Jacek Krajewski: 2023 passed under the sign of coordinated care

"It has been an interesting year, but at the same time not an easy one. It took a huge effort on the part of our team to achieve our goal of introducing coordinated care into primary health care. At the beginning, however, the conditions for its implementation were not right, there was a lack of consultation with the community. As a result, we decided not to participate in the work of the OK team under the Minister of Health. However, the situation has changed, and we, through our efforts, have created conditions favorable enough that we can now confidently recommend the introduction of coordinated care into the POZ.

Initially, we assumed that the possible involvement of 10 percent of POZs in coordinated care would have already been a success, realizing that this is a multi-year process. However, we now have 30 percent of POZs that have successfully implemented coordinated care - a definite success! It's also a success for the Zielonogórski Porozumienie Zielonogórskie Federation, as we have supported this program from the very beginning. Many specialists from the PZ Federation have been immensely involved in this project. One of them is Andrzej Zapaśnik, who prepared the assumptions of coordinated care, and has been successfully implementing this program in his clinic for several years.

Doctors saw an opportunity to restore the proper importance and rank of the POZ. We have the opportunity to effectively treat patients, diagnose them well, properly set up treatment at the POZ level without having to go deep into the system, that is, we don't have to refer the patient to other doctors, they don't have to look for specialists or help in the hospital. There are already more than 2,000 POZ clinics in Poland that provide coordinated care, and half of these facilities are POZ of doctors from the Zielonogórski Federation Porozumienie Zielonogórskie.

But the work is not over. It is still necessary to convince the unconvinced and look for other sources of funding. Now training, courses, meetings are needed. Coordinated care restores family medicine specialists to their rightful role. Primary care centers have a large offer of services, but European funds are needed and for training, but above all for equipping dispensaries with appropriate diagnostic equipment. We can already perform many examinations at our facilities, but we lack specialized equipment. This will be possible thanks to the European funds we have applied for. We should have ECG, ultrasound, holter, spirometers in our facilities. Further digitization is necessary - computers, a good network in every facility, even the smallest one on the borders. We are only now building a good foundation for the health care system in Poland, and we hope that this direction will continue.

What are the plans for the new year? The most important - we propose to the new government to partner our Federation. We want to talk, we want to be treated as a partner. Everyone should care that this system works well. It is necessary to have a strategy for further implementation of coordinated care, to create the right conditions for those who are not yet convinced. The undecided should be helped to enter this project at their own pace. Provide them with peace of mind, security, certainly not to rush or scare them.

In addition to the topic of coordinated care, we have other pressing issues. For example, it is necessary to liberalize drug reimbursement regulations. Reimbursement regulations need to be simplified, because now it feels like a minefield. This is the bane of all doctors. For the sake of patients first and foremost, but also doctors, this needs to be changed, and we are ready to cooperate.

It is also necessary to refine the law on PCP. The current legislation is outdated, unlivable, there are a lot of restrictions, which, for example, in the absence of doctors, are a major impediment and unnecessary burden.

The legislation of the Quality Law is also before us. The proposed provisions were too broad and threatened us. In consultation with other organizations, we have brought about the fact that now we can discuss these provisions, now we can talk about quality. But this requires cooperation, and we very much hope for such cooperation for the sake of our patients and doctors."

Source: Porozumienie Zielonogórskie