Progressive networks are the only option

Hospital networks and new primary care zones are ‘top of mind’ among care centres and care providers considering that they have far-reaching consequences for the future way of working.

Whenever you pick up a newspaper or journal today, the pages are plastered with articles on the healthcare reforms, with hospital networks and primary care zones leading the way. Both are ‘top of mind’ among care centers and care providers considering that they can have far-reaching consequences for the future way of working. It also colors the dynamic that exists today in this regard among care providers, who have already put a lot of valuable time and energy into consultations with possible network partners. Everyone hopes that there will be sufficient returns on the investments.

These primary care zones are already a fact in Flanders and the government has received a declaration of intent from the hospital networks. The last remaining pieces of the puzzles have since been put in their places. Partnerships in Wallonia must be shaped further in the coming weeks. But things are progressing, and the most important challenge will be to maintain this dynamic.

The government has resolutely opted for a bottom-up approach which has been fruitful: after all, this is only possible if both partners are fully invested in the relationship and that is much simpler if you can pick your own partner. Moreover, trust will be essential because this process promises to be a bumpy ride. The reforms must ensure better care and health at a higher level of efficiency. We must also mention that the required rationalization will have an impact on employment.

After all, the government has quite a few parallel bottom-up projects running simultaneously: the primary care zones, mental healthcare, and hospital networks. A map of Flanders shows that the limited amount of steering and the freedom to pick the network partners have still lead to well-delineated zones. It was inevitable that the maps for the primary care zones, hospital networks, and mental healthcare would not match perfectly. You can only achieve the right amount of overlap if you launch the processes consecutively, but that will not benefit the dynamic.  After all, we aren’t starting with a blank slate for the organization of the primary care zones, mental healthcare, and hospital networks; we must take the current care center locations, existing primary care partnerships, and traffic barriers that will impact transport time into account.

Although the shaping of the partnerships and primary care zones represented the crossing of the first hurdle in the reform process, the real work is only starting now.

Two things are important in the next step.

1. A joint purpose that must be transcribed into a strategic care plan which will serve as the policy cornerstone for our minister.

It will become the leading planning and
accreditation tool and must ensure that we can jointly move towards an integrated care model and a regional strategy that evolves based on need. The first task will be to create sufficient added value for the patients so that we do not lose them to another network. It is important to involve other actors in this regard. Many assisted-living centres and other care providers have had practically no impact upon the creation of the hospital networks and primary care zones, even though they are essential links in the development of solutions for chronic patients and the elderly who are actually at the foundation of the current reorganization.

2. A partnership model and network model that can build trust.

Principles of self-governance can help in this regard. In a self-governing or network model, each of the network partners can – within an agreed-upon context – take on a role and responsibilities, on the condition that the roles are clear and transparent rules are in place. The neutral role of facilitator is often a lever here to make progress, whereby all network partners participate in the same way as equals. This way, a distributed authority is achieved between the partners who make progress via small, frequent, step-by-step iterations.

No time to lose!

Networks that think offensively and organize themselves around a purpose, carried by all employees of the network, will detect opportunities and respond to them much faster. As a result, networks with a wait-and-see attitude risk to miss the boat. After all, technology does not stand still: new capital-intensive techniques, mhealth, sensors that facilitate remote monitoring and super-specialization of doctors make it necessary for us to consolidate the cooperation as quickly as possible in order to be able to fully focus on progress, supported by a broad base.

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