Abstract
Introduction: Health and social care in the Netherlands is undergoing a major transition. People receive health and social care at home as long as possible. Informal care has become more important and the municipalities have more legal tasks in providing social care for their citizens. The number of beds in nursing homes and psychiatric hospitals has fallen. After hospitalisation, people go home as soon as possible. Medical care after hospital discharge is given in the home environment. Since 2015 the Dutch Health and Youth Care Inspectorate (IGJ) has explored how to adjust their inspection policy to this transition.
Policy context and objective: The transition in health and social care requires IGJ to shift attention from inspecting health care providers to inspecting care networks. The object for IGJ is to:
get a basic understanding of what care networks are;
decide at what level care networks should be assessed;
develop methods to inspect care networks;
select items that are key for integrated care.
Targeted population: Integrated care is essential for people with multiple care needs, living in home environments. Target groups for IGJ are frail elderly people, people with severe mental health problems or seriously ill children who receive specialist care.
Highlights: IGJ has developed a policy for inspecting integrated care. The main points are:
-Care networks should be considered from the client perspective. Personal care networks are the starting point for inspecting integrated care;
-The inspection framework for personal care networks in home settings poses four key questions concerning whether the care network:
provides person-centred care?
collaborates with principal carers?
collaborates to provide coordinated care?
provides safe care?
-Results on the level of the personal care networks can be aggregated on a local or regional level. The key question on the local or regional level is:
-Do health and social care providers facilitate collaboration in care networks?
-The role of IGJ in integrated care is to ‘identify, set the agenda and promote’. This role fits in with the changing care landscape in which care networks are still undergoing development.
Comments and transferability: IGJ has executed several projects to develop and test a new policy for inspecting integrated care. These projects were small and mainly executed on a local level. To expand this is a main challenge for the next years. The question of who is ultimately responsible for the quality of care networks has not yet been answered. That makes the governance of care networks a major issue in the coming years.
This policy could inspire inspectorates in other countries. It is clear that the policy should be adjusted to the country context.
Conclusion: IGJ has developed a new policy for inspecting care networks for people with multiple care needs. This policy is consistent with changes occurring in health and social care in the Netherlands. Further development is needed and the question of accountability for the quality of care networks is on the agenda for the next years.