Territorial medicine starts again from the organizational standards envisaged by Ministerial Decree (DM) 77/22: one community home for every 40 thousand-50 thousand inhabitants (i.e. 1350 structures of this type), one family nurse for every 3000 inhabitants, one Continuity of Care Unit every 100 thousand inhabitants, one Territorial Operations Center for every 100 thousand inhabitants (i.e. 600 in total) and a Community Hospital with 20 beds for every 100 thousand inhabitants.
Patient associations play an active role in decision-making processes on the revision of local medicine, which can lead to significant results in assistance and treatment. And, in Ministerial Decree 77/22, which indicates the lines of action to implement the provisions of the PNRR for the development of community medicine, for the first time a specific role for Patients’ Associations is established for the creation of Community Homes , which ranges from the co-planning of services, to constant participation in programming, up to the implementation and monitoring of the promoted activities. These elements are considered mandatory standards for the creation of community houses and represent unavoidable tools also for the financing of the planned services.
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And it is precisely to promote participatory healthcare that, on 30 November and 1 December in Milan at Cascina Triulza in the MIND Area (Milan Innovation District), the eighth edition of the ‘Patient Advocacy Network’ took place, a training initiative aimed at patient associations and organized by the High School of Economics and Management of Health Systems (ALTEMS), of the Catholic University, with the unconditional support of AstraZeneca.
Demonstrating the relevance of the role of advocacy, around 30 associations representing patients with chronic, oncological and haematological pathologies participated in the event, includingACTO Italia ETS (Alliance Against Ovarian Cancer), ADPMI (Diabetics Association of the province of Milan), AIL (Italian Leukemia and Lymphoma Association), AISM (Italian Multiple Sclerosis Association), ANDOS National Onlus (National Association of Women on Breast Surgery), A.N.F (ODV Neurofibromatosis Association), ANGRY ODV (National Association of Rheumatic Patients), APIC APS (Italian Cholangiocarcinoma Patients Association), Italian Association of COPD Patients, Association of Kidney Patients, C.L.A.D (Coordination of Lombardy Diabetics Associations), Code Purple (Pancreatic Cancer Patients Association)EpaC ETS (Association of Patients with Hepatitis and Liver Diseases), Europa Donna, Europa Man, FAND ODV (Italian Diabetics Association), Federasma and Allergies ODV, FederDiabete Lazio, ER Diabetes Federation, IncontraDonna Foundation, LES Italian Group ODV, POP (Together for lung oncology patients), Loto Onlus, Let’s breathe together, Women’s Health ODV, Tu.To.R. Onlus (Rare Thoracic Tumors Association) Lung Transplant Union Padova ODV, Onlus rollers.
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The initiative was created with the aim of involving patient associations, active in different areas, to promote training and discussion on strategic issues in the country’s healthcare agenda, helping to strengthen their advocacy role towards institutions and decision makers.
The central theme of this year’s edition of the ‘Patient Advocacy Network’ was “Co-planning between Institutions and Associations: DM77 in real life”.
In September, the National Agency for Regional Health Services (AGENAS) established the working group for the definition of guidelines for the activation and implementation of Community Houses. The initiative was therefore configured as an opportunity for dialogue between the associations on the meaning of terms such as co-creation and co-planning in the field of advocacy and as an opportunity for a meeting between the AGENAS working group and the associative community represented by the ‘ Patient Advocacy Network’.
During the two days of the Patient Advocacy Network, the speakers included institutional representatives, including Guido Bertolaso (Councillor for Welfare of the Lombardy Region), Ornella Casati (President of CARD Lombardy), Pierpaola D’Alessandro (Deputy Deputy General Director of the Municipality of Rome Capital), Domenico Mantoan (General Director AGENAS), Giovanni Pavesi (General Director of Welfare of the Lombardy Region) e Ugo Plot (Head of Medicines Policies of the Campania Region), Flavia Cardinali e Sara Carzaniga (AGENAS).
The first day had as its main focus the sharing by Agenas of the updates of the dedicated working group while the second day was dedicated to interaction, through workshops in which the participants discussed the state of the art of regional health services , on the implementation of Ministerial Decree/77 and on the participation of citizen-patients in health policies.
“We are very happy to have organized the ALTEMS Patient Advocacy Network again this year. It is the task of the High School to deal not only with the training of professionals who work in the world of healthcare but also with fundamental actors such as patients and their organizations, whose competence is a fundamental factor in orienting healthcare services towards greater sustainability and attention to the needs of chronic, oncological and rare patients. There are many challenges that await us, doing it all together is certainly the best path to take“, he claims Giuseppe Arbia, ALTEMS Director.
“The challenge of proximity and services that are more attentive to the daily needs of citizens is at the center of our commitment to patient participation. Having included organizational standards in Ministerial Decree 77 that oblige administrations to involve citizens’ associations in the co-planning of services in community homes is a big step forward. To make it a daily reality we need to work together and train ourselves to make effective, concrete and incisive tools and methods of civic action our own”, he declares Teresa Petrangolini, Director Patient Advocacy Lab (PAL) of ALTEMS.
“It’s not enough to be there to count, you need to be truly prepared and “on par”, and it is precisely on this that ALTEMS has worked in recent years. This is why AstraZeneca has supported this initiative for 8 years, with the aim of making an important contribution to the autonomy and effectiveness of the advocacy process. When patients’ priorities are also included in all decision-making contexts, we will have better and probably more efficient healthcare”, he comments Francesca Patarnello, Vice President Market Access & Government Affairs of AstraZeneca Italia. “In the new scenario, which is emerging in light of the reorganization of the healthcare system, it is desirable that those who carry out a patient representative role also increasingly have skills and tools for an effective dialogue with both national and regional decision makers for a co-planning of health policy, starting from local medicine”.