IPCHS. Integrated People-Centred Health Services


Learn from real-life experiences with health services reform. We distinguish three types: emerging, promising and leading practices. Share your practice by clicking "Add practice".

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Sept. 7, 2016 Europe

Introducing evidence-based guidelines through a best practice accreditation programme to improve care quality in Spain

Problem: Variability in nursing practices across Spanish health care organizations and concerns regarding the quality and safety of services provided; lack of comparable indicators across institutions with which to systematically monitor or evaluate nursing practices.

Solution highlights: The Best Practice Spotlight Organization accreditation model (developed by the Registered Nurses’ Association of Ontario in Canada) was rolled out in Spain to encourage care organizations to improve adherence to best practice guidelines; while the initiative activated a well-established and structured programme model, flexibility in implementation supported the tailoring of new practices to local needs; providers were given lead roles in implementing the ...

Sept. 7, 2016 Europe

Developing an integrated primary care model in Slovakia

Problem: Political concern for the chronic disease burden and suboptimal population health outcomes; limited availability of health promotion or disease prevention services;  concentration of service delivery in higher-level settings and weak gatekeeping at the primary level; fragmented delivery of services, with limited continuity of care for patients with chronic disease.

Solution highlights: Networks of primary-level integrated health care centres (IHCC) that co-locate providers and promote interdisciplinary team working are being developed and piloted; piloting of reforms will enable gradual introduction and testing of planned changes; a national-level framework provided the initiative with a strong starting base from which to develop ...

Sept. 7, 2016 Europe

Introducing palliative care in Serbia

Problem: Ageing population with increasing prevalence of chronic disease and progressive illness; concept of palliative care in Serbia was underdeveloped and end-of-life services had an acute, reactive focus.

Solution highlights: The Ministry of Health established the Palliative Care Task Force and adopted the National Strategy for Palliative Care to guide the development of palliative care across Serbia; partnerships with international organizations, local NGOs and supportive government actors helped secure buy-in at the national level; developing a legislative and political base was essential for creating a foundation on which to build the initiative; securing EU funding provided additional resources to support ...

Sept. 7, 2016 Europe

Integrating health and social care in San Marino

Problem: Ageing population with increasing chronicity and multimorbidity; increasing demand for greater coordination between health and social sectors.

Solution highlights: In 2004, the Government of San Marino began the process of integrating the health and social care system to improve care coordination and efficiency, and published the first social-health plan in 2006 to help guide change; health and social care reforms reinforced already widespread informal practices in service delivery and nurtured the existing spirit of mutual respect, collaboration and effective communication; familiarity and close professional relationships across health and social care sectors were integral to the development of the initiative ...

Sept. 7, 2016 Europe

Advancing nursing roles to improve disease prevention services in Samara, Russian Federation

Problem: Declining life expectancy during the mid-1990s indicated worsening health outcomes in the Russian Federation; risky health behaviours were highly prevalent in the population; service orientation was largely reactive and the availability of health promotion and disease prevention was limited; a restricted scope of practice for nurses left physicians overburdened.

Solution highlights: Polyclinic 15 led an initiative to expand health promotion and disease prevention services by advancing nursing roles. Nurses now independently care for lower-risk patients, perform screenings and deliver health education; expanding nurses’ scope of practice helped to overcome physicians’ capacity barriers. Physicians now report having more time for ...

Sept. 7, 2016 Europe

Integrating occupational therapy into cancer care in the Netherlands

Problem: Increasing number of patients living with or recovering from cancer; lack of rehabilitative services for people affected by cancer.

Solution highlights: Reade – an organization specializing in rehabilitative care – introduced a package of services specifically tailored to the needs of cancer patients and cancer survivors; support from Reade’s management in developing protocols and negotiating with national-level actors was essential for the implementation of the initiative; providers within Reade were brought together to apply their skills to treating the complex needs of cancer patients and survivors. Providers work in multidisciplinary teams to enable the delivery of more comprehensive care; initiative ...

Sept. 7, 2016 Europe

Strengthening cancer screening in Montenegro

Problem: Rising burden of cancer; high cancer mortality rates; lack of a proactive, preventive approach to cancer care.

Solution highlights: 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 ...

Sept. 7, 2016 Europe

Establishing a Gerontology Coordination Centre to improve care for the elderly in Monaco

Problem: Increasing chronicity in an ageing population; lack of coordination between health and social sectors; fragmentation across different levels of care.

Solution highlights: The Ministry of Health and Social Affairs opened the Gerontology Coordination Centre as a dedicated resource to support and provide services to elderly people aged 60 years and over; Monaco's small geographic and population size lent itself to a centralized approach. The initiative created a hub for the coordination of multiple aspects of health and social care for the elderly; services offered by the Centre are holistic, integrated, tailored to individual needs and place strong emphasis ...

Sept. 7, 2016 Europe

Developing an integrated information system in the Former Yugoslav Republic of Macedonia

Problem: Long waiting times for health services; weak communication channels between providers; lack of coordination and standardization in referral practices; dependence on paper-based referrals and inconsistent use of technology.

Solution highlights: The Ministry of Health designed and implemented a web-based appointment platform to streamline information flows and reduce artificially-inflated waiting times. Additional features, such as e-referral and e-prescription applications, have since been incorporated into the information system; a comprehensive investigation at the beginning of the initiative supported the development of an informed solution to directly address key challenges; alignment with previous investments in technological infrastructure enabled rapid uptake of the ...

Sept. 7, 2016 Europe

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

Problem: High rates of cancer mortality; projected rise in both cancer incidence and prevalence; concerns regarding the financial sustainability of cancer-related services provision; lack of coordination for cancer-related services.

Solution highlights: 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 ...