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i M pact on practice o U t comes and costs of N ew RO le S for health professionals. Professor Christine Bond, University of Aberdeen o n behalf of MUNROS team. Aim: Describe how new health care professionals are deployed Explore effect of skill mix on costs and outcomes
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iMpact on practice oUtcomes and costs of NewROleSfor health professionals Professor Christine Bond, University of Aberdeen on behalf of MUNROS team • Aim: Describe how new health care professionals are deployed • Explore effect of skill mix on costs and outcomes • Make recommendations for workforce planning
Project overview • high prevalence • significant morbidity and mortality • national guidelines • acute, chronic and surgical condition • Heart disease • (STEMI) • Breast cancer • Type2 diabetes
Project overview • high prevalence • significant morbidity and mortality • national guidelines • acute, chronic and surgical condition • SURVEYS and ROUTINE DATA • -12 hospitals (teaching; large general; other general; city/urban/small town/rural) • -Associated general practices • -Health care professionals/-Health care managers: Demographics, Educational qualifications, Hours worked, Perceptions of integration and specialisation, Drivers and barriers, Factors influencing decisions, What they do! • -Patients: Demographics, health care utilisation, experiences, satisfaction, perceptions • Heart disease • (STEMI) • Breast cancer • Type2 diabetes
Early findings • Care pathways and team composition are changing • External drivers are mostly professional influences and need for service redesign • Professionals also highlighted new legal rights • Managers make team composition decisions on staff skills and competences, staff experience and regulation • Budgets and perceptions of patient preferences least important • Patients are satisfied • Experience of care suggests it is not ‘patient centred’ • Care feels integrated but doctor is often still seen as ‘main’ provider • Next steps • Inter and intra country comparison • Cost effectiveness and clinical effectiveness • Recommendations for optimal team • Workforce planning tool
Issues for research • Engaging clinical colleagues • Differences in health systems, definitions, terminology across European countries • Distinguishing exact contribution to health care delivery to quantify substitution • Dynamic workforce context • Generalisability beyond three conditions
Acknowledgements We thank • 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 . • All those who supported and guided this work both within the MUNROS research project team and as external associates. • All the MUNROS research and project partners for their continuing collaboration in this research.