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Independent Hospitals Association of IrelandNational Healthcare Conference 2014, CEO Forum

Opportunities for Collaboration Between Public & PrivateCatherine Whelan, Chief Executive1st April 2014

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Agenda

IHAI Introduction

Current Collaboration

Opportunities

What’s Required?

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IHAI Introduction

Who We Are Representative group for the independent hospital sector in Ireland

Our members operate almost one-third of Ireland’s acute hospitals

Represent 20 independent hospitals providing acute & mental health services

“A high performance health system should provide patients with a wide choice of quality and

innovative services at an affordable price”

IHAI aims to help its members to deliver this vision to the patients they serve

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IHAI IntroductionOur Contribution to Patient Care Nationally

bed nights provided per annum

available hospital beds

patients cared for per annum (1 in every 5)

theatre procedures completed each year

diagnostic tests undertaken per annum

of all mental health care treatment

of all open heart surgeries

of all spinal surgery

people employed across Ireland

c1,000,000

1 in every 6

400,000

250,000

3,000,000

c22%

c50%

c65%

8,100+

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IHAI Introduction

Our Members

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Each sector working independently to address key challenges

Independent sector collaboration governed by competition law parameters

Many differences in operating models but many common challenges exist

Collaboration between sectors adhoc; no formal mechanisms to facilitate

Independent sector invited to participate in some fora, e.g., NCEC, NCAG

Opportunity being lost to share best practice, much duplication of activity

Current Collaboration

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❶National Standards for Safer Better Healthcare– Accreditation: Culture, Buy-In, Engagement

– Developing/evolving the Standards

❷Quality/Audit Initiatives– National Clinical Programmes

– National Guidelines, e.g. NEWS implementation

– Local initiatives, e.g., hand hygiene

– NOCA initiatives, e.g., INOR, IASM

– Training and implementation support

Opportunities for Collaboration

Patient Safety & Quality

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❸Research, Education & Continuous Learning

❹Joint Public Awareness Initiatives– Chronic Disease Management initiatives

– Mental Health Awareness programmes

Opportunities for Collaboration

Patient Safety & Quality (continued)

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❶Reimbursement– Claims Processing

– Days Sales Outstanding

– Pended Claims

– E-Claims System

– Data Protection Issues

❷Human Resources– Haddington Road Agreement

– Medical Manpower Planning

– Training & Development Initiatives, e.g., Open Disclosure, Complaint Handling

Opportunities for Collaboration

Efficiency

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❶National Service Planning – Optimal use of all national resources, expertise, capacity (early adoption of UHI principle)

– Address Waiting List challenge & underutilised capacity

– Avoids duplication of capital spend

– Govern by agreed protocols/MoUs via Hospital Groups

– Integrate State service strategy with independent sector facilities, e.g., mental health services

❷Technology & Innovation– Joint approach to introduction of new technologies/treatments on a partnership basis

– Optimise choice/access for patients to innovation

Opportunities for Collaboration

Service Delivery

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❶Licencing– Accreditation “Licence to Operate”

– HIQA Standards & Regulation

❷Hospital Groups/Trusts– Corporate Governance/Board structures

– Alignment to optimise use of local resources/expertise

❸Money Follows the Patient– Similar to current payer model re private healthcare

– ICD 10 Coding

– Composition of Tariff

Opportunities for Collaboration

Universal Health Insurance

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❹“Integration”– Basket of Services, Values Framework

– Systems, processes, etc.

❺Early Wins?

Opportunities for Collaboration

Universal Health Insurance (Continued)

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Willing

Established Structure/Mechanism

Follow Through

“Art of the Possible” approach

What’s Required to Make It Happen?

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Many common challenges exist

Efforts are being duplicated and best practice not shared as widely as possible

Many reasons why collaboration has not been optimal to date

Opportunities exist in many areas to collaborate for benefit of the entirety of the health system, and especially for patients

Moving towards “one tier” system – opportunity to move in that direction pre UHI introduction

Summary