Northlake Analytics’ Post

Long-term care start-ups in Germany are announcing new partnerships with statutory payers almost every month. Yesterday, I had the pleasure to join a webinar organized by Vilans, a leading long-term care organization in the Netherlands. I presented the key dynamics in long-term care in Germany and the main start-ups to watch. A few additional thoughts: 1️⃣ 𝐒𝐡𝐨𝐫𝐭𝐚𝐠𝐞 𝐨𝐟 𝐧𝐮𝐫𝐬𝐢𝐧𝐠 𝐬𝐭𝐚𝐟𝐟 & 𝐥𝐨𝐧𝐠-𝐭𝐞𝐫𝐦 𝐜𝐚𝐫𝐞 𝐦𝐢𝐠𝐡𝐭 𝐛𝐞 𝐭𝐡𝐞 #𝟏 𝐩𝐫𝐢𝐨𝐫𝐢𝐭𝐲 𝐢𝐧 𝐡𝐞𝐚𝐥𝐭𝐡𝐜𝐚𝐫𝐞 There is a crisis on the demand side (always more elderly people in need of care) and on the supply side (not enough nursing staff). Technology is a key enabler to address this. 2️⃣ 𝐃𝐢𝐏𝐀 𝐢𝐧 𝐆𝐞𝐫𝐦𝐚𝐧𝐲 𝐦𝐢𝐠𝐡𝐭 𝐧𝐞𝐯𝐞𝐫 𝐜𝐨𝐦𝐞, 𝐛𝐮𝐭 𝐭𝐡𝐢𝐬 𝐦𝐢𝐠𝐡𝐭 𝐧𝐨𝐭 𝐛𝐞 𝐚 𝐩𝐫𝐨𝐛𝐥𝐞𝐦 I was first invited to the webinar yesterday to talk about #DiPA, which is the "DiGA for nursing". The DiPA framework would define a standard certification process and certified Care Apps (that are not medical products) would be reimbursed by the social care fund (up to 50 € / month). Even if DiPA should have been implemented in 2022, it is still not there. And it might never happen. However, this DiPA framework might not be needed. For example, Nui Care, a Caregivers' coordination App, which would typically be eligible for DiPA, is showing good traction, making direct deals with statutory payors. 3️⃣ 𝐓𝐡𝐞 𝐍𝐞𝐭𝐡𝐞𝐫𝐥𝐚𝐧𝐝𝐬: 𝐚 𝐫𝐨𝐥𝐞 𝐦𝐨𝐝𝐞𝐥 𝐰𝐢𝐭𝐡 𝐢𝐭𝐬 𝐨𝐰𝐧 𝐦𝐚𝐣𝐨𝐫 𝐜𝐡𝐚𝐥𝐥𝐞𝐧𝐠𝐞𝐬 Before the webinar yesterday, I always took the Netherlands as the role model for long-term care in Europe. A company like Buurtzorg, based on self-organized care teams, is a best practice example. However, the Netherlands is spending 4%+ of its GDP on long term care (ranking the highest with Denmark), while the average in the OECD country is 1.5%. If nothing changes, 1 out of 4 persons in the Netherlands would have to work in #healthcare in 2040 to cope with the demand. This is not sustainable. 4️⃣ 𝐍𝐮𝐫𝐬𝐢𝐧𝐠 𝐡𝐨𝐦𝐞𝐬 𝐚𝐫𝐞 𝐝𝐢𝐬𝐚𝐩𝐩𝐞𝐚𝐫𝐢𝐧𝐠 𝐚𝐧𝐝 𝐥𝐨𝐧𝐠-𝐭𝐞𝐫𝐦-𝐜𝐚𝐫𝐞 𝐢𝐬 𝐦𝐨𝐯𝐢𝐧𝐠 𝐭𝐨 𝐭𝐡𝐞 𝐡𝐨𝐦𝐞𝐬 The Orpea scandal in France is one example that #nursing homes might not be the solution for long-term care. Germany prioritizes keeping patients in need at home. Even at "level 5" care needs (the highest level), over 50% of patients receive #care at-home. 5️⃣ 𝐇𝐞𝐚𝐥𝐭𝐡𝐓𝐞𝐜𝐡 𝐚𝐝𝐝𝐫𝐞𝐬𝐬𝐞𝐬 𝐢𝐧𝐞𝐟𝐟𝐢𝐜𝐢𝐞𝐧𝐜𝐢𝐞𝐬 𝐢𝐧 𝐧𝐮𝐫𝐬𝐢𝐧𝐠 The at-home nursing market is a very fragmented market. In Germany, the top 15 players only capture 5% of the market. This creates inefficiencies. Typically, a nurse would do up to 50% of tasks that a less qualified person could do. Shifting care tasks to the appropriate skill level is a significant improvement lever. This is just one examples out of many. #healthtech Thank you Henk for the invite and insights! And join HLTH Europe in June to discuss!

Commitment To Moving More Care Away From Hospitals Questioned As Analysis Reveals Funding Cuts To Key Services A new analysis of day-to-day funding for NHS services shows that successive governments have not put their money where their mouths are to meet much-touted ambitions of moving more care away from hospitals. The analysis published today by the Nuffield Trust shows that when accounting for inflation (in real terms), total funding for NHS-ran patient care services has increased by 3.1% a year over the past six years, but this increase has not been applied equally to different sectors. While acute, ambulance and NHS mental health services have seen real terms increases, overall funding for NHS community healthcare services has grown much more slowly, at only 0.5% per year since 2016/17 or 3.2% in real-terms over the entire period. Some services – dentistry, public health, and prescribing - have seen real-terms cuts to their budgets over this time. The picture is even more stark once these figures are adjusted to take account of healthcare need, to reflect our aging population (known as “needs adjustment”). Needs-adjusted spending on NHS community health services in 2022/23 was 4.2% below where it was in 2016/17, meaning those services received £6 less per person in 2022/23 - when demand for their services is taken into account - than they did seven years ago. For dentistry the drop is 20% over time or the equivalent of a drop of £11 per person when adjusted for need. Local authority public health spending – which buys vital services like health visiting, school nursing, and promotion of good health - has been cut by 24% per person during this time, equivalent to a cut of £15 per person. Meanwhile, funding for mental health care, which has grown most significantly per person when adjusted for need, was £43 more per person, all stated in 2016-17 prices. The analysis of NHS funding by care sector is drawn from the detailed annual accounts of all 212 NHS provider trusts, supplemented with information from NHS England’s and the Department of Health and Social Care’s annual accounts. It is published as part of an update to the Nuffield Trust's Health and care finance tracker funded by the Nuffield Foundation and calls into question the commitment to moving care closer to people’s homes, a key plank of policy over the past decade. Of the nine NHS service funding lines examined in the analysis : - Four experienced average annual real-terms increases over the period - acute services (4.4%) mental health (5.3%), ambulances (5.2%) and GP primary care (3.3%) - Three experienced average annual real-terms cuts: public health (-3.9%) dentistry (-2.2%), ophthalmic and pharmacy spend (-2%) - Two were broadly flat: community services (0.5%) and prescribing ( –0.5%) on average each year over this period. The analysis also shows that: - When healthcare need is taken into account, the Nuffield Trust reveals that overall funding per head rose by …

Canada's primary care crisis is a growing concern, highlighted by the 10,000 patients in Sault Ste. Marie who recently lost their family doctors. A new Nurse Practitioner (NP)-run clinic is now serving as a bridge for these 10,000 patients, ensuring continuity of care until more primary health care providers are recruited: https://tgam.ca/45iwxYw These NPs have a larger scope of practice than many might think and can reduce the need for a general practitioner in many cases: CIHI Report: NP Scope of Practice: https://lnkd.in/dCp6HfWm An increased utilization of NPs in all primary care clinics in Canada, through a team-based care approach is a key step in solving this crisis. This approach not only reduces physician burnout but also improves patient access to care. At #Healtheon, we provide clinics with a sustainable solution using this team-based care approach and AI-enabled technologies that improve clinic efficiency. Together, we can address the healthcare access gap and build a sustainable future for Canada's healthcare system. #Healthcare #TeamBasedCare #PrimaryCare #NursePractitioners #AccessToCare #NPScopeOfPractice #PatientCare

Simon Parker posted an interesting headline about Care Workers being set to be trained to carry out basic NHS health checks such as taking blood pressure. I have had a quick look to see what is beneath the headline and it raises more questions than answers. The Government want to slash NHS waiting times by asking care workers to undertake e.g. taking blood pressures, injecting insulin with results being digitised to hook up with patients medical notes so they are not having to repeat themselves to medical professionals. My initial thoughts: Who is going to train the carers? Already, in some regions (if not all), district or community nurses are coming out to people's home, to care services to train PEG care and administering medication via PEG. If carers are going to be tasked to carry out basic NHS checks, then the training needs to be very carefully planned and very clear as WHAT checks will be within the Social Care remit. Taking blood pressure is easy. I do it at home, go onto the NHS website to the blood pressure checker, put in the digits and then I find out whether I have low, normal, or high blood pressure. But what do the carers do with the results? What will their be guidance as to when the blood pressure is of concern and what do they do if it is at a dangerous level? Who makes the final decision regarding actions, the carer or the office? When it comes to administering insulin, there are certain mathematics involved. Whilst I understand there are thousands who measure their own insulin, it can be a bit of a minefield. Medication is usually dosed, the carer follows specific instructions e.g. '1 to be taken 3 times a day'. Even, 'When required' medication (PRN's) have guidelines as to what and when that medication can be administered. But, working out and taking your own insulin is one thing, but when you are having to calculate and administer medication for somebody else, that is different. How are the competencies going to be measured? How would carers feel about this huge responsibility? Has anyone actually spoken to carers, services and managers about the logistics of this happening? Until I find out more about how this is rolled out and the thoughts of the professional carers, I'm keeping an open mind but I have a final niggle. In 2013, there was an independent review of Care after serious failings in care were discovered after the Mid Staffordshire NHS Foundation Trust scandal i.e. The Cavendish Enquiry. It was found that Care Workers were performing tasks that nurses or even Doctors were trained to do. It was found there was no clear line between the Care Worker and Health Worker roles and so there was a call for national standardise training to make that line clear. The Care Certificate was launched in 2015 for this purpose. If the plans to go ahead with Carers doing basic NHS checks, where will that clear line be now? Very interested in your thoughts on this. Further reading in comments

Most Canadians have a health-care provider but could be waiting weeks to see them, report suggests; "ER doctor sees 'trudging steps of progress' on health-care priorities"; "Most Canadian adults, 83 per cent, say they have access to a regular family doctor or nurse practitioner, according to a new report. But those with a dedicated provider may face lengthy waits, the report's author says. "The one thing that surprised me was the number of people who said that they had access to a regular health care provider," said Kathleen Morris, vice president of research and analytics at Canadian Institute for Health Information (CIHI) in Toronto. But, even those with a family doctor may have trouble getting in to see them without waiting weeks, said Morris. "Some of it might be because people have more chronic conditions that take longer when they have a visit." Thursday's report from CIHI takes the pulse on shared priorities agreed to by federal, provincial and territorial governments in 2023. That includes: Increasing the supply of the health workforce and decreasing wait times for surgeries, which recovered to pre-pandemic levels.  Improving access to mental health and substance use services. Modernizing health care information systems and digital tools for secure sharing of electronic health information. In 2023, 5.4 million (17 per cent) Canadians aged 18 and older didn't have access to a regular health care provider, such as a family doctor, general practitioner, medical specialist or nurse practitioner, according to the report."; (This report that claims 83 percent of Canadian access to a family physician or nurse practitioner is miss-leading. A physician has specialized education in medicine and is not that same as a nurse practitioner. The method and statistics used for this "report" should be presented here. It is likely that the majority of Canadian's do not have access to a family physician. - CJL); Amina Zafar · CBC News · Posted: Oct 24, 2024: https://lnkd.in/eUpSS9zz

No matter where you live, change is a constant in our world. Political shifts impact how resources are allocated for social systems, including healthcare. While some may debate the classification of healthcare under social systems, evidence suggests that health is fundamental for a functioning society. We've witnessed the effects of financial cutbacks that reduce preventive care, limit access to healthcare professionals, and overlook the growing needs of a diverse and aging population. At CHEN, our goal is to equip clinicians and healthcare workers—whether in harm reduction, rural/remote areas, or community settings—with the tools they need to navigate society's evolving landscape and more effectively meet the population's needs in a cost-efficient manner. Two prime examples of our focus: Healthcare Navigation: Navigators provide essential assistance in the complex and often confusing landscape of healthcare—appointments, referrals, and managing healthcare challenges (mental health, physical health, older adults, new immigrants, First Nations, and LGBTQ2+ communities). Many individuals feel overwhelmed and discouraged by long waits and lack of continuity, not due to healthcare providers' faults but because the system itself is strained. Professional Patient Navigators and Peer/Community Navigators bridge this gap, ensuring smoother journeys for individuals and families. They enhance the utilization of healthcare resources by maintaining continuity and communication. Wound Care: Chronic wounds in Canada are an increasing burden. Although it's challenging to gather accurate data on costs, chronic wounds are slow to heal and often poorly managed—not for lack of effort, but due to outdated knowledge on treatments. Wound care is not part of the curriculum for nurses or doctors (and what information they do receive as students is often out-of-date). While we expect current, evidence-informed care for cardiac and cancer treatments, chronic wounds are frequently neglected, with best practices often ignored due to perceived costs. However, appropriately treated wounds can heal within 6-12 weeks, yet many chronic wounds persist for months or years due to lack of knowledge and inconsistency as different care providers have conflicting ideas about what to do. Our wound care courses for nurses, PSWs, paramedics, and harm reduction workers focus on practical, effective, and cost-efficient treatments. At CHEN, we believe our programs offer valuable support to healthcare professionals, helping them navigate and manage the ever-changing healthcare landscape. Contact us at info@chenetwork.ca to find out more about the Fall/Winter schedule for all our courses and programs.

Continuing Healthcare Funding (CHC) is funded by the NHS and is payable whether you live at home or in a care home. It is not automatically awarded for certain health conditions, and it is not means tested. The assessment process is comprehensive and can be confusing, and success rates for being awarded the funding are on the lower side. In short, it can be difficult to get NHSCHC funding. Furley Page Solicitors have written this helpful guide which sets out to help you understand more about the funding, as well as providing information on making a successful application, and the appeals process. Read it here: https://lnkd.in/e7hGpVk6 #payingforcare #funding #nhschc #continuinghealthcare

Can the NHS being optimised? 🤷♂️ I was interested to read the recent Lord Darzi report which has once again highlighted the pressing need for innovation and efficiency within the NHS. As we look to the future, it’s crucial to consider not just how care is delivered, but also how it’s funded - yes and this is coming from a parent of a complex needs child. Fundamentally reliant on the NHS and it’s amazing services to keep my child alive and to provide the best quality of life he can get in challenging circumstances. In the world of Personal Health Budgets, care being provided to children with complex medical needs, requiring Continuing Health Care, there are 3 key headline figures. 💷 £256M (yes, 1/4 billion) is spent on Personal Health Budgets (PHB) each year across 42 Integrated Care Boards in England 🧑🧑🧒🧒 25,855 children are supported with PHBs, with the number growing by over 3,000 every 3 months, which means that this is not sustainable in the long term. 🍰 Slicing the overall £256m cake between Notional, 3rd Party and Direct Payment is heavily weighted towards Notional PHBs ❤️ 80% Notional - care agencies 🧡 5% 3rd Party - organisations 💚 15% Direct Payments - parents There is an absolute need for all 3 scenarios of PHBs, with care agencies being required when child first out of hospital, 3rd party if there are financial risks or just a little more control for parents and DP for those parents wanting full control and flexibility or currently through no other choice due to care agency breakdown. But, I believe that a lot more can be achieved by supporting parents to give them the skills and confidence to manage their child’s care package with the right oversight and ongoing support. By placing decision-making power in the hands of those who use the services, we can drive innovation, improve patient satisfaction, and ensure that every pound spent delivers maximum value. This model also aligns with the patient-centered vision outlined in the Lord Darzi report Reducing reliance on notional budgets and increasing the use of direct payments isn’t just about cutting costs—it’s about creating a more responsive and resilient NHS. To achieve this, the Parent-Empowered Model (PEM) needs to be more widely adopted across England and although some ICBs are ahead of this curve today change needs time, awareness and acceptance as well as implementation. So, in essence, from one parent to the NHS, we are a valuable resource that in some areas are yet to be discovered but with the right support and guidance by both NHS and lived experience can provide a more collaborative solution to provide a sustainable solution for the long term of Personal Health Budgets.

NPs are masters of finding ways to provide care when a need exists. Kudos to brave NPs like Kevin Zizzo for doing what needs to be done to ensure patients have a choice for access to care. With few options if not hired into one of the funded primary care positions in FHTs/CHCs/NPLCs, having patients pay an NP out of pocket is a workaround that most wish they didn't have to resort to. I appreciate their courage as many have faced harrassment for doing so (not so much from patients but from other providers, you know who you are). At least it has forced this government to review how healthcare is funded and who/how we compensate to provide that care. Our current model of paying for healthcare delivery is 60 years old and no longer matches the realities of team-based care and the complexity of patient needs. Other healthcare providers have the compentence and knowledge to provide much of the care that is needed, but we lack an integrated way to compensate them, forcing many patients to already overcrowded and fragmented walk-in clinics or emergency departments.

In the face of England's acute healthcare staff shortage, efficiency in healthcare delivery has never been more critical. The NHS is grappling with a severe scarcity of doctors and nurses, with just 2.9 doctors per 1,000 people compared to the OECD EU nation average of 3.7. This crisis highlights an urgent need for innovative solutions that can do more than just bridge the gap—they must revolutionize how care is delivered. At Navenio, we understand the gravity of this situation and the importance of a swift, effective response. Our technology is designed to optimize healthcare operations, ensuring that even with limited staff, patient care remains uncompromised. By improving operational efficiency, streamlining workflows, and supporting healthcare workers in their daily tasks, we can help alleviate some of the pressures caused by these shortages. Read the full article for more insights and solutions: https://bit.ly/4bA2NZ7 #NHS #HealthcareInnovation #PatientCare