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This month’s edition of Healthcare Review – OnlineTM presents an overview of integrated care from Professor John Ovretveit. This edition is the first in a planned series focussing on integrated care, an area which has created considerable recent interest in New Zealand.
Professor Ovretveit is Professor of Health Policy and Management at the Nordic School of Public Health in Goteborg, Sweden and was formerly the Director of the Health and Social Services Management Programme at Brunei University in the United Kingdom.
Professor Ovretveit draws on his expertise in service quality management and his many years’ experience in evaluation of health care delivery systems. His paper provides a valuable overview of integrated care and outlines five models around which integrated care systems can be based.
The paper includes a review of those considerations which should be taken into account when deciding which model and methods of integration to develop and in deciding how to evaluate a proposal or active integrated care scheme. These considerations point to important issues for wider debate throughout New Zealand.
Professor Ovretveit describes the purpose of integrated care as the use of resources to the best effect to improve the health of a population through planning and through organising care and community actions in an integrated way. He goes on to define the intention of such an integrated care system to be the creation of a working health system from the variety of providers and informal groups which can identify local needs and priorities and the organisation of interventions in a collaborative way to meet the most pressing needs. Enigma Publishing will continue this series on integrated care in a number of editions to be published during the next six months which will focus on integrated care in the New Zealand environment. Each edition in the series will focus on different influences on the development of integrated care.
The May edition of Healthcare Review – OnlineTM will look at the roles of policy and ethics in the development of integrated care and will bring you viewpoints from some of those people who are most influential in the development of integrated care in New Zealand.
A contribution from Mr Philip Davies, General Manager Sector Policy at the Ministry of Health will focus on how policy could potentially influence the development of integrated care in New Zealand.
Complementing Philip Davies’ paper will be a contribution from Dr Graham Scott, Chairman Health Funding Authority, who will consider the role of policy in integrated care development from a funder perspective.
Ms Loraine Hawkins who is currently working in HM Treasury will provide some background to the two papers above by reviewing the role that policy has played in the past in health care developments in New Zealand.
To complete the contributions on the role of policy, Ms Cindy Kiro, Department of Social Policy and Social Work, Massey University will review the role of policy in integrated health care development from a more academic perspective.
Contributions reviewing the influence of ethics on the development of integrated care will be provided by Sir John Scott, Head of the Ethics Committee, NZMA, who offers his clinically oriented view, Professor Grant Gillett, Healthcare Otago, who has a strong grounding in philosophy and a bioethical focus, and Andrew Holmes, Senior Medical Advisor on the National Health Committee, who also offers a philosophical perspective along with Ministry experience.
These papers will address both the influence of ethics on the development of integrated care and the ethical issues around integrated care.
In addition Professor George Salmond, Victoria University, of Wellington, will write more broadly around issues associated with integrated care. He will address such subjects as the need for a balance between the influence of market forces, regulation and professional expectation in health care development and the need for developments in health care to be formulated alongside planned changes in other areas which impact on health, for example, changes in social policy.
The follow-up to the May edition will review the role of funding and development processes in the development of integrated care.
Planned contributions for this edition will address various issues in the development of integrated care. Papers will review issues relating to providers (Dr Clive Stone, GPA Chairman and Dr Ross McCormick, Department of General Practice, University of Auckland), structural issues (Dr Ian MacPherson, Executive Director Strategic Development, First Health Limited), and change processes and development issues (Karen Wells, Manager Integrated Care, Health Funding Authority).
A contribution from Dr Paul Brown, Midland Health will address the need for evaluation in integrated care development. A review of the ways in which funding and funding issues can influence the development of integrated care will be provided in a paper from Mr Steven Anderson, Principal Advisor, Health, Crown Company Monitoring Advisory Unit (CCMAU).
The role of funding and development from a Maori perspective will also be considered in papers from contributors who are yet to be confirmed.
Subsequent issues in the series will consider delivery systems in integrated care, with reviews of experience from health care primary and secondary care providers in both the public and private sectors, and the influence of technology on the development of integrated care.
We trust that you will find the integrated care editions form a stimulating and rewarding series.
