Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1694840222694.pdf (Malta)
EMPOWERING PRIMARY HEALTH CARE Health Committee Document 23 Meeting 10 Dr Renzo De Gabriele MD MMCFD Cert.

Diab.

(ICGP) Chief Executive Officer Primary Health Care Department Standing Committee on Health - 11th March 2015 COMPREHENSIVE PRIMARY CARE  Long-term relationship between patient and provider in which medical services, support for self-care and care coordination are the foundation.
 Patient-focused rather than disease-focused (holistic)  Timely  Research has associated comprehensive primary care with better system quality, equity and efficiency (reduced cost).

 Benefits will be reaped over time.
 “The Starfield Model” – an approach to measuring quality, capacity and total system cost THE STARFIELD MODEL PHCD Strategy Prevention Services Infrastructure Equipment Prevention Screening Immunization Health Education School Services Screening  Introduce Cervical Screening for 25 – 35 year age group  Increase age bracket of Breast Screening (50 – 65 year olds)  Increase age bracket of Colon Screening (51 – 61 year olds) Immunization  Human Papilloma Virus Vaccine to prevent most types of cervical cancer (79% in 2013; 87.5% in 2014)  Immunization services have been re-engineered to have 97 more hours of patient contact per month  zero added cost as regards HR  Evening and afternoon sessions at Immunization  zero added cost as regards HR  Planned expansion of travel vaccination hours Health Education  Lifestyle Clinics in certain Bereġ  Zurrieq, San Gwann, Tarxien, Kalkara, Msida, Gżira, Gudja  Health promotion activities in collaboration with HPU  World Kidney Day, World Diabetes Day, outreach activities in local councils, etc  Media Promotion Campaigns  Facebook page  Liaison with Blood Bank  Flyers  Free services to local councils School Services  School Medical Services throughout primary schools  Scoliosis Screening at Floriana Health Centre  School Immunization Programme  Manpower request to increase activity in secondary school sector Refurbishment New Premises STRENGTHEN INFRASTRUCTURE  Ongoing process as there is a continuous  increase in demand  development of new technologies  Aim is to have proper infrastructure with high quality equipment of the latest technology compatible with MDH  This will permit  High quality service delivery  Staff motivation and enthusiasm  Less referrals to secondary care  Holistic treatment  One stop shop Refurbishment  Mosta Health Centre Refurbished  Rabat Health Centre Refurbished  Floriana Health Centre in 3rd phase of refurbishment  1st Phase – Immunization wing  2nd Phase – New Wing for Physio, Podiatry, Diabetes, Ophthalmic  3rd
 Phase – Central reception, new cold room, bigger generator  Upkeep of Paola Health Centre is ongoing  New generators for Paola, Mosta and Rabat  Programme of refurbishment of health centres  Bereġ Refurbishment New Premises  Kirkop Health Centre  Paola Regional Hub (ERDF application)  Physiotherapy wing at B’Kara Health Centre  Bereġ relocation where possible in collaboration with local councils Equipment  2 Digital X-ray Machines  2 Fundus Cameras  3 Vascular Dopplers  Interferential Units and Ultrasound for Physiotherapy Department  Podiatry instruments  ECG Machines  Ophthalmic equipment (auto-refractor, glaucoma machines)  Various specialized couches  Mosta and Rabat Health Centre were stocked with completely new equipment in all areas Services Consolidation New Services Consolidation  B’Kara Health Centre opening hours are now in line with others (previously Monday to Friday 8am – 1pm)  Orthopaedic Outreach Clinics have increased in frequency (Mosta, Paola, Qormi)  Physiotherapy Access to Private GPs  X-Ray access to Private GPs  Bone Density requests can be done by all medical practitioners in Malta and Gozo (previously only Orthopaedic and Gynae consultants) – no waiting list and results given to patients New Services 1  Anticoagulant Clinics (Paola, Cospicua, Qormi, Floriana, B’Kara, Rabat, Gozo)  Chronic Disease Management Clinics – holistic patient care (Qormi, Rabat till now)  Digital X Ray machines at Paola and Floriana Health Centres  Conversion of Gzira and Qormi X-Ray machines into digital X-Ray Machines  Backslab plaster service from Floriana Health Centre(previously only Mosta).
 Soon all digitalized Health Centres will have this facility – no MDH referrals  Lifestyle Clinics in Bereġ New Services 2  Minor Operations at Mosta Health Centre  Orthopaedic  Surgical  Ophthalmic  Dermatology  Outreach Clinics  Orthopaedic  Cardiology  NAPRO technology  Paediatric  Genitourinary  Fibromyalgia New Services 3  Retinal Cameras (Floriana and Mosta Health Centres)  Vascular Dopplers (Paola, B”Kara, Floriana)  New Migrant Liaison Office to cater for this select population (including services of cultural mediators at Floriana Health Centre)  Call Centre for appointments  PPP – involving the private sector to make a level playing field  B’Kara Physiotherapy Department PRIMARY HEALTH CARE EMPOWERMENT All this will help empower Primary Care in order to follow the “Starfield Model”.
This will lead to a better quality system, equity efficiency (reduced cost) REFERENCES 1.

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