REGIONAL HEALTH PLAN 2010-2012 publish some comments and considerations of the regional secretariats FIALS - CONFSAL relating to health and community health region 2010-2012. The legislative framework in the context of national and regional health planning tools and social services, provides a regional level, developing a plan of management programs of the Social Health System. The PSSR
2010-2012 would seem to agree with regard to that portion which establishes certain principles such as: the centrality of the citizen, the care of people with disabilities living with chronic and degenerative diseases, the recognition of a high quality and efficient SSR, and the reorganization of the hospital network and the service 118.
But they are not explicit in the detailed implementation of the Principles so that it becomes difficult to provide a thorough review on the merits of his proposals.
In 2010, the available economic resources are the most funding in 2009 's 1.7% increase, for which we are witnessing a reduction in budget compared to previous years where funding was equal to + 4.5%, and then ensured the maintenance of services and quality.
With fewer resources becomes difficult to maintain the welfare levels of all services in place. Philosophy del Piano è tesa a ridurre gli sprechi, a recuperare efficienza, riqualificando i servizi e valorizzando la professionalità attraverso una maggiore responsabilità. Già questa scelta presume una revisione degli aspetti organizzativi a livello territoriale ed un potenziamento della dotazione organica di personale con preparazione specifica rispetto alle prestazioni che andranno a dare.
Sul territorio risulta essere assegnato il 6% di personale in rapporto alla dotazione organica. Inoltre, al numero di operatori assegnati a volte non corrispondono le professionalità specifiche al tipo di prestazioni richieste. Va altresì evidenziato che, attualmente, i servizi territoriali soffrono di carenze di personale, come ad esempio i centri di salute mental (CSM) that are not turned on for 24 hours a shortage of nurses and other specialist services will be suspended for not only nursing staff shortages, but also of medical specialists.
the regional financial close expected on recruitment in the public sector. Speaking of health, in our opinion, the staff reductions have already been made with the implementation of local business plans in 2008/2009. Now, with this measure, you may go to a decrease not only performance but also in services.
If you support the expansion of territory as a response to inappropriate admissions and difficulties related to hospital discharge, it is necessary to quantify the costs and identify where to find resources to support the implementation of the Plan.
The area also lacks such specific structures. RSA beds to be activated, post-acute activated only 120 out of 550 pl; hospice facilities to enable. Strengthen the area also means investing resources on these services.
OPERATING CENTER 118 The Plan is highlighted the need for a revision of the plan of 'Medical Emergency, this to make it more efficient and more consistent at the regional level. This analysis is shared and there is no opposition to a project that has as its goal a greater efficiency and equity of treatment to all the people of Friuli Venezia Giulia in the event of a medical emergency. What I do not agree with is the establishment of a 'single regional operations center, located in Palmanova accompanied by that of Civil Defence. First
not know but the results of analysis on the current system 118 arranged in four provincial offices. The only information revealed and highlighted as an element of inconsistency of treatment between citizens, is on the relationship between health professionals and the catchment area that is different in the four realities.
With the centralization of health care workers in a single regional operations center, it is said that it would create a fairer treatment, since every answer the same number of inhabitants.
In our view, the choice to be pursued is pejorative, given that the stated objective is to reduce the number of players every day at the COR, which, although less in number, should respond to the same number total calls, and this would only increase because of the waiting time of those who turn to 118 for help.
The COR can not be regarded as a call - center, because who answers calls is a trained and skilled professional who knows the territory from both geographically and socio-cultural decide on the modalities of intervention in cases of emergency, it interfaces with hospitals, with the districts, with family doctors, the medical service and has one goal, to provide timely and effective responses to health needs of users .
To ensure fair treatment for citizens of the region, in our opinion, it is necessary to increase the workforce, modernize and adapt the fleet, to ensure a more widespread throughout the region, share and standardize the protocols and operational training of health workers and reduce operating centers.
Today, with the current organization, the answer is guaranteed effective and appreciated. Therefore we believe that if the intention is to establish the Regional Operations Centre in Palmanova, as necessary, before starting any centralizzazioen Evaluate the impact from the point of view in the emergency response, both from an economic standpoint, given the high costs to be incurred for new technological equipment, elements that, to date not known.
HOSPITAL NETWORK Current opsedali network hinged on the territory must maintain the professionalism and excellence, including the ability to respond to the population quality, and can not be a container of large hospitals. They also must be able to provide the current performance through the maintenance of levels of care. In addition, on the basis of the Plan, it is impossible to understand what will be the fate of some hospitals not elsewhere in the same.
Waiting List on the waiting list, the Region is committed to provide economic resources to reduce waiting times within acceptable limits and consistent with user needs. The problem has been solved only partially, but still, there remains a problem difficult to solve.
We believe that it is sufficient only to provide economic resources, but should address the structural problem on the management activity and the criteria for outpatient management of all services equipment, providing an organizational plan for greater use of instrumentation (eg, RX and all other equipment), and a direct involvement of all stakeholders and members working in services for user outside the building, and 'essential to make a pact with the leaders of Medica Health prescrittrice performance and only person able to reconcile both the demand and supply of healthcare services.
OUTSOURCING SERVICES AND TURN THE BLOCK - OVER L 'outsourcing of services and the activation of outside consultants do not always correspond to save money, many times end up being simply a tool for effective reduction of employees in the sector, without the expected economic results. D 'on the other hand it is clear that the service is necessary to give staff, whether employees of the' Administration or other entity. In support staff reductions in working capacity due to the performance characteristics affecting approximately 25 - 30% of staff in the sector, in particular nurses, social health and personal care.
CONCLUSIONS In conclusion, some astrattatezza of the Plan, the reduction of economic resources and human resources, non-explicit about the fate of some hospitals, the difficulty of identifying how you will actually find the resources necessary to achieve the objectives spelled out, are factors that can cause great confusion and to make clear the need to examine the documents subsequent implementation.
