Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej HOW THE EU STRUCTURAL FUNDS SUPPORT THE HEALTH CARE SECTOR IN POLAND Małgorzata Zadorożna, Deputy Director of the European Funds Department Pilsen, of June 2013

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej The goal of the Ministry of Health is to ensure a fair, equal and effective access to high quality health services for society

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej European Funds Department - Organizational Chart Who we are?

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej The overall amount of funds involved in implementation of the National Cohesion Strategy is approx. EUR 85.6 billion. The average annual expenditure for the implementation of NCS (until 2015) will amount to approx. EUR 9.5 billion, which corresponds to approx. 5% of gross domestic product. The amount covers: Structural funds in Poland

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej Support for the health care sector within the EU Structural Funds Infrastructure & Environment Operational Program (I&E OP) – 396 million EUR Human Capital Operational Program (HC OP)– 118,2 million EUR 16 Regional Operational Programs (ROP) – 613,8 million EUR Innovative Economy Operational Program (IE OP)– 215 million EUR Total = approx million EUR

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej IMPLEMENTATION OF THE STRUCTURAL FUNDS THE HEALTH CARE SECTOR I&E OPHC OPIE OP MA - MRD IB - MoH 2nd level IB - CHIS MA - MRD IB – ML&SP 2nd level IB - MoH Beneficiary - CHIS MA - MRD IB - MAD Individual beneficiariesSystemic beneficiaries Projects under the call for proposals procedure Projects under the call for proposals procedure

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej Health sector in I&E OP (European Regional Develompent Fund) Priority Axis XII Health security and improving the efficiency of healthcare system Total financial allocation for Priority Axis XII: Initially 411,75 million euro Currently 465,55 million euro ERDF contribution to Priority Axis XII: Initially 349,99 million euro Currently 395,72 million euro

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej The objective of Measure „Reducing the mortality rate and consequences of complications caused by accidents and other sudden health and life-threatening situations” Health sector in I&E OP (Measure 12.1)

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej Hospital Rescue Wards (A&E) (approx 100 million Eur) (approx 30 million Eur) Landing grounds and bases for the Polish Medical Air Rescue helicopters (approx 30 million Eur ) Trauma Centres. Ambulances for the needs of EMS teams (approx 25 million Eur ) 17 Voivodship Emergency Call Centres (approx 15million Eur ) Health sector in I&E OP (Measure 12.1)

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej Landing ground for helicopters in Health Care Institutions Complex in Ostrów Wielkopolski

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej The objective of Measure „Increasing quality and access to specialised and highly specialised medical services” Health sector in I&E OP (Measure 12.2)

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej Extension and modernisation of trans-regional health care institutions Purchase of diagnostic and therapeutic medical devices Purchase of medical imaging equipment Approx 70 projects will be implemented under Measure 12.2; Total value of ERDF contribution is 200 million Eur; About 55 health care institutions will receive support, i.e. over 70 % of all trans-regional units; Health sector in I&E OP (Measure 12.2)

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej Hemodynamics Laboratory in the Silesian Center for Heart Diseases SCCS w Zabrzu

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej announced competitions (calls for proposals); 33 individual projects (including 2 reserve projects); 331 financial agreement signed; 1,34 bn zl - total value of ERDF contribution; 217 completed projects; Location of the projects on the map of Poland Health sector in I&E OP - progress

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej Priority II: Development of human resources and adaptation potential of enterprises and improvement in the health condition of working people. Measure 2.3: Strengthening the health potential of the working persons and quality improvement of the healthcare system functioning. Total financial allocation for Priority Axis II, Measure 2.3: Initially 105 million euro Currently 118 million euro Health sector in HC OP (European Social Fund)

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej Health sector in HC OP (ESF) Sub-measure Development of complex healthcare programmes – systemic projects. Sub-measure In-service training of medical personnel – systemic projects. Sub-measure Enhancement of the healthcare management quality – systemic projects. Sub-measure Development of personnel qualification contributing to improvement of the healthcare management quality – call for proposals projects.

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej Type of conducted operations (projects): 1. Development of complex prevention programmes adjusted to the needs of particular employee groups/occupational groups, in particular the ones oriented at the reduction of occupational disease occurence; 2. Development of complex programmes oriented at return to the market of specified employee groups/occupational groups with confirmed occupational diseases; 3. Education within the specialization of deficit physicians, i.e. oncology, cardiology, occupational medicine physicians; 4. Vocational education of nurses and midwifes, in particular under bridging courses; Health sector in HC OP (ESF)

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej Type of conducted operations (projects): 5. Postgraduate and vocational education of the representatives of other medical professions; 6. Support for the quality accreditation process of healthcare institutions; 7. Training for personnel, in particular the managing staff of healthcare institutions i.e. the NFZ (national payer) managing personnel, development of qualification standards for the managing personnel in the healthcare system. 8. Courses, training and postgraduate studies for non-medical personnel of healthcare institutions (especially managing and administrative staff). Health sector in HC OP (ESF)

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej „Professional training of nurses and midwives - bridging studies” Value: around 43,8 million € - the biggest budget in sub-measure Beneficiary: Ministry of Health – Department of Nurses and Midwives Implementation period: – Outcomes: total of nurses and midwives have graduated from the programme (it was planned to support nurses and midwifes but the big interest cause raising of the outcome to nurses and midwifes); project is being co-realised by 61 medical schools/universities accredited by the Ministry of Health in the aspect of providing nursing and midwifery training;

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej „Professional training of nurses and midwives - bridging studies”

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej „Support to the system of medical rescue through training physicians, paramedics and medical dispatchers” Value: around 8,6 million € Beneficiary: The Medical Centre of Postgraduate Education Implementation period: – Outcomes: (planned to be 8500) paramedics trainned, 595 (ultimately 1920) medical dispatchers trainned, 62 (ultimately 200) physicians finished full cycle of training, creation of „Simulation Centre” (pictures attached)

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej

Project on Diagnosis Related Groups (DRG) as best practice of ESF systemic intervention Value: around ,00 € Beneficiary: The National Health Fund- the sole payer in the system which is in charge of health care financing and contracts with public and non-public health care providers Implementation period: – Outcomes: 1600 persons trained and prepared for DRG system implementation in Poland

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej DRG Project The reason for starting DRG Project was necessity to prepare the tools to support the implementation of new reforms for financing the healthcare services in inpatient care. The inpatient care constitute the biggest share out of all healthcare services. It consists of the series of conferences, workshops, seminars and regular courses of trainings for different types of health sector workers: - managers of hospitals, - coders, - managerial staff of NHF’s Central Office and its regional branches

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej DRG Project - implementation The directors of hospitals were equiped with actual sets of DRG’s analysies in division of the procedures included and the average length of patient stay in the hospital, etc. The analysies that were produced for DRG’s Project have gained recognition among the managers of health actors. Currently it is annually published as a managerial tool on the NHF’s website. There have been worked out 2 training programmes: 1.DRG. The management in a healthcare system 2. DRG. Theory vs. Practice The training courses, apart from education values, provided a field for exchange of expierences connected with newly launched DRG system and the improvement of the system. There have been organized 3 conferences that enabled the exchange of experiences between the employees of healthcare system. The remarks and comments of participants were the basis for implemention of new regulations of NHF’s President

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej DRG Project - implementation The personnel of NHF had been prepared to use the analitical tools for collecting data by NHF. The international cooperation in a field of DRG has been established throughout Europe.

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej DRG Project – Publications (Books, Leaflets, Newsleters)

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej DRG Project – Publications (Books, Leaflets, Newsleters) There have been issued two unique publications: Diagnosis Related Groups. A guide to system by Adam Kozierkiewicz Diagnosis Related Groups. A basis of the system by Dariusz Gilewski

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej DRG Project - e-learning online platform

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej DRG Project - e-learning online platform The free of charge portal has been launched, the sole one that is dealing with DRG’s issues. It is intended for employees of hospitals and NHF. In response to the participants’ demand, instructional films and decision-making game have been designed and included in the platform.

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej DRG Project - e-learning online platform

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej DRG Project - e-learning online platform

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej DRG Project - e-learning online platform E-LEARNING SAMPLES OF CODING DRG GROUPS

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej National Health Funds’s Academy Project The Project – NHF’s Acadey is partially a continuation of a project called „DRG”. It resulted from introduction of new way of settlement (DRG) of further healthcare services ( rehabilitation in X 2010 and outpatient care in VII 2011). The assumtions of the Project are the answer to trainig needs in health sector. That is why they’re very popular among beneficiaries.

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej NHF’s Academy Project Value: around 1,5 milion € Implementation period: – Outcomes: persons trained through stationary courses, persons trained though e-learning Beneficiaries: Managerial staff, Employees of administrative units, Specialised employees ( analystics, physicians, nurses), Lower staff ( secretaries, receptionists), Patients

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej NHF’s Academy Project – stationary courses Patients’ rights ( 6 editions + 3 additionally), Principles of functioning the healthcare system in Poland ( 6 editions), Principles of appropriately prepared offers within competition for healthcare services ( 3 editions), Prinicples of contracting healthcare services (11 editions), Principles of reporting medical services that has been realised ( 3 editions)

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej NHF’s Academy Project – expected results The courses are aimed at: developing abilities of effective management and successful using of practical knowledge among staff of healthcare providers, improving the level of healhcare services, improving the patient’s services, improving the relations between personnel and patients, increasing the level of patients’ consciousness about the rights they are entitled to.

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej NHF’s Academy Project – activities Additionally, within the project we are supporting the development of DRG system to improve effectiveness of expended public funds alloted for healthcare services and the development of modern forms of training like e-learning, The national conferences are intended for people connected with healthcare system in Poland and will aim to expand the knowledge on organizational regulations, exchange of experiences, identify the possible problems to arise and seek a new forms and methods of solutions of them.

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej NHF’s Academy Project – activities Evaluation of management and financial system of healthcare in Poland will be the basis for assessing the assumptions and financial effectiveness fulfilled by NHF, The preparation and issuing the guidebook for patients that includes patients’ rights and information that ease moving inside the system will have a positive effect for the whole healthcare system’s image.

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej NHF’s Academy Project – activities After the first cycle of the training destined for healthcare providers on patients’ rights ( XII 2011-III 2012), three forth of particpants has decalred the increase of their knowledge by 75%, All beneficiaries (99%) responded positively to the question whether the Project had the impact on the improvement of informative politics conducted by NHF.

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej NHF’s Academy Project – goals The development of effective management abilities among directors of medical entities, The improvement of the level of medical services and patients’ service, The improvement of effective expenditure of public funds alloted for healthcare services

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej Support for the health care sector in Poland beyond 2014 (the EU financial perspective ) OUR PLANS AND EXPECTATIONS

INNOVATION IN HEALTH CARE (ERDF, ESF): Main goal: Strengthening the competitiveness of the Polish medicine industry and the effectiveness of the health care system in particular by stimulating and supporting R&D, product, process and organization innovations.

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej INFRASTRUCTURE OF HEALTH CARE (ERDF): Main goal: Strengthening the health safety and improving the health condition of the society – the determinants of the increase of the social cohesion and work activity.

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej HUMAN CAPITAL IN PUBLIC HEALTH (ESF): Main goal: Increasing the work activity of the society and reducing health inequalities.

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej V/S

Fundusze strukturalne dla sektora ochrony zdrowia w perspektywie finansowej Thank you for your attention Ministry of Health – European Funds Department 15 Miodowa Str., Warsaw Poland Tel. no /68 Fax no