Preparing Irish healthcare for a patient-focused approach

As the Irish healthcare system prepares for an ageing population, bringing care to the home will be a key component

Front row: Mairéad McCaul, managing director of MSD’s Human Health Business in Ireland; Deb Mangone, Ireland country manager, Pfizer; David Clancy, director and country general manager, Ireland, Oracle Cerner. Middle row: Mark England, chief executive, HN; Shay Cloherty, managing director, iQuest/Business Post Live; Brita O’Reilly, market access and government affairs director, Janssen. Back row: Shane Williamson, business development manager, Clanwilliam Health; Alastair Allen, partner and head of healthcare technology, EY Ireland; Graham Armitage, managing director, EIT Health Ireland and UK; and Dr Ronan Glynn, partner and health sector lead, EY Ireland. Pictures Maura Hickey

“It’s been two decades of some of the finest minds here in Ireland and around the world sharing their creativity,” said summit chair Audrey Carville, journalist and broadcaster and host of Radio 1’s Morning Ireland, opening the 20th National Health Summit.

“I always leave the health summit full of hope and belief that, despite the system’s pressures, incredible work is going on all the time.”

While there was much hope to take from this year’s summit, which took place on Wednesday, February 7 in Croke Park, a full house heard both the progress and challenges facing the health sector laid bare, providing much food for thought for the next 20 years.

The scene was set up for the opening keynote from Damien McCallion, chief operating officer of the HSE.

Giving a robust overview of all the progress made and challenges faced, he mentioned the importance of having a north star to bring about change, using the country’s cancer strategy as an example of having a challenging implementation but led to a strong, positive outcome.

Leading into this was the technology and data viewpoint and how it can be used for integrated care delivered by Alastair Allen, partner and head of healthcare technology at EY Ireland.

Speaking about how new and emerging models of care are moving proceeds from the hospital to the community and home, there’s a danger that the technology supporting these changes ends up fragmented, resulting in what he calls “spaghetti architecture”.

“Organisations need to move away from an organisation-focused view of the world to a patient-focused view of the world,” he said.

The first panel session of the day looked at the past two decades of Irish healthcare to help better understand what actions to take for the future, which set the tone for the rest of the day, mainly that panellists and speakers would be candid about where the flaws are and what needs to be done.

In this were Georgina Cruise, national manager at the Patient Advocacy Service; Tony O’Brien, leadership, governance and strategy consultant and columnist; Mary Harney, independent director and business adviser and Minister for Health 2004-2011; and Robert Watt, secretary general for Department of Health.

Cruise highlighted the importance of putting a value on the patient voice and experience to help drive quality improvement for all, saying that it is about that communication with the patients, and putting it at the centre of that process.

Harney mentioned the flaw of the current set-up being “system-orientated rather than patient-orientated” with Watt stating that for the HSE to go for radical change, it needs the room to try things and potentially fail, knowing that the learnings will drive it forward.

The following panel discussion looked at cancer care and future innovations, which brought together Dr Grainne O’Kane, consultant oncologist and director of the Cancer Clinical Trials Unit at Trinity St James’s Cancer Institute, Dr Thorsten Giesecke, GM of commercial business at Janssen Sciences Ireland UC, and Averil Power, chief executive of the Irish Cancer Society.

O’Kane made clear her concerns in this area, stating that cancer patients deserve access to clinical trials stating that: “In Ireland, we don’t have enough clinical trials – the drugs are expensive, but they can help with [cancer care].”

Giving the international perspective for the panel, Giesecke mentioned that the discrepancy between urban and rural is something that exists in all countries, with patient perception playing a major role.

“This discrepancy between urban and rural areas is everywhere . . . and it’s a challenge we’re currently having, on one end, asking the clinics [to provide] more expertise, and do more special procedures,” he said. “On the other side, centres of excellence aren’t everywhere, so patients feel safe knowing they have a hospital close by. It means that this is what people need in order to feel well, and that’s something we need to solve.”

Making healthcare fit for the future

For the late morning sessions, the talks split up into three streams. The first was The Future of Aged Care which was chaired by Carville. This stream focused on areas that would help create an innovative and integrated care services as well as anticipatory care before concluding on a panel discussion on how policymakers can approach the challenge of an ageing population.

The second stream on Moving Care Closer to Home saw Paul Carroll, GP of Churchtown Medical, leading the discussion. One of the major focuses here was on the new Regional Health Authorities (RHAs), cited as a fundamental change in how healthcare will be delivered in Ireland. Coming into effect this month, the plan is that RHAs will aim to overcome the structural, political, financial and cultural barriers that have prevented integrated care and moving care closer to home.

Much of the focus was on how to bring care closer to home, with ways of looking at the role pharmacies can play, and the challenges in bringing innovations to the general populous.

The third and final stream focused on the challenges facing the workforce and was chaired by Colin MacHale, experienced EMEA sales director & former chair of Healthtech Ireland’s Digital Leadership Group.

He highlighted the importance of putting a value on the patient voice and experience

This delved into topics like a case study on how Scotland developed doctors for rural areas, the upskilling of healthcare workers, and how HR digital solutions can enhance healthcare efficiency.

Carville welcomed back the delegates returning from lunch to begin the afternoon sessions and paved the way for Deb Mangone, Ireland country manager at Pfizer. Mangone set the stage for the next session by mentioning how health care has gone full circle - from the home to hospitals and now moving back to the home again.

This set the tone for the afternoon keynote from Jos Creese, independent digital transformation consultant and non-exec director of Hampshire Hospitals Foundation Trust.

In a thought-provoking discussion on technology and digital, as well as the core challenges faced on an international level, one area he highlighted that governments fail to do is “make the connections between economic outcomes and health outcomes and the reverse”.

There were two more panel discussions before the day was out.

The first focused on accelerating digital transformation in the healthcare sector. It included Oracle Cerner representative Robbie Cline, joint CIO of London Northwest University Healthcare NHS Trust & The Hillingdon Hospitals NHS Foundation Trust; Neil O’Hare, professor of health informatics for UCD and group CIO for Children’s Health Ireland; Patricia Maguire, professor of biochemistry, UCD and director of the UCD Institute for Discovery, and Robert Forde, eHealth director & CIO of Dublin Midlands Hospital Group in the HSE.

O’Hare was blunt when saying the industry was miles behind when it came to digital transformation, with Forde mentioning that most care is on paper and requires capturing it in a meaningful way, saying it needs a “culture of understanding from the CEO in each organisation going right down”.

Maguire best summed up the current theme of the panel: “Any decision on incomplete data is guesswork.”

The final locknote panel discussion took a long-term view and analysed what can be done to best prepare the sector for 2040.

Driving the discussion forward was Prof Desmond O’Neill, geriatrician and stroke physician; Niall Conroy, acting chief economist and head of secretariat at the Irish Fiscal Advisory Council; Mairéad McCaul, managing director of MSD’s Human Health business in Ireland; and David Cullinane TD, Sinn Féin party spokesperson on Health.

Cullinane stated there was a huge appetite for change in healthcare, with such changing needing to happen more quickly.

When asked what his hopes for the next 20 years will look like, Prof O’Neill kept his concluding remarks simple.

“The danger is always the potential for novelty, so what we’re looking for is a more efficient way of what we do and what we know we can do,” he concluded.”