MUNROS is funded by the European Commission FP7 programme MUNROS is funded by the European Commission FP7 programme,

MUNROS is funded by the European Commission FP7 programme www.abdn.ac.uk/munros

MUNROS is funded by the European Commission FP7 programme, HEALTH-F3-2012-305467EC. Project co-ordinators Prof Bob Elliott, [email protected] and Prof Christine Bond, [email protected]

www.abdn.ac.uk/munros

On Health Care Reform: the iMpact on practice, oUtcomes and costs of New roles for health pROfeSsionals

Antoinette de Bont, Iris Wallenburg and the MUNROS team lead by Professor Elliot and Professor Bond.

Presentation to Zorgplatform, Utrecht,3rd December 2014

http://www.abdn.ac.uk/munros

mailto:[email protected]



http://www.tu-berlin.de/

https://www.abdn.ac.uk/

http://www.eur.nl/

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http://www.cuni.cz/UKENG-1.html


http://www.uib.no/en

http://www.manchester.ac.uk/


Agenda

• The aim of the study• Development of new professionals roles• Drivers and barriers to new professional roles• Conclusions about the impact



Aims of the study

• Detail the nature, scope and contribution of the new professional roles.

• Evaluate their impact on clinical practice and outcomes.

• Identify their scope to improve the integration of care.



Project Phase Lead Partner and Support Partner Work packages included

1. Mapping health system integration, skill mix and competencies

Scotland and Turkey WP 1 Understanding health systems

Netherlands and Norway WP 2 Mapping skill mix

2. Methodology and Study Design

Netherlands and Scotland WP 3 Case studies

Scotland and Netherlands WP 4 Questionnaire design

3. Data Collection, Data Management and Analysis

England and Germany WP 5 Impact on clinical practice and organisation of care

Italy and Poland WP 6 Outcomes: the Patient Experience

Norway and Czech Republic WP 7 Outcomes: Process, Productivity and Clinical Effect

Netherlands and Norway WP 8 Changes in Costs and Benefits

4. Translation into Policy: Delivering Impact

Germany and Scotland WP 9 New Professional Roles and the Integration of Care

England and ItalyWP 10 Management of Human Resources and Successful Workforce Planning

Scotland WP 11 Scientific Structure, Policy Engagement, Impact and Dissemination

5. Scientific Coordination

Scotland WP 12 Scientific Co-ordination

Structure of Research





Traditional care delivery with one specialist within a care organization responsible for the care delivery to a patient, supported by general nursing, technical and/or administrative staff

Physician-centred care

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SPECIALIZATION OF CARE Developments in medical technology and training

Developments in information technology







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Multiple specialists within a care organization involved in care

delivery to a patient, simultaneously and/or

consecutively, based on the required expertise, supported by

specialized nursing, technical and/or administrative staff

Expertise-centred care

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Production centred care

Co-ordination of care delivery to a patient with new general professional roles within a care organization (e.g. expansion of services) and/or between care organizations (e.g. primary and secondary care)








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Co-ordination of care delivery to a patient with new general professional roles within a care organization (e.g. expansion of services) and/or between care organizations (e.g. primary and secondary care)

Patient-centred care

Specialized, integrated care pathway








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Italy, Germany

Patient-centred care

Netherlands, Scotland

Turkey, Norway


The Czech RepublicPoland


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• New professional roles thrive within organisations, when they:–Increase efficiency;–Contribute to documentation work;–Offer patient centered care;



• New professional roles largely depend on individual willingness of an established professional.–Need to work close together to be

recognized as knowledgeable and competent; –Do the dirty work; –Go beyond qualifications to “get the

job done”



• The impact of new professional roles is SMALL but SIGNIFICANT.

• Small: – Few new professionals in new roles.– Physicians set the rules.– New professions are not well yet connected to

institutional agents.• Significant:– New professions do work physicians and nurses used

to do.– Health care organizations can and do create new roles.









Next steps

• Measure the distribution of tasks in the three care pathways in 12 hospitals and 12 primary care clinics in each country.

• Measure patients experiences in the three care pathways in 12 hospitals and 12 primary care clinics in each country.

• Compare the costs and outcomes.• Develop task- based workforce planning model.



• We wish to thank the European Commission for funding this research programme ‘Health Care Reform: The iMpact on practice, oUtcomes and cost of New ROles for health profeSsionals (MUNROS), under the European Community’s Seventh Framework Programme (FP7 HEALTH-2012-INNOVATION-1) grant agreement number HEALTH-F3-2012-305467EC .


Documents

MUNROS is funded by the European Commission FP7 programme MUNROS is funded by the European Commission FP7 programme,