How Sláintecare is the appropriate framework for achieving personalised healthcare in Ireland
Liam Doran, Former General Secretary, Irish Nurses and Midwives Organisation (INMO and member of the Advisory Council for Sláintecare). Liam is also a member of the Irish expert panel for the FutureProofing Personalised Health Index, which is supported by Roche.
As he announced the biggest health budget in history last October, the Minister for Public Expenditure Michael McGrath, TD said: “We must grasp the nettle, implement Sláintecare and re-double our commitment to a publicly funded, universally accessible health service.”
Our health service has been the beneficiary of similarly grand pronouncements on many occasions but Sláintecare, for the first time, clearly articulates an ambitious but sustainable blueprint for a truly modern health service, one that has cross-party support and is non-political. This redesign and reimagination of how we deliver healthcare in Ireland has been further galvanised by the bruising experience of the Covid-19 pandemic.
But while many have heard the term Sláintecare, they may not be entirely sure what it means or the potential it holds for how we or our friends and families utilise and experience the healthcare system in Ireland.
The scope of health reform as outlined in Sláintecare, representing the greatest shift in social policy in this country in decades, is as vast and as complex as one would expect but ultimately it aims to improve patient and service user experience, as well as the clinician experience. Yes, it aims to deliver cost savings so that our health service is more efficient, but this is with a view to improving patient outcomes, not in spite of patient outcomes.
Central to this ambitious vision will be the delivery of truly personalised healthcare, with a focus on the patient and maximising the benefit they derive from their care. The paternalistic one-size-fits-all model of healthcare is outdated and now we must look to the needs of the individual to shape service delivery. Personalised healthcare is essentially tailored healthcare; it is quality assured, is individualised, is flexible, and is delivered where the person wants it delivered on a 24/7 basis. It keeps people at home, as far as is possible, recognising their autonomy and independence.
Historically, we have explained many of the failings of our healthcare system because ‘that’s the way it was always done’. This argument is no longer valid. The person is what is important – not the system. Bureaucracy should come a distant second.
The good news is that the building blocks of this revolutionary approach to healthcare are already being laid, even with the disruption to services that the Covid-19 pandemic has wrought. Critical to this transformation will be data, and the use of patient data to improve the wider health service, informing planning and addressing deficiencies. Ireland’s health service has a chequered past when it comes to the prudent and judicial use of people’s data so transparency and trust will be key tenets of this approach. Considerable political and public buy-in will be necessary if we are to utilise this priceless information to deliver enhanced healthcare in a more precise and expedient fashion. The recent findings of the FutureProofing Healthcare Personalised Health Index, supported by Roche, showed Ireland lagging significantly behind our European counterparts in this regard, with poor collection of, and access to, health data. As a result, Irish patients are missing out.
Building blocks require scaffolding – in this instance it is our IT infrastructure that must be carefully built first. Ireland has considerable problems with legacy IT infrastructure. Our failure to introduce a fully integrated electronic health record and individual patient identifier as part of a cohesive and coordinated eHealth strategy must be rectified and the necessary investment made if we are to truly future proof Irish healthcare and protect the privacy of our citizens as we roll out personalised healthcare and deliver Sláintecare.
The health system is a dynamic entity. Service users should be able to traverse seamlessly between the acute sector and the community, between the GP and elder care, with their records effortlessly accompanying them. The multidisciplinary team approach to providing care should be the default one and obstacles to accessing the right healthcare at the right time in the right place must be removed.
Essentially upgrading our entire healthcare system is not an overnight task but over the course of the 10-year strategy, Sláintecare should ultimately deliver us a health service that is fit for purpose and fit for patients. Its implementation has already begun but the urgency of its adoption is greater than ever. The Covid-19 pandemic has provided us with an opportunity to rethink the status quo and consider personalised healthcare as our fundamental approach within a patient-centric healthcare system. Sláintecare is a carefully considered, ambitious yet achievable roadmap for where we want to go. Bringing the public along on this journey will be critical.