From regional plan to implementation
Regional plans, how was it again?
All region plans were submitted by the end of 2023. These regions describe their care needs for the coming years. The plans are based on pictures of the area that came out earlier in the year. In February, health insurers provided feedback on the regional plans, the outcome of which has yet to be shared with the public¹. The next step is to concretise the plans further by describing how the plans can be implemented. Despite this going well in many places, the NZA also sees room for improvement. They argue that the objectives of the regional plans need to be formulated in specific, measurable and time-bound terms to use the plans as a basis for further policymaking¹. This paves the way to actual execution. But how to do this sometimes needs to be more precise.
Themes, opportunities and challenges
In the regional plans, the theme 'prevention' predominates, with 'vital ageing', 'mental health', and 'labour market' as major priority tasks that follow directly from it. To a lesser extent, 'healthy youth' and 'acute care' are also features. The latter theme is less prominent in the regional plans because acute care is handled in the Regional Acute Care Consultation images and plans.
Opportunities
To address the themes mentioned earlier, the regions aim to use the opportunities offered by digitalisation, intensified cooperation with the social domain, and other collaboration in the area, among other things. Here, digitisation is not an end but a way to keep care accessible. Examples of initiatives proposed in the regional plans are data exchange and digital care applications, the latter of which should enable remote care².
Challenges
One of the main challenges in the region is labour market shortages. A telling example of this is Zeeland, where without intervention, a shortage of 7,500 healthcare professionals is expected by 2030, a percentage shortage of 11.1%. To put this in perspective, on average, in the Netherlands, a shortage of 7.8% is expected. Combined with a contraction in the informal care workforce, this creates a severe problem in Zeeland and the rest of the country²,⁴.
Focus for 2024: concretisation of regional plans and (start of) execution
With the regional plans almost complete, many regions face a new challenge: making their plans concrete. On 1 January 2024, for instance, the Haaglanden Region started drawing up a working agenda. This lays down how the plans will come to fruition. A logical and necessary next step after drawing up the region's plans, which in some cases are still lofty and strategic. However, concrete examples are given of how the region intends to realise its plans when it comes to ongoing projects.
On the other hand, it is understandable that some regions still need to be so far along for all themes. As described in the 'criteria for region plans' LINK, region plans contain agreements on how the parties involved will jointly commit to the regional challenges and who will be involved. The relevant healthcare parties must now work out the concrete transformations in specific transformation plans⁵. But how do you get from plan to execution?
Tips for execution
Boer & Croon's motto is 'get it done'. Because our work involves translating ambitions and plans into execution and lasting results, we would like to share tips.
Results and activities
Joint picture of urgency
The regional plan should already describe the problem in the region and the hindrance to healthcare organisations that cannot be solved within the current structure and own walls. The steps of urgency and objective form the basis for successful execution. Questions to be answered in this process are:
- Which healthcare organisations should we involve?
- What can we do for each other in the solution?
- Combining out-of-the-box solutions with joint traditional solutions
Setting preconditions
The cooperating parties should agree on the preconditions. If you do not have these clear, implementing plans will not succeed because you will run into preconditions later in the implementation. Questions that need to be answered are:
- What preconditions are there for all organisations to be able to resolve?
- Who can solve which preconditions?
- What can we not solve ourselves, and what do we need externally?
Jointly defining the care concept of the future
Based on the preconditions, a new care concept of the future must be defined. It is important that all parties have exactly the same images of ambition and goal so that every organisation works towards the same end goal.
- Defining a shared vision, SMART objectives and results
- Maintain clarity on the common goal throughout the process
- Defining the 'what in it for me' for each player
Prepare execution plan
Why an execution plan? With clear roles and division of tasks, you can hold each other to agreements and adjust where necessary. Don't you do that? Then, many hours of hard work will lead to no results. Agreeing on clear roles and responsibilities helps achieve the desired result.
- Determine what objectives are needed over the next 5-10 years to set up this care concept;
- Agree on method and form to achieve this goal;
- Agree on an approach to setting up preconditions;
- Organising support from organisations, co-determination, care offices and other key stakeholders;
- Establishing the joint roadmap to which parties can commit;
- Approach achieving results as project-based as possible, celebrating small milestones and successes. If you don't set deadlines and milestones, little will happen;
- Making people from their organisations responsible for achieving results. Why? That way, you can maintain sustainable results even in the long term.
Establishing governance
You have an execution plan. And now what? We recommend setting up governance in which you will jointly steer the progress of implementation and be responsible for the new way of working after execution.
- Agree: who is responsible for what change? Now, and in the long term? Place responsibilities in the line as much as possible.
- Who owns the result? Does the current organisational form of the joint working method fit with that? If it is challenging to organise ownership within an organisation's line of responsibility, consider a network, consortium, or other control form.
- Set up a straightforward project or programme structure with as many line responsibilities as possible that can be held accountable for progress and results.
Realisation of the strategic plan
- Transparent progress reporting: short and clear so that everyone from the cooperating organisations knows what still needs to be done to achieve the common goal;
- Interim adjustments if the planning runs out or risks arise
- Checking in: is everyone still optimistic about the formulated goal?
- Motivate and enthuse employees to participate.
- Achieve results! Get it done!
- Secure? This is not an extra step after the execution plan and execution. You have already done this by anchoring line responsibilities and choosing a governance form.
Lasting results: Boer & Croon's approach
Let's get it done! That's how we stand. By working together on realistic plans and focusing on execution, we can help healthcare move forward. With expertise in implementation and project and programme management, we at Boer & Croon work with driven professionals with extensive healthcare experience. In hospitals, district care, and elderly care, we realise projects, assist in strategy formation, and make change plans a reality. The model shows which principles we consider most important. In 2024, we will take the next step in healthcare and turn ambitions into a new reality. Want to know more? Blog post number 3 will follow in April.
