Why are we implementing Community Healthcare Networks?
As we know, the healthcare system in Ireland is facing significant challenges.
We have a growing and ageing population. Life expectancy is increasing, as is the prevalence of chronic disease. These and other factors continue to place increasing pressure on our health services. There is consensus that the way we deliver services needs to change if we are to continue to meet the needs of people who use our services and for our staff.
The implementation of Community Healthcare Networks is about delivering this change. Networks will support multi-disciplinary team working and localise decision making. This will allow decisions to be made closer to the point of care and specific to population needs within the Network.
This will strengthen Primary Care team working and improve the experience for people who use and provide our services.
What is a Community Healthcare Network?
A Community Healthcare Network will deliver Primary Health Care Services across an average population of 50,000. The Network, will consist of between 4-6 primary care teams involving General Practice (GPs) in the planning and delivery of services in a structured way. There will be 96 Community Healthcare Networks across Ireland.
The Networks will manage specified Primary Care Team staff and enable collaborative multi-disciplinary team working, ensuring better co-ordinated care for people using our services. This will also improve integration with other community support services e.g. older people, disabilities, mental health and access to acute hospital services. The Networks will manage and deliver local services in a defined area, working together to meet the needs of the local community.
Benefits of Community Healthcare Networks for people who use our services and for staff?
Improving the experience for people using our services is at the heart of implementing the Community Healthcare Networks.
- Support people to live more independently in their community,
- Co-ordinate and integrate services to meet our changing health needs,
- Support collaborative working together to provide person-centred care,
- Ensure timely access to quality services nationwide.
Community Healthcare Networks are a foundational step in building a better health service. The Networks put the structures in place that will enable a better service be delivered to the people using our health and social care services and for the staff delivering them. It provides the framework for future healthcare reform and supports Sláintecare.
Benefits for people who use our services?
- Increased locally accessible services;
- Efficient move from community to acute services and back;
- More care at home than in hospitals;
- Prioritisation of service based on needs; and
- Early intervention and prevention.
Benefits for staff?
- New leadership roles with GPs and clinicians involved in Network management teams;
- Networks will provide staff with opportunities to work with colleagues from other disciplines in a new dynamic and integrated manner;
- Greater say and involvement in decision making at a local level;
- Investment in Learning and Development with appropriate mentoring, and development of leadership and management skills;
- Champion innovation and accountability.
Are Community Healthcare Networks part of Sláintecare?
Sláíntecare is the 10-year vision of the Oireachtas Committee on the Future of Healthcare. Central to the Sláintecare vision is integrated community-based care at the Right Place and at the Right Time.
Community Healthcare Networks will deliver Sláintecare's vision of bringing the majority of care closer to people's homes. Sláintecare supports a coordinated system of care, integrated around patient needs, with health professionals working in patient-focussed teams. This is what the Community Healthcare Networks will deliver.
The Sláintecare Report also called for the establishment of regional bodies based on the alignment of current CHO and Hospital Group structures. Six new regional health areas have now been announced. These new structures will be in charge of their own budgets, planning and delivery of both hospital and community care. The Networks will provide a framework for local integrated care within the regional reorganisation of services. The design of the structures for these new health care areas will take place over the next 12 months. This process will involve engaging with stakeholders, including the public and healthcare staff.
“Community-based care at the Right Place and at the Right Time”
What is the Learning Site process?
To ensure the implementation of the 96 Networks is successful and conducted in a safe manner, without disruption to services, an initial Learning Site process has been developed. Full scale implementation of a large and complex change can bring with it a lot of risk. Testing the model in a controlled and smaller scale helps mitigate against this.
Having an initial testing phase also strengthens the change management process. It provides us the opportunity to learn as we go – helping to support the successful full roll out on a wider basis.
How many Network Learning Sites will be implemented?
There will be one Learning Site in each of the nine Community Healthcare Organisations (CHOs). The Learning Sites will be in a mix of rural and urban areas and each Learning Site will serve an average population of 50,000.
How were the Learning Sites selected?
The nine Learning Sites were recommended by Chief Officers and their Senior Management Teams. The aim was to ensure that the identified Learning Sites tested as much of the service as possible to inform learning.
What are the timeframes for the Learning Sites?
- There will be a three month Launch phase;
- There will be a six month Implementation phase;
- Following implementation there will be a three month period to prepare for expansion.
Throughout both the launch and implementation phase, evaluation data will be gathered, analysed and lessons learned incorporated into the final Community Healthcare Network model.
How will you assure us that service delivery is maintained in the Learning Sites?
The Learning Site process was developed with the need for maintaining service delivery at the heart of it. The best way to test and learn from the implementation of Networks is to operate them in a real environment.
Additional monitoring and oversight controls have been put in place to ensure service delivery is not negatively impacted by the Learning Site process. To ensure it will be conducted in a safe manner, we will be collecting, monitoring and evaluating data from the beginning to inform learning and decisions.
All staff in the Learning Site will be provided with Learning and Development support relevant to their needs. The Chief Officer, Head of Primary Care and CHO Senior Management Team in each CHO will be involved every step of the way, establishing standardised governance and ensuring that the Network Manager and their teams are supported and set up for success.
How will Learning Sites be evaluated?
In order to monitor the implementation process, evaluation will take place on an on-going basis. Within each Learning Site we need to identify both what works well and any potential risks or issues prior to full scale implementation. Once launched, Learning Site evaluation data will be collected, monitored and reviewed.
We will be using staff surveys, interviews, stakeholder forums and existing quantitative data sources. Participants in the evaluation process will include CHO management, Community Healthcare Network Managers, Heads of Discipline, GPs, all Network staff and union representatives. We will share learning and evaluation results with staff.
What staff will be working in the new Learning Sites?
Primary Care professionals will be working within the Learning Sites. For the initial nine Learning Sites these include; Occupational Therapists, Speech and Language Therapists, Physiotherapists, Podiatrists, Dieticians and administrative roles.
A new role has been designed to support the model, the Community Healthcare Network Manager.
Other Primary Care staff will interact with the Networks including Social Workers and Psychologists depending on the needs of the population served by the Network but they will not report directly to the Network Manager for the Learning Sites.
How will staff within the Learning Sites be recruited?
The first role was advertised on the 29 May 2019 was the Community Healthcare Network Manager. This new role was open to applications from staff with a clinical background currently working in the health services (HSE, TUSLA etc.).
Any further recruitment required will be done by local HR, Chief Officers and the CHO Senior Management Team, in line with a national approach.
What will the Network Manager do?
The Network Manager will be responsible for the operational management of services in the Community Healthcare Network. Using a multi-disciplinary team model, the Network Manager will have responsibility and accountability for managing specified Primary Care staff within their Network.
The Network Manager will co-ordinate the integration of community healthcare services within the Network in response to the needs and requirements of the population. They will be responsible for service user involvement and lead out on engagement with communities.
What will the Head of Discipline do?
The Heads of Discipline will provide the clinical assurance and governance regarding the practice of each professional in the Community Healthcare Network.
The working relationship between the Head(s) of Discipline and the Network Managers(s) and the wider Community Healthcare Networks Teams are key relationships which must work effectively in order to ensure that the Network delivers on its objective of ensuring timely access for the right people at the right time.
It is envisaged, that in line with normal working arrangements that there will be on-going collaboration, engagement and communication between the Head of Discipline and Network Manager.
What ‘Learning and Development’ support will be provided to Learning Site staff?
Learning and Development support will be provided to all Learning Site staff. The programme team will be providing induction and orientation to staff working in the new Community Healthcare Networks. We want to support staff and ensure they understand their roles within the Learning Sites.
An orientation booklet, along with other supporting documentation will be provided so that staff can reflect and review this information following briefings and orientation sessions. An online learning ‘Network Hub’ will also be established in which all orientation and learning and development materials with be available to view online.
How will Community Nurses interact with Networks?
Community Nurses will be integral to the success of the Networks and will continue to work collaboratively with their Primary Care colleagues, as they do today, to ensure standards of care continue to be met.
How will GPs interact with Networks?
GPs are a crucial partner in the success of the Community Healthcare Networks. A designated GP Lead role will act as a representative for GPs at a Network level. The GP Lead will play a major part in the management and delivery of services within the Network and other community voluntary providers. Optimising integrated service planning at a Network level will support better coordinated care, allowing gaps in services to be identified and services to be put in place.
By enhancing community services at a Network level, we ensure that services are available where and when they’re needed.
How will Networks link to other teams delivering community services?
While the Network Manager is directly responsible for delivering primary care services, they will also be responsible for ensuring integration with other services, including home support, social inclusion services, community mental health etc.
They will maintain close working relationships with the people delivering these services and will ensure that access to all services is as smooth and clear as possible.
How will we communicate with staff?
We will communicate with staff on an on-going basis. Communications planning has been completed to ensure that information will be provided in a wide range of channels including face to face meetings, email updates and online at hse.ie/CommunityNetworks.
Communications will be on-going for the duration of the Learning Site. Staff will be invited and encouraged to provide feedback throughout. Local communications will be led by CHO staff and supported at a national level.