
Nora's Story, depicting an integrated care for older people
The National Integrated Care for Older Persons (NICPOP) is a multi-faceted approach to designing and delivering integrated care across local communities and hospitals between providers, users and carers. The concept requires a complete change in how health and social care is delivered nationwide, with a strong focus on patient experience and quality of care. Health and social care systems recognise that sustainability strategies lie in a population based health approach. The key cohort of this approach is older persons. At the essence of such change is a need to transition from an acute, episodic care to longitudinal, coordinated and integrated care models.
The key deliverables of the Integrated Care Programme for Older Persons included establishing local and national governance and recruiting clinical posts to become a catalyst for integration locally. A core component of the ICPOP approach is to leverage existing community resources in the local health ecosystem. These include acting as a conduit to and coordination of integrated care in tandem with social care providers (public and private), community intervention teams, day hospital, day care, community intervention teams etc.
The Integrated Care Programme for Older Persons now looks to build important work through active collaboration between clinicians and managers across the system. The 10-Step ICPOP Framework seeks to bring together the best elements of local health systems and support clinicians and managers to build on the delivery of design models established in NCPOP (2012) using an integrated framework.
Importance of the Programme
The increasing aging population is having a significant effect on the healthcare system. Such a trend is resulting in a greater health and social care consumption. This section of the population represents a “high need, high cost” patient group within which 5% occupy between 27% and 50% of hospital beds.
It is important to understand demographic trends when estimating the need for health services. The Department of Health (Health in Ireland, Key Trends December 2015) has highlighted that the over 65s are increasing at a faster rate in Ireland compared to most other EU countries.
The sustainability of these health and social care strategies are clearly under stress. The life expectancy of females and males have grown significantly over the past few decades particularly for those aged 75 and above ( 29% and 39% respectively). There is an expected growth of 60% more people aged over 65 in the next ten years, with the population over 85 to double. In order to meet the needs of the later, a 15% increase in resources will needed by 2021, in order to meet this demand. People aged over 65 generally occupy 50% of acute hospital inpatient bed days, this is projected to increase greatly in the coming years; at this rate a required increase in beds is needed, at a rate equivalent to building a new midsize hospital every day for the next ten years.
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