Statement 1 Flashcards
Statement 1
‘An understanding of Section 2 of the Bengoa Report, Systems, Not Structures: Changing Health and Social Care: The Burning Platform - an unassailable case for change.’
The Bengoa Report
Chaired by Professor Rafael Bengoa, the then Minister of Health appointed a clinically led panel to examine and create plans on how to develop the future of health and social care within NI. The Panel was appointed in January 2016 and the report was completed in October 2016.
The Case for Change
The overwhelming evidence is that the existing system for providing health and social care in NI is struggling to sustain services in the face of changing circumstances and so a new model is required.
-Demographic Change
-Health Inequalities
-Demand
-The Workforce
-Financial Sustainability
Demographic Change
•People are living longer
•Ageing brings an increased likelihood of disability, dependency and illness
•Profile of older people requiring care is becoming more complex with older people now living with multiple chronic illnesses
What is the impact on the Health and Social Care (HSC) System of demographic change?
•People 65+ account for 42% of the HSC spending
•Due to people living longer with long term illnesses there is a huge pressure placed on the HSC system’s finite resources
•The current system is not able to cope with the significant demand associated with chronic conditions
•Acute hospital beds are being taken up by individuals who have long term illnesses
Health Inequalities
•Stark differences between life experiences of people in the most and least deprived areas within NI
•Males in most deprived areas live on average 7.5 years less than their counterparts
• Females in most deprived areas live on average 4.5 years less than their counterparts
•This difference impacts the HSC system, to include hospital admissions, emergency care etc
•Action is required across the government to improve universal public services
•40% of health outcomes are related to socio-economic factors
•To enable change to occur the health differentials within NI need to be addressed across all areas of health and social care
Rising Demand
Primary Care Service
•First point of contact for most people is the GP, ie the demand for access to GP surgeries has increased significantly as has that of GP out of hours
•Increased number of people with complex health issues
•The present system is not coping with these increased demands and requires a new model of care
Hospital Services
•Increased demand for specialist care, inpatients, outpatients and ambulance services
•Sharp increases in waiting times and lists
•Existing model is not addressing these challenges
Social Services
•There is a great diversity of providers of social care with significant amounts of social care being provided by the private and voluntary providers
•Poor social well-being can impact negatively on the quality of people’s lives, including health, so affecting the demands on the health care system
•Demands for domiciliary care, residential care and nursing home care are set to rise significantly largely due to the ageing population
Demand and the Patient Experience
•The sum of these pressures means that patients are admitted to hospitals unnecessarily and once admitted are forced to stay longer than they need which causes a range of further problems including poor inpatient experience
The Workforce
•Difficulties in recruiting and retaining staff
•HSC needs to encourage people to take responsibility for their own health and well-being
•Greater recognition of roles and expertise of all members of the HSC team and employing them in the areas that they are best trained for, thus providing the patients with the best care
•It is proving difficult to recruit and retain junior medical staff
Workforce difficulties:
•Locum & Agency Costs - Stark increase in the cost of locums is expensive. This money could be invested in developing services that are sustainable and long term.
•Primary Care Workforce - Growth in the GP medical workforce has not kept up with the demand.
•Social Care Workforce - Significant growth of independent sector in providing social care with recruitment and retention difficulties (partly due to the poor terms of employment, ie zero hour contract). Informal caters are the largest group providing care and they are unpaid.
•Nursing & Midwifery - Issues include vacancy rates, absence rates, age profile of nursing workforce and working patterns.
•Staff Morale - Very poor staff morale due to a range of factors including pressures associated with poor staffing levels and workload pressures. Staff feel demotivated as they feel they cannot do their job due to staffing pressures.
Financial Sustainability
•DOH’s budget is the largest among the Executive Departments, ie 46% (£4.6 billion) of the entire NI Executive Spend
•Current health care system will need a 6% budget increase each year to simply stand still
•If the system continues in its current form the costs are expected to double to £9 billion by 2026/27 simply to maintain current levels of performance
•Yearly funding needs to change to longer term funding plans of services to enable better services to be provided
Executive Summary - Introduction
Bengoa Report: Changing HSC
AS 5 ADULT SERVICE USERS: BENGOA REPORT - FACTFILE
