Dr. Sarah Barry

Summary

Health systems all over the world are struggling to provide equitable access to integrated, patient centred services that better meets the needs of individuals and populations. In Ireland, the way our health system is funded and structured creates particular barriers for people trying to access effective, responsive, quality care. The 2017 Oireachtas report, Sláintecare, set out a ten-year roadmap to deliver universal access to integrated care. In August 2018, the Department of Health published the Sláintecare Implementation Strategy which specified how Regional Integrated Care Organisations (RICOs) will be a central mechanism to funding and delivering healthcare regionally, based on population health needs, with a much stronger focus on prevention, better health outcomes, accessing care in the community. This research will be instrumental in influencing the design of RICOs and providing knowledge to enable those responsible for implementing Slaintecare (Sláintecare Implementation Office, Department of Health and HSE) to make evidence-informed decisions to deliver more effective, person-centred regional integrated care organisations (RICOs). This research will draw on international and national theory, evidence and experience to assist the Slaintecare Implementation Office work with key stakeholders to co-design the best implementation approach for RICOs. This research will be happening as the RICOs are at design and early implementation stage allowing evidence and knowledge learnt to actively feed into the realisation and development of RICOs. This learning will be useful for implementation of integrated care and major health system reform in the Irish context and internationally. The design and policy implementation process will be documented and a Living Implementation Framework with Evaluation (LIFE) will be devised in order to create a learning, iterative and collaborative practice of RICO implementation. The essence of this project is to use academic and real-world knowledge and evidence to bring about health system change in the public interest.

Funding Agency

Health Research Board

Programme

APA

Project Type

Applied System Change Mapping and Evaluation

Person Months

6

Summary

Review design, development, drafting and production; liaison with commissioners, collaboration with co-authors and supervision of research assistant

Funding Agency

Organisation Development and Design Services, HSE

Project Type

Research

Person Months

4

Summary

Funding Agency

Government of Ireland

Project Type

Technical Support

Person Months

2

Summary

Technical Assistance including in-depth engagement and collaboration with the All-Party Oireachtas Committee on the Future of Health Care in Ireland, generation of international evidence, data generation, coordination and management, report drafting and completion

Funding Agency

Government of Ireland

Project Type

Technical Support

Person Months

4

Summary

The current Irish Government has committed itself to achieving universal access to health care, free at the point of delivery, by 2016. Yet, at the moment, timely access to essential healthcare in Ireland is often determined by ability to pay, such as with private insurance. Further, those without medical cards or GP visit cards face high charges for GP care and may put off seeking care when they need it. The benefits of universal health coverage for relieving the economic hardship from seeking care and ensuring prompt access are well recognised and there is a strong international push to achieve this, led by the WHO. In 2005, all WHO member states, including Ireland, committed to achieving universal health coverage. Nevertheless, in the current economic environment, with a 22% cut in the health budget over seven years, high indebtedness and increased demand for health and social care, achieving universal coverage is a challenge. While there is a government commitment to universalism, much government action since coming to power in 2011 has involved squeezing budgets and transferring the cost of care from the State to the people. This research adapts and applies to Ireland new international methods for assessing the progress made towards universal access to health care and measuring the gap with universalisation. It also appraises options for getting there, reviewing international case studies and assessing and modelling options according to key criteria such as cost, requirements and complexity. Finally the research identifies the challenges likely to be faced, by assessing international experiences and evaluates whether and to what extent the current systems of organisation have the necessary capacity and flexibility to deliver their stated objectives. This evidence will help inform decision making and progress Ireland towards universal access, free at the point of delivery, for all the population.

Funding Agency

Health Research Board

Programme

HRA

Project Type

Applied System Change Mapping and Evaluation

Person Months

18