National Health Service: Responding to Current Challenges Through Necessary Transformations

Detalhes bibliográficos
Autor(a) principal: Sakellarides, Constantino
Data de Publicação: 2020
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12626
Resumo: After a decade experiencing clear difficulties, the Portuguese National Health Service needs a significant public investment for its development. This means more resources for the National Health Service, but also an increased capacity to manage its necessary transformation. Current health challenges differ significantly from those prevailing when the National Health Service was institutionalized, 40 years ago: (i) A significant increase in the prevalence of patients with multimorbidity has been observed; (ii)There is a need to delay and attenuate the expression of multimorbidity; (iii) In this context, a strong investment in integrating health care is of a paramount importance. The transformations that the National Health Service needs to respond to these challenges are very complex and demanding: (i) Effective local adaptive change management requires a very elaborate strategic, governance and government framework, which is yet to be developed; (ii) Collaborative architectures, processes and tools need to be promoted in order to induce and facilitate change in the Portuguese health system; (iii) Common understanding of current challenges and increased capabilities to deal with complex change processes may facilitate the implementation of effective strategic management in the National Health Service, focused on its more critical domains – financing, infrastructures and resource management, organizational development, policies for attracting and retaining health professional and cooperation with the social and private sectors. Such a transformation agenda is urgently needed.
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spelling National Health Service: Responding to Current Challenges Through Necessary TransformationsServiço Nacional de Saúde: Dos Desafios da Atualidade às Transformações NecessáriasHealth PolicyHealth Status IndicatorsHealthcare DisparitiesNational Health ProgramsPortugalDisparidades em Assistência à SaúdeIndicadores Básicos de SaúdePolítica de SaúdePortugalProgramas Nacionais de SaúdeAfter a decade experiencing clear difficulties, the Portuguese National Health Service needs a significant public investment for its development. This means more resources for the National Health Service, but also an increased capacity to manage its necessary transformation. Current health challenges differ significantly from those prevailing when the National Health Service was institutionalized, 40 years ago: (i) A significant increase in the prevalence of patients with multimorbidity has been observed; (ii)There is a need to delay and attenuate the expression of multimorbidity; (iii) In this context, a strong investment in integrating health care is of a paramount importance. The transformations that the National Health Service needs to respond to these challenges are very complex and demanding: (i) Effective local adaptive change management requires a very elaborate strategic, governance and government framework, which is yet to be developed; (ii) Collaborative architectures, processes and tools need to be promoted in order to induce and facilitate change in the Portuguese health system; (iii) Common understanding of current challenges and increased capabilities to deal with complex change processes may facilitate the implementation of effective strategic management in the National Health Service, focused on its more critical domains – financing, infrastructures and resource management, organizational development, policies for attracting and retaining health professional and cooperation with the social and private sectors. Such a transformation agenda is urgently needed.Após uma década de evidentes dificuldades, o Serviço Nacional de Saúde necessita de um significativo investimento público para o seu desenvolvimento. Isso significa repor e acrescentar recursos ao Serviço Nacional de Saúde. Mas quer dizer também adquirir as capacidades necessárias à gestão da sua transformação. Os desafios de saúde não são hoje os mesmos de há 40 anos: (i) Observa-se um considerável aumento da prevalência das pessoas com morbilidade múltipla, de evolução prolongada, requerendo uma utilização contínua de serviços de saúde; (ii) É necessário atrasar e atenuar a expressão da morbilidade múltipla; (iii) Neste contexto, é particularmente importante uma forte aposta na integração dos cuidados, gerindo o percurso das pessoas através do serviços de que necessitam. As transformações indispensáveis para responder a estes desafios são complexas e muito exigentes: (i) Há que reconhecer que uma gestão efetiva das necessárias ‘mudanças adaptativas de proximidade’, requer um elaborado enquadramento analítico, estratégico, de boa governança e governação, que ainda não temos; (ii) É preciso ativar, no conjunto da sociedade portuguesa, fatores indutores e facilitadores de mudança – arquiteturas, processo e instrumentos colaborativos; (iii) Uma forte consciência coletiva da natureza dos desafios de saúde da atualidade e uma acrescida capacidade em gerir mudanças socialmente complexas, permitirá organizar uma direção estratégica para o Serviço Nacional de Saúde, capaz de atuar efetivamente em domínios críticos para o seu desenvolvimento – financiamento, gestão de infraestruturas e recursos, desenvolvimento organizacional no âmbito da administração pública portuguesa, uma política para as profissões de saúde e a articulação com os setores social e privado. Sem um investimento imediato e significativo na capacidade de gerir as mudanças necessárias, as dificuldades do Serviço Nacional de Saúde em corresponder a aquilo que os portugueses precisam, não deixarão de se acentuar nos próximos anos.Ordem dos Médicos2020-02-03info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/mswordapplication/mswordapplication/mswordapplication/mswordapplication/mswordapplication/mswordapplication/pdfapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12626oai:ojs.www.actamedicaportuguesa.com:article/12626Acta Médica Portuguesa; Vol. 33 No. 2 (2020): February; 133-142Acta Médica Portuguesa; Vol. 33 N.º 2 (2020): Fevereiro; 133-1421646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12626https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12626/5871https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12626/11709https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12626/11710https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12626/11711https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12626/11712https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12626/11713https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12626/11714https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12626/11790https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12626/11791Direitos de Autor (c) 2020 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessSakellarides, Constantino2022-12-20T11:06:39Zoai:ojs.www.actamedicaportuguesa.com:article/12626Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:20:12.776532Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv National Health Service: Responding to Current Challenges Through Necessary Transformations
Serviço Nacional de Saúde: Dos Desafios da Atualidade às Transformações Necessárias
title National Health Service: Responding to Current Challenges Through Necessary Transformations
spellingShingle National Health Service: Responding to Current Challenges Through Necessary Transformations
Sakellarides, Constantino
Health Policy
Health Status Indicators
Healthcare Disparities
National Health Programs
Portugal
Disparidades em Assistência à Saúde
Indicadores Básicos de Saúde
Política de Saúde
Portugal
Programas Nacionais de Saúde
title_short National Health Service: Responding to Current Challenges Through Necessary Transformations
title_full National Health Service: Responding to Current Challenges Through Necessary Transformations
title_fullStr National Health Service: Responding to Current Challenges Through Necessary Transformations
title_full_unstemmed National Health Service: Responding to Current Challenges Through Necessary Transformations
title_sort National Health Service: Responding to Current Challenges Through Necessary Transformations
author Sakellarides, Constantino
author_facet Sakellarides, Constantino
author_role author
dc.contributor.author.fl_str_mv Sakellarides, Constantino
dc.subject.por.fl_str_mv Health Policy
Health Status Indicators
Healthcare Disparities
National Health Programs
Portugal
Disparidades em Assistência à Saúde
Indicadores Básicos de Saúde
Política de Saúde
Portugal
Programas Nacionais de Saúde
topic Health Policy
Health Status Indicators
Healthcare Disparities
National Health Programs
Portugal
Disparidades em Assistência à Saúde
Indicadores Básicos de Saúde
Política de Saúde
Portugal
Programas Nacionais de Saúde
description After a decade experiencing clear difficulties, the Portuguese National Health Service needs a significant public investment for its development. This means more resources for the National Health Service, but also an increased capacity to manage its necessary transformation. Current health challenges differ significantly from those prevailing when the National Health Service was institutionalized, 40 years ago: (i) A significant increase in the prevalence of patients with multimorbidity has been observed; (ii)There is a need to delay and attenuate the expression of multimorbidity; (iii) In this context, a strong investment in integrating health care is of a paramount importance. The transformations that the National Health Service needs to respond to these challenges are very complex and demanding: (i) Effective local adaptive change management requires a very elaborate strategic, governance and government framework, which is yet to be developed; (ii) Collaborative architectures, processes and tools need to be promoted in order to induce and facilitate change in the Portuguese health system; (iii) Common understanding of current challenges and increased capabilities to deal with complex change processes may facilitate the implementation of effective strategic management in the National Health Service, focused on its more critical domains – financing, infrastructures and resource management, organizational development, policies for attracting and retaining health professional and cooperation with the social and private sectors. Such a transformation agenda is urgently needed.
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publisher.none.fl_str_mv Ordem dos Médicos
dc.source.none.fl_str_mv Acta Médica Portuguesa; Vol. 33 No. 2 (2020): February; 133-142
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