Integral care agreement
It has now been a month since the integral care agreement was signed. Never before have so many parties made agreements with each other about what healthcare should look like in the future. In case you do not yet know what the integral healthcare agreement actually entails and what it means for your care in the future, we will explain it here as briefly as possible.
To start with, why was the integrated care agreement actually created?
Healthcare in the Netherlands is already under pressure, and the future does not look very rosy, to put it mildly. Today’s healthcare workers experience high work pressure, bureaucracy and little autonomy. This results in high absenteeism, outflow of staff and an even higher workload among the still active healthcare staff.
The current personnel problem can be described as a kind of vicious circle that becomes more problematic with each round. Then about the future perspective. The Netherlands is going to age, and not just a little. In addition, people are also getting older and deadly diseases are turning into chronic conditions. If the current healthcare system does not change, 1 in 4 working Dutch people will be needed in healthcare by 2040, instead of the current 1 in 6. From an economic point of view, that number is not feasible because there will not be enough working people to keep all the other sectors in the Netherlands running. Healthcare costs will also triple between now and 2060 if nothing changes.
The challenge is to keep healthcare accessible, affordable and of high quality in the future. In order to achieve this, the parties have included eight components in the agreement that will be leading in the work agenda. Below we briefly explain them:
Appropriate care
Regional cooperation
Healthcare parties and government first look at the importance of healthcare instead of self-interest. They accelerate the concentration and distribution of medical and specialist care. Close to home when possible, further away from home for highly specialized complex care. The right care in the right place.
Strengthening the organisation of primary care
Permanently available primary care for everyone, these are general practitioners, physiotherapists, dentists and district nurses. The workload is relieved by the use of digital (self) care. This should provide more time for the patient with, among others, the GP.
Collaboration between the social domain, general practitioner care and mental health care
Offering care as early as possible in coherence. For too long, general practitioners have been responsible for people with a complex mental health care request. Healthcare must be present nearby and digitally and in the form of self-help modules where possible. These measures are intended to provide people with the right care earlier, improve quality and reduce waiting lists.
Healthy living and prevention
Prevention is better than fixing. A healthy lifestyle will have to become part of daily life. Support will first come from the public or social domain and will mainly be used for people with illness or an increased risk of illness.
Labour market and unburdening healthcare professionals
Working in healthcare must become more attractive. There must be more room for job satisfaction. Something must also be done about bureaucracy, autonomy and training opportunities for staff. Working as an employee must also be made more attractive.
Digitization and data exchange
Exchanging data is important to achieve the goals in the agreement. Electronic data exchange is becoming the standard in healthcare. From 2025, all Dutch people will also have their own health environment to which they can access digitally. Appropriate care also means a mix of digital and physical, i.e. hybrid. The starting point is as follows: yourself if possible, at home if possible and digitally if possible.
Contracting
Appropriate care also requires appropriate interaction between healthcare providers and insurers. Health insurers are committed to more equal focus in impactful transformations. As a supervisor, the NZA is important to ensure that sufficient care is purchased with a view to appropriate care.
In order to be able to realize these agreed changes, €2.8 billion has been set aside in addition to specific investment funds. The progress of the agreements will be monitored and accountability to society will be given. The implementation of the agreements will be tested for sustainability, among other things.
However, the healthcare agreement has not (yet) been signed by everyone. The National Association of General Practitioners (LHV) has not yet said ‘YES’ to the agreement. The general practitioners want to concrete result in the field of ANW and ‘More time for the patient’. If this can be met within 3 months, GPs are willing to sign the agreement. Actiz (trade association of approximately 400 healthcare organizations) also did not sign the agreement in the first place. Meanwhile, the members of Actiz have sufficient confidence that the agreements can be fulfilled and how this will be implemented in practice.
Source: Ministry of Health, Welfare and Sport. (2022, October 10). Integral Care Agreement: “Working together on healthy care”. Report | Rijksoverheid.nl. Retrieved 1 October 2022, from https://www.rijksoverheid.nl/documenten/rapporten/2022/09/16/integraal-zorgakkoord-samen-werken-aan-…
For an extended version of the agreement, we refer to: Integral Care Agreement: ‘Working together on healthy care’ | Report | Rijksoverheid.nl
