Recommendations on the reform of the hospital landscape
An expert panel assigned by the Interministerial Convention (IMC) Public Health has published their recommendations for the reform of the hospital landscape: "Change to preserve." Discover the implications for the hospitals and how Hict can help with analyses on strategy, capacity, and financial impact.
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Why a group of independent experts and to what aim?
The Inter-ministerial Conference (IMC) Public Health created an independent expert panel to formulate recommendations on the organisation of the hospital landscape in Belgium. The goal? Guarantee qualitative care and optimal use of human and financial resources. The panel applied the following principle based on current insights (increased acute care, low occupation rates in ambulatory beds, fragmentation, staff shortage): "proximity care where possible, concentrated care where necessary."
Main findings from the report
- Cumulative conditions for hospital sites to be able to take care of hospitalised patients.
- Incentives for moving towards ambulatory care and concentrated interventions.
- They propose 4 types of care provisions (excluding psychiatric care):
- Regional General Hospital (RAZ)
- University hospital (UZ)
- Local Medical Centre (LMC) (without emergency service)
- Hospital for intermediary care (ZIZ) (without emergency service)
- The reform should start in 2026 and be finalised within 10 years:
- Phase 1, 2029: hospital sites that do not meet the norm of 150 justified acute beds, should become an LCM or fuse by 2029.
- Phase 2, 2031: hospital sites that have more than 150 justified acute beds, should scale up to meet the cumulative conditions of a RAZ in 2031. Extra inflow via fusions can help to meet the required norms.
- ≥ 180 justified acute beds
- ≥ 240 beds (incl. A, K, Sp)
- ≥ 600 births if there is a maternity
- Phase 3: after a intermediary assessment in 2031, there will be an assessment if the norms need to be increased, for instance from 180 to 210 justified acute beds.
- A new legal framework will be set up, together with the implementation of a transition fund for the needed financial support.
Sites that currently do not meet the norm of 150 justified acute beds, need to be reformed by 2029.
Implications for hospitals
The reform of the hospital landscape demands collaboration between hospitals or fusions to meet the norms per site. Today there are 39 hospital sites that do not meet the norm and thus must reform to an LMC or fuse with another hospital; 26 sites still have to follow a trajectory to meet the norms in 2031. This means that most hospitals need to reconfigure their organisation, infrastructure, and collaborations.
Have a look at the infographic below with the key numbers and the timeline of the proposed reform:
The report (Dutch)
Our approach
The reform of the hospital landscape is high on the agenda. The independent expert panel formulated their recommendations to guarantee qualitative care and to make optimal use of resources. These recommendations are guiding, but the final decisions from the minister still need to follow. However, it is important for hospitals to prepare themselves now for possible scenarios. We can help:
- Hict has many years of experience in supporting hospitals and networks with strategic reconfigurations. We help organisations anticipate changes by thorough (capacity) analyses and substantiated scenario exercises. We calculate the impact of moving pathologies between campuses, taking into account the impact on market shares, driving times, OR capacity, number of beds in the hospital and day-care, quality, staff, and patient.
- We use our CaSPr platform to map the impact of possible shifts, to perform scenario analyses based on realistic data.
- Our expertise goes beyond operational analyses. We also present the financial impact of the decisions when putting together these business cases.
- We guide hospitals in rewriting their medical strategic plans. We have experience is setting up regional care strategic plans for hospitals and strategic trajectories for first-line care zones.
Hict combines data-driven insights with practical experience to assist hospitals and networks in making substantiated decisions in a changing care landscape.