On July 5-6, 2018, at the Loggia dei Mercanti in Ancona, the workshop "The commitment of European healthcare systems to prevent and manage the frailty challenge" was held - organized by ProMIS with the subgroup of Regions composed of Campania, Marche (the leader of the initiative), Piedmont, Tuscany, and Veneto. The event had the aim of facing the challenge of the ageing of the population, with particular attention to frailty and its related clinical, psychological, social and economic dimensions, in an effort to design to design coordinated implementation frameworks across different regional settings.
Representatives of the European Institutions, Ministry of Health, international, national, and regional Agencies took part in the event.
The first day addressed the presentation of shared priorities for frailty at the international level in terms of public health:
• Marc Vandenbroeck (CHAFEA) shared objectives and expected results of the projects (FRAILCLINIC, FRAILTOOLS, SUNFRAIL, APPCARE, FOCUS and the Joint Action ADVANTAGE) as well as future directions for health promotion in the area of active and healthy ageing. He underlined policy objectives and expectations of future financing European tools to significantly contribute to addressing frailty, the development of personalised integrated care, facilitate coordination among professionals and reduce unnecessary use of health resources.
• Paolo Michelutti (Ministry of Health), addresses the issue of new skills and new roles to meet the needs of an ageing population. Investing in training and in the workforce becomes absolutely crucial as evidence emerges that skills mismatches lead to poor quality of care, poor patient outcomes and low productivity.
• The Joint Action (JA) ADVANTAGE was presented by Inés Garcia Sanchez (Advantage JA deputy coordinator). She illustrated the State of the art Report, underlining the local realities and the various differences and conditions of frailty. The main message that frailty is not an inevitable consequence of aging, but with planning, can be prevented and addressed to promote a long and healthy life was clearly understood by the audience.
• Giuseppe Liotta, (EIP-AHA, Action Group A3) explained the need to foresee all those factors that contribute to functional decline. Only coordinated and complementary interventions bring more successful results. For Liotta, the components to be implemented are: social care integrated with health care, combination of interventions, health promotion and knowledge of risk factors. Integration should be managed by staff trained to work in both the social and health fields.
• Anne Hendy (NHS Lanarkshire, Scotland, UK - Advantage JA partner), illustrated how in order to achieve good results in managing integrated care for frailty, it is necessary to focus the intervention both on the needs of the patient and the person caring for him/her (family member, caregiver, etc.), by providing them with the tools to manage the patient's condition independently. It is necessary to anticipate what the needs of the population may be in 20 years time. In this context, within the framework of WP7 of the JA Advantage, a model of care for frailty was developed, which provides for a series of elements in order to promote individual treatment plans (involving interdisciplinary teams), with the aim of activating a transition of care from hospital to home.
The second day focused on different regional contexts:
• Sharing good practices emerged in Europe, trying to identify a common thread that unites them;
• identifying the enabling factors and possible future scenarios of the services offered by the Regional Health Systems thanks to the use of new sustainable business models;
• understanding how the national strategic public health actors can support the Regions to replicate and transfer "winning" experiences in their local contexts.
Lucia Di Furia (Director of Health Service Marche Region – ADVANTAGE partner) explained the cornerstones of the Regional Health and Social Plan (PSSR) which is inspired by the common model of Health 2020 policy, agreed by the 53 Member States of the European Region of WHO, which puts the person at the center of health systems and informed by the first ADVANTAGE JA results. She highlighted the innovative aspects of the SSRP and, above all: a) listening to all stakeholders and citizens, which has made it possible to draw up a concerted plan; b) the attention paid to frail people in the health service system.
Maddalena Illario (Campania Region – ADVANTAGE affiliated entity to Marche Region) addressed the adoption of digital solutions for health and care, which remains slow and varies considerably from one MS to another. Further action at EU level is essential to accelerate the significant use of digital solutions in public health. In its mid-term review on the implementation of the Digital Single Market Strategy, the Commission expressed its intention to take further action in three areas: (1) secure access to and sharing of cross-border health data; (2) better data to promote research, disease prevention and personalised care; and (3) digital tools for citizen empowerment and people-centred care. In order to fully implement health promotion and thus contribute in the best way possible in order to obtain impacts on the wellbeing of the population, the Campania Region has approved an act of guidance for education and health promotion activities. The document is based on some fundamental principles that have been universally shared in the past.
The final session, was articulated in the form of an interview to the most important representatives of the main Italian institutions (Giovanni Nicoletti - MoH; Mario Braga - Agenas; Lucia Galluzzo – ISS; Giovanni Lagalla – ARS-Marche Region) and stakeholders representing citizens (Monia Mancini – CittadinanzaAttiva). It was moderated by the journalist Maurizio Socci.
The event was well attended and participants showed high interest and actively participated to the final debate.