EU funding in the health sector
� Impact of cross border directive
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Definition
A health system consists of all organizations, people and actions whose primary intent is to promote, restore or maintain health
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Project development
� WHO technical support through Bilateral Collaborative Agreement
� National Health System Strategy
� Health System Performance Assessment
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Underlying principles
� NHSS based on WHO and EU principles and targets
� Health 2020 (WHO)
� Health Strategy 2008-2013 (EU)
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Overarching objectives ofthe health system
ACCESSEQUITY
QUALITY SUSTAINABILITY
PERFORMANCE
Strategies for Action
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People centred approachPUTTING PEOPLE AT THE HEART OF THE NHSS
Real transformation can only occur when all these domains mutually reinforce each other
Individuals, Families & Community
Health practitioners
Health Org
HA
HA =health authority
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Objective 1
Respond to changing demand and emerging needsfocusing throughout the course of life
Strategic Direction 1A
� Prolonging stay / care in community for persons with complex needs and dependency
Strategic Direction 1B
� Strengthening disease prevention and health promotion focusing on healthy lifestyle choices and social determinants, early diagnosis and control of disease progression
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Actions
� Restructure and renew customer care
� Formally recognise and support informal care networks possibly also by engaging local councils
� Relocate services from hospitals to primary care
� Engage the health care workforce in prevention
� Further develop rehabilitation and long term care service capacity
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Objective 2
Ensure equitable access to services and medicines in a timely manner
Strategic Direction 2A
� Improving management and efficiency of services through research and innovation, needs based prioritisation, process re-engineering, and innovative service provision models including public-private mix
� Monitoring to take immediate remedial action in case of slippage
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Actions
� Enshrine patients rights whilst promoting civic responsibility amongst service users
� Improve bed utilisation: the right bed for the right patient
� Fully implement the waiting list management system
� Further develop financial and activity-based information
� Introduce new models for service provision
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Objective 3
Improve quality of care by ensuring consistency of care provided by a competent health care workforce supported by robust systems
Strategic Direction 3A� Setting and enforcing quality standards including licensing and accreditation and development and systematic application of case management protocols
Strategic Direction 3B� Facilitating continuity of care through co-ordination and integration between service providers, improving communication and sharing information through the development of e health systems
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Actions
� Legislate for systematic patient safety and quality
� Develop, update & implement clinical guidelines
� Enhance the role and responsibility of the family doctor as care coordinator in public and private primary care
� Strengthen the effective use of multidisciplinary teams
� Focus on recruitment, training and specialisation
� Invest in IT systems
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Overall Objective 4
Enhance the sustainability of the Health System
Strategic Direction 4A
� Improving systems governance through policies that promote a sustainable health system aiming for added value in all financing mechanisms, entitlement criteria, work practices and supply chain management
Strategic Direction 4B
� Building leadership and capacity for health and well being to develop the whole-of-government and whole-of-society approaches for health
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Actions
� Build the appropriate incentives for health system sustainability
� Increase consumer confidence in primary care
� Simplify entitlement processes and establish clear evidence based entitlement criteria for services
� Strengthen Financial and ICT capacity
� Exploit the potential of carefully managed PPPs and service provision through NGOs
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Discussion
� Will these priorities address the main bottlenecks in our health system?
� Will we succeed to put in place systems to prevent/ immediately recognise and rectify failures?
� Are the objectives sufficient to secure our health system in the coming years?
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Patients and Civil Society
� How can patients play a central role in further developing and monitoring the implementation of the strategy?
� Which mechanisms are most suitable to engage with patients for feedback and dialogue?
� Rights and responsibilities: How do we get this delicate balancing act right?