WORKSHOP
“Community houses and territorial assistance reform: where are we in Lombardy”
Thursday 30 March 2023
Mario Negri Institute of Pharmacological Research IRCCS – Guasti Room
PRESENTATION
The National Recovery and Resilience Plan (PNRR) provides for 18.5 billion for interventions in the health sector, which concern the implementation of proximity networks for territorial health care and innovation, research and digitization of the national health service. Among the interventions for territorial health care, the opening of at least 1,350 homes in the community by 2026 is envisaged.
With the DM 77 of 23/5/2022 “Regulation containing the definition of models and standards for the development of territorial assistance in the national health service” the rules and standards for their implementation are defined. The community house should “…become the physical place of proximity and easy identification where the community can access in order to get in touch with the health and social-health care system. …promote an organizational model with an integrated and multidisciplinary approach through local teams. …constitute the privileged venue for the planning and provision of health and social integration interventions”.
In the Lombardy Region, with the approval of Law 22 (14/12/2021), the interventions to improve the organizational set-up of the Lombard health and social-health system were defined, through the strengthening and creation of territorial structures and home care, the development of telemedicine and more effective integration with all social and health services. Subsequently, with Resolution No. XI/6426 of 05/23/2022, the headquarters of 216 Community Houses were identified and the relevant Districts and territories defined. The latest information available on the Lombardy Region website reports that, at the end of January 2023, 90 had been activated, without however providing a list (https://www.regione.lombardia.it/wps/portal/istituzionale/HP/sanitaterritoriale). With Resolution No. XI/7592 of 12/15/2022, the Region implemented the regulation of Ministerial Decree 77 and issued the implementing provisions for the consequent programming of territorial assistance.
Starting from this context, the Study Center of Social-Health Policy and Planning of the Mario Negri Institute for Pharmacological Research IRCCS has launched a project to evaluate the structural, organizational and personnel models involved in the creation of these new structures.
The aim of this workshop, open to all stakeholders and operators who are doing their utmost to implement these structures, is to present the scientific rationale for this reorganization of territorial assistance, take stock of the progress of the project with the presentation of the preliminary results of the evaluation carried out in the first 30 community houses already inaugurated, bring the contribution of realities where this type of structure has already been operational for several years and that of some realities in the Lombardy area to open a discussion table on the strengths and on the critical issues that are being encountered, with particular reference to the difficulties:
– in the implementation of the territorial assistance reform in the Lombardy Region,
– in carrying out a multidisciplinary work within the Community Houses,
– in the organization of a real social-health integration involving the community and the territories.
A light bulb of the program
(Draft dated 2023-3-16)
INTRODUCTION OF THE WORKS (Giuseppe Remuzzi)
13.00 – 14.00 RATIONAL AND STATE OF THE ART (Moderator: Alessandro Nobili)
– For a true reform of territorial assistance (Livio Garattini)
– Preliminary results of the survey on community houses conducted by the Mario Negri Institute
(Angel Bearded)
14.00 – 16.00 FIRST SESSION Workshop (Moderator: Alessandro Nobili)
COMMUNITY HOUSES: COMPARING EXPERIENCES
– Portugal (Fabrizio Cossutta)
– Tuscany (Gavino Maciocco)
– Lombardy: “Where are we at with the creation of the Community Houses”
– Community houses of Goito and Asola
– Nave Community House
– Center of Social and Health Culture of Pieve Emanuele
– Discussion
16.00 – 18.00 SECOND SESSION Workshop (Moderator: Angelo Barbato)
COMMUNITY HOUSES: CRITICAL ISSUES AND ISSUES TO BE SOLVED IN LOMBARDY
Panel discussion:
– Speakers: Daniela Luigia Invernizzi (ASST, CoC Executive), Giorgio Barbieri (MMG Limbiate), Loredana Viviano (IFeC, ASST Rhodense), Sara Santagostino (ANCI Lombardia), Fulvia Colombini (AUSER Lombardia)
– Discussion
CONCLUSIONS AND CLOSING OF THE WORK (Alessandro Nobili)
Speakers
Barbato Angelo, Mario Negri Institute of Pharmacological Research IRCCS, Milan
Giorgio Barbieri, General Practitioner, Limbiate
Colombini Fulvia, AUSER Lombardy
Cossutta Fabrizio, Almirante Family Health Unit, Lisbon
Gandellini Maria Gloria, Upper Mantua District, ASST Mantua
Gandini Cristiano, General Practitioner, Pieve Emanuele
Livio Garattini, Mario Negri Institute of Pharmacological Research IRCCS, Milan
Invernizzi Daniela Luigia, ASST Melegnano Martesana
Maciocco Gavino, International Health
Alessandro Nobili, Mario Negri Institute of Pharmacological Research IRCCS, Milan
Remuzzi Giuseppe, Mario Negri Institute of Pharmacological Research IRCCS, Milan
Santagostino Sara, ANCI Lombardia
Soldo Maria, Community House of Nave (Brescia)
Viviano Loredana, ASST Rhodense Territorial Center (Milan)