Europrean Health Futures Forum FAN Club Presentation
- 1. European Health FuturesForum FAN Club 01.02.13,LSBU Marius Buiting, David Somekh 1
- 2. The future ofEuropean healthcare – a possible scenario 2
- 3. Adapted from Kees van der Heijden Scenarios: the art of strategic conversa;on: 2004 3
- 4. Source: Hans Kluge.Director Division of Health Systems and PH, WHO Europe 4
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- 7. Comment: note the‘solutions’ in the previous two slides. The whole presentation is a convincing over view of current threats to EU health systems. What is not convincing however is the proposal to do what EU health systems have signally failed to over the last 20 years (make significant inroads into the estimated annual 25% wastage of resources across the board). Systems are to be ‘strengthened’, not changed. Ironically, it shares characteristics of the ‘future is techno.’ approach (e.g. see Mike Jackson’s presentation on Shapingtomorrow, which skillfully scans potential technological advances and their impact but because of the audience it was aimed at doesn’t tackle the ‘elephant in the room’ issue that unlike airlines or production lines, present day health is manpower intensive and complex and especially vulnerable to the vagaries of the human psyche). 7
- 8. To summarise: ‘Sickness care’in its present form is notoriously wasteful and significant savings are likely to be achieved only by substantial change in the form of care delivery. There are many barriers, both institutional and political which hamper this transformation Increasing life expectancy results in an increased burden of potential healthcare costs which ironically may be exacerbated by increasing expectations from the public for care, the effects of greater health inequalities and of other factors such as migration, climate change etc. In the present setting, financial forecasts suggest that the envelope for healthcare spending has limited capacity for expansion Chronic mismanagement of workforce planning makes it likely that serious shortfalls will impact on quality of care 8
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- 14. There is indisputable evidence that European healthcare systems are simply not sustainable – even in the medium term future, but percep%on of threat cannot in itself bring about societal change. If the possibility of a poten;al collapse of the system can’t be contemplated, people will behave as if it isn’t there. Just like they did in the banking crisis. Analysis over a number of years of the barriers to fundamental change in health delivery systems leads to the inevitable conclusion that there is huge vested interest in maintaining the status quo: • For many clinicians (and some pa;ents), the cultural change is just too threatening • Despite accumula;ng evidence, policy-‐makers are simply not convinced about cost/ or poli;cal/benefit • Ci;zens are not sufficiently persuaded that personal responsibility pays off: being all too human • For business, stable condi;ons protect shareholder value 14
- 15. If all four major players are not really signed up to the concept of co-‐crea;ng health, perhaps its because the implica;ons of doing so are poten;ally a profound change in the nature of Health(care) provision, which inevitably threatens the vested interest of any of these stake-‐holders. Its like a ra;onal, progressive, energy policy: the means are there, but the resistance to change, from so many sources, is just too great. 15
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- 17. An interes%ng idea Several years ago (at the end of 2006 to be precise) a group of us found ourselves in a very unusual situa;on .....we were drinking in the bar of a hotel in a European capital city, late at night. We had by then spent many years working on improving healthcare quality, but recognised that the results of the labours, not just our own, but those of other prac%%oners in the field, represented a very poor return on investment. We concluded that what was required was a radical transforma;on in the way that healthcare was delivered; an ac%ve collabora%on between representa%ves from Industry, Educa%on and Healthcare, crossing tradi%onal boundaries. This we called our BIG IDEA. However, it took several years to find a means to put the idea into prac;ce… 17
- 18. In addition toour existing expert knowledge, we started to look at futures methods, such as scenario planning, horizon scanning and wild cards and weak signals methodology, to see to what extent these techniques had successfully been applied in the health field. We discovered William Gibson (author of ‘Neuromancer’)… “The Future is already here – it is just not evenly distributed” We decided to use what we had achieved thus far within Europe to establish quite a different enterprise… 18
- 19. ESQH was set up as a European NGO in 1998. It is registered as a charity in Ireland and the idea was to create a society of na;onal healthcare quality socie;es, to represent the grass-‐roots staff across Europe and whose mission statement was: • to promote communica;on between the stakeholders in European health quality • to champion quality in healthcare in Europe • to s;mulate innova;on in healthcare quality in Europe 19
- 20. Networks of networks EU agencies and Associates Offices Socie;es 20
- 21. ESQH offices – loca%on and func%on semi-‐autonomous franchise of ESQH brand London: Pa;ent safety Krakow: Quality Networks in Eastern Europe Aarhus: Indicators Padua: Pa;ent par;cipa;on Utrecht: Research in effec;veness Gothenburg: Transfer of methods from Industry to Health Barcelona: Quality in Mental health, Elderly; Social Care Lisbon: Health Futures (established November 2010) Vienna: Collabora;on between Health and Industry Sussex: Governance Athens: Cross-‐border Healthcare Berlin: Guidelines 21
- 22. Rela;onship to various European agencies • Links to EC – Membership of Health Policy Forum and PSQCWG – SANCO projects and networking – FP7 projects • WHO -‐ Europe: joint conference Copenhagen ‘05 • OECD -‐ involvement two indicator projects ’04/5 • Council of Europe -‐ working rela;onship on PS • EOQ and EHTEL -‐ memoranda of understanding • HOPE,CPME,EPF, EHMA -‐ ac;ve rela;onships 22
- 23. In summary, thereare several reasons that ESQH is well placed to provide a springboard for a new European NGO which concentrates on health futures. Among these are: It has a well established network involving 20 countries and contacts within several stakeholder groups in each Experienced at becoming involved with policy issues at a significant level, starting from scratch and building a brand Run as a lightweight, flexible but effective organisation that is more or less virtual but has appropriate governance Will build on ESQH’s work but will create its own brand and intends to operate faster, smarter and more effectively 23
- 24. What are thekey features in the current context that provide a rationale for EHFF? • Overall turbulence and interconnectedness of systems • Failure of experts to consider contingencies, even when recognising threats • Prevalent culture that supports innovation but is confused about the meaning and implications of the concept • Slow-adapting systems that are embracing sustainability but not resilience and do not espouse a holistic model of health 24
- 25. What are theUSPs that EHFF offers, that merit participating in its development? • Supporting disruptive innovation with a cross-sectoral focus using a network structure • Offering an approach to health scenarios which fosters on-going multi-stakeholder dialogue • Aiming to collect data that identifies potential threats to health systems in a more realistic timescale • Operating in a 21st century organisational mode, with an effective but fluid, inclusive and open-source orientation • Cognisant of current policy but side-stepping political pressures and the constraints of traditional institutions 25
- 26. Consistency of EHFFprinciples with Foresight concept 26
- 27. Brief summary of what EHFF will aKempt to do Create an open interac%ve forum, whose members will seek out, process and exchange knowledge and informa%on in real %me that may either influence the future of health and healthcare in Europe and/or provide a beKer understanding of future possibili%es and risks in this area. We aim to facilitate beKer ques%ons, not offer solu%ons. The business model involves establishing a diversely populated not for profit legal en;ty and incrementally building web presence, funding streams, eclec;c network of expert associates linked to current network, involvement in relevant European ac;vi;es, ini;a;ng own projects, on-‐going horizon scanning and promo;on of values. 27
- 28. Elements of firsttwo years’ work plans • Set up and refine web portal • Initiate marketing and fund-raising for projects and core operational costs • Align activities to current EU policy initiatives both at central level (EC) but potentially with selected regional initiatives also • Develop model for establishing mutual benefit network with wide range of partners • Create one innovative European event per year which reflects the philosophy and values of EHFF • Establish mechanism to attract young citizens, students, and entrepreneurs to become involved in EHFF activities 28
- 29. The three ini%al work streams (project categories) • A Europe-‐wide innova;on laboratory for improving health: its first projects would be a) involvement in European projects on pa;ent self-‐management b) the young health innovators project: EVY (a network project) c) a community of prac;ce for those at the leading edge of health professional educa;on d) other poten;al projects under review • The first ever Europe wide scenarios exercise for health that includes all the stakeholders • Linked to web-‐portal, begin scanning exercise on emerging health trends using sophis;cated techniques imported from other fields 29
- 30. Thank you for your ;me. Now, how might we work together? EHFF will become an established legal entity very shortly, at which time its web portal will become accessible 30