HEALTH Minister Tom Binet has set out the first strands of his vision to transform disparate sections of the Island health services into a “seamless and integrated” new model.
He said that he wanted to bring together private-sector operators, including GPs and care-home providers, third-sector organisations and the various limbs of his own department to improve collaboration, address issues and understand the bigger picture.
This, the minister believes, would improve care for patients and create a happier Health Department.
Deputy Binet has spent eight months observing how the department and the wider health sector functions, and has challenged his team to consider what it all might look like if it was redesigned from scratch.
He now wants to see a much improved patient journey as people move between GP care, the Hospital and aftercare in a community or care-home setting.
To help achieve a more integrated model, he wants to appoint a new chief executive to oversee what he described as a more holistic approach.
This new leader, Health Minister Tom Binet told the Health and Social Services Scrutiny Panel, would be responsible for co-ordinating all the various elements of the current health system.
He said that he had “made some observations” about the department since taking the reins at Health at the start of the year and that plans for a new structure were in development.
He explained: “At one of the meetings recently, I said to the people we’re talking to: ‘If you were designing a health service, would you design the one that we’ve got now?’
“And the answer, I think unanimously, was no. So I think that leads us to suggest that it might be time for a review.”
Asked about any particular roles he would like to change, he said: “I think the overarching difference at the moment is that what I’d like to see is somebody as a chief executive of an entire health service, rather than just HCS. And the terms of reference would be to provide a sort of holistic, single, seamless, integrated health service.”
Currently, the Health Department’s chief officer Chris Bown oversees the services delivered by the department itself – but not GPs, charities, public health, care homes and private organisations.
“There’s nobody to blame for that,” Deputy Binet told the JEP, explaining that the health service had started small and grown to be “bigger” and “more comprehensive”.
“If you were designing a health service for Jersey, it wouldn’t be what we’ve got now.”
Patients are most affected, he said, “when they move from one section to another, in-between primary care, secondary care, into a charity and public health.
“It’s not as seamless as it needs to be.”
As part of the changes, Deputy Binet said he would like to see a unified IT system. Currently, if a patient goes to hospital – he cited the Emergency Department as an example – staff are not able to access their medical records.
A “comprehensive” new system would solve these issues, Deputy Binet said, adding that he hoped it would lead to “better patient experience and better outcomes… and hopefully, a slightly happier team of people involved in healthcare provision”.
He told the panel that the chief executive position could be filled by the person running the department currently, or by “somebody who also works as a co-ordinator at that level”.
They would “reflect the composition of Health” and draw in public health, the Health Department, primary care and the charitable sector.
He pointed in particular to GPs, who went ten years without an uplift in their subsidy – which put increasing costs on the patient, ultimately leading Islanders to wait longer before they sought medical help and costing the Island more.
“The interaction between the various parties is sometimes a bit fractured,” he added.
This comes just under a month after the closure of Jersey Recovery College. The charity provided courses on mental health both to the general public and on commission, not just by the Health Department but also by businesses.
The department is now faced with the aftermath of the closure.
Speaking to the panel, director of mental health and adult social care Andy Weir said the charity had provided 79.5 hours of courses over four months, which the department could surpass during October.
The department is due to take over the offering from October on, with workshops underway to develop the offering.
Prior to the closure, the department had spoken to Jersey Recovery College about “more of a focus on serious mental illness” as well as groups and activities, alongside education, stigma reduction and workplace mental health.
He added that he had taken legal advice regarding the duration of the contract with Jersey Recovery College, particularly after special measures were put into the contract in January when there was “a financial sustainability issue”.
Speaking to the JEP, Deputy Binet added that Jersey Recovery College was relatively small in size and that its work would be absorbed by Health.
