Child health general practice hubs: increasing access to paediatric care in the community

Developing paediatric capabilities of GPs and other healthcare professionals facilitates more healthcare delivery in community setting; "Whole-population approach" also addresses difficulties patients have in obtaining a GP appointment, as well as promoting self-care where appropriate; Attendance at A&E in relevant areas has declined, and patients feel more satisfied with care delivery in a community, as opposed to hospital, setting.

“Year of care:” GP delivered packages of care for long term conditions in inner-city London

In 2007, the borough became a pilot site for the “Year of Care” Project. This involved clinics “redesigning” the annual review that they undertook with patients. The newly-redesigned annual review took the form of a co-productive care plan, where patients were asked what was important to them, and what health outcomes they themselves would like to achieve.                                                 

In 2010, it was decided that ALL general practices in the borough should offer a core Service to people with type-2 diabetes. This involved creating additional packages of ideal care for people with type 2 diabetes across four clinical subgroups: newly diagnosed, controlled ...

The House of Care: Re-imagining primary care in Scotland

“House of Care” is a sequence of several interrelated, synergistic strategies, at the core of which is a patient-led care programme design; patients design their own care plan in consultation with practice nurses; patients report having more agency. Some patients report an improvement in biomedical markers, as well as overall wellbeing; Staff morale appears to have increased.

At Risk Individuals (ARI) programme, Counties Manukau Health (CMH) Auckland, New Zealand

The model of care provides early and planned interventions, establishes general practice as the centre of coordinated healthcare, provides care based on patient set goals and improves access to a range of specialist and community services; uses risk profiling as means to identify and judge patient eligibility; care goals are set and progress overseen by an assigned care coordinator; funded by flexible regime managed by the providers to ensure care goals can be achieved.

Integrating health and social care in Highland, Scotland

A lead organization model was introduced in Highland to promote greater integration between health care and social services. This new management structure united previously fragmented professional groups, serving to streamline service delivery and improve working relationships; broad political support for integrated care created a favourable environment for change; strong support from local senior management drove the initiative forward; extensive local engagement across all care levels ensured widespread buy-in for the initiative and reduced resistance to change across stakeholder groups; design and implementation of the initiative was iterative and not every detail was worked out prior to its launch; leaders stressed ...

Strengthening cancer screening in Montenegro

In 2008, the Government of Montenegro released the National Cancer Control Plan. Responding to recommendations proposed by the Plan, the Institute of Public Health developed a comprehensive cancer screening programme for colorectal cancer. Following successful piloting, the colorectal cancer screening programme is now being expanded to cover other priority cancers; partnerships with stakeholders outside of the health sector provided access to technologies and tools for engaging the public. Text messaging was the main tool used for outreach; moving from a reactive to a proactive approach was important for reaching and engaging the target population and increasing uptake of screenings; a ...

Developing a national cancer plan to coordinate the fight against cancer in Luxembourg

A national cancer plan was developed by the Ministry of Health to unite current services and coordinate the fight against cancer; ten priority areas for action were identified by the initiative: governance, health promotion, prevention, screening, diagnostics, treatment, rehabilitation, resources, patients’ rights and research; strong government commitment was essential for realizing a coordinated national approach; involving a diverse range of stakeholders from the beginning helped to guide the initiative; implementation of the national cancer plan is still in the early phases and any improvements will take time to observe.

Implementing targeted cancer screening programmes in the Czech Republic

The Ministry of Health developed a national cancer screening programme to increase population uptake of existing screening services. Through this programme, health insurance companies proactively send at-risk enrolees personalized invitations to participate in cancer screenings; strong Ministerial leadership provided an overarching direction for the initiative, promoting alignment across key stakeholders; use of available data helped identify key problems and supported tailoring of activities to meet observed gaps in service delivery; national information campaigns, run through various media channels, supported efforts by educating the public on the importance of cancer screenings; the initiative prioritized a proactive approach to addressing cancer mortality ...

Introducing home care services in Bulgaria

The introduction of home care services was proposed as a patient-oriented solution for ensuring appropriate service provision closer to home; a pilot approach allowed the gradual rollout and testing of an existing home care model being implemented abroad, which was adapted to meet the Bulgarian context; efforts to introduce home care included creating new roles and responsibilities for the health workforce and developing information and communication resources; establishing the necessary health system conditions, including the development of a supportive legal framework, is an important area of focus for advancing the sustainability and scale of the current transformations.

SUSTAIN: Sustainable tailored integrated care for older people in Europe

Problem: The project started from their observation that in all European countries, care for older people is often poorly coordinated. This prevents care from adequately meeting the needs of older adults, and it shows that quality of care and outcomes could be much improved.

Solutions:  SUSTAIN will in particular aim to support and improve what we call ‘integrated care’. By a better ‘integration’ of care, it means that: care for older people is better organised, and professionals coordinate the care they deliver; older persons’ health and social care needs are well assessed; care services listen carefully to older persons and ...