Conferences of health and care related sectors at the local level

Why was this example implemented?

Before the introduction of the conferences, no comprehensive policy on health promotion, prevention and long-term care existed on a local level. Many public and private stakeholders worked independently in the borough. The intention of the conferences is to enable a comprehensive approach in the LTC system with a special focus on participation by professionals, users and informal carers. A multidisciplinary network of important stakeholders in local care policy (including administration, formal and informal carers, public and private sector and self-help organizations) should bridge the sectoral gaps.

Description

In advance of the first official care conference two preliminary meetings with 30 stakeholders took place. The initiator of the care conference was the local health authority in co-operation with the authority of consumer rights. At the first kick-off meeting the local health authority spelled out the aims and challenges of the planned care conferences and interviewed the participants about their expectations and demands. It was suggested that an existing Geographic Information System (GIS, an interactive data-base of information and local service providers on health and LTC) should be further developed. Another topic was to change the name of the conference to ’Health and Care Conference Eimsbüttel’. Thus a Health and Care Conference was organised by the local authorities in co-operation with the task force groups and relevant actors and is held once a year. Agreed topics of the current conferences are further developed in task force groups. Currently four groups are in progress:

• Workgroup 1: Wohnen im Alter (housing in later life) 
• Workgroup 2: BEST (Prevention): Bewegung (mobility), Ernährung (nutrition), Soziale Teilhabe (social participation) 
• Workgroup 3: Sterbebegleitung (terminal care) 
• Workgroup 4: Gesundheit via Internet (health via internet) The municipality of the Eimsbüttel allocates a fixed yearly amount (€1,000) plus personnel and overhead costs for the running of the Health and Care Conferences.

What are/were the effects?

The Health and Care Conferences of Hamburg-Eimsbüttel bring together a multidisciplinary network of important stakeholders of public care administration, providers of formal and informal care as well as self-help actors and volunteers. The first step towards achieving this aim was to strengthen existing local networks of care services and connect different stakeholders in care activities with each other. The second step was to develop joint aims and strategies and create professional standards for health and social care quality (e.g. guidelines for preventing falls or improving comprehensive advisory services for persons with needs of care and carers). To disseminate results of the Health and Care Conferences an internet platform was established for carers and users with information and guidelines. It was important for the conference to include a plurality of different stakeholders from within and outside of the care sector and to commit to joint activities. Local health and care authorities have to be open to participative processes and demands articulated by the citizens. On this note health and care conferences could be recognised as a kind of “new public management strategy” targeting gaps and problems in LTC which are mostly out of the focus and accountability of the local authorities. Health and care conferences of the bottom-up type, like in Hamburg-Eimsbüttel, are not a common method of joint action of LTC stakeholders in Germany.

The practice of health and care conferences is established in all boroughs of Hamburg, in several cities of North Rhine-Westphalia and in Munich. Unfortunately, except for the minutes and documentation from each annual conference and the workgroups, there has been no evaluation of outcomes to this point. In 2007, on behalf of the Health and Care Conference and the local Health Municipality, a representative survey (n = 950) was carried out to explore the life and health situation of people older than 60 years living in Hamburg-Eimsbüttel. The results from the surveyed older people inform the objectives for the year’s following conference.

What are the strengths and limitations?

Strengths

• High network potential with a bottom-up strategy.
• Supporting interdisciplinary and inter-sectoral co-operation.
• Attention to and intervention on local demands.
• Creating precisely matched interventions on demands of LTC actors and users. 

Weaknesses

• No long term commitment of the participants.
• No direct influence on regional and state policies.
• Local health and care conferences are an attempt at compensating for gaps in general care policy.
• A pluralised proceeding sometimes leads to difficult and tedious decision making.

Opportunities

• Comprehensive health and care policy with user and carer participation.
• User-orientated solutions on the basis of local experiences.
• Networking of normally unconnected stakeholders, e.g. GPs and self-help groups. 

Threats

• The impact of improving strategies is highly dependent on the engagement of the participants in the health and care conferences.
• Changing majorities in the conferences could bring different opportunities for interest groups, which may not always mean benefits for users/carers, e.g. insurances, private stakeholders with market interests.

Credits

Links to other INTERLINKS practice examples

• Joint Strategic Needs Assessment (JSNA)
• The ‘Big Care Debate’ – public engagement in LTC funding

External Links and References

• Pflegekonferenz Eimsbüttel
• Grundlagenpapier