A NEW PARADIGM FOR THE HEALTH SYSTEM - FOR THE PEOPLE & WITH THE PEOPLE

HOW WE CAN ESTABLISH THE HEALTH SYSTEM WE DREAM

The WHB-GHA Primary Care Service represents the first gateway to its health service. It represents the most inclusive, equitable, convenient and efficient approach to improving the physical, mental and spiritual health of individuals, as well as the wellbeing of society. Primary Care is defined as: "the provision of universally accessible, integrated, person-centred services in response to the majority of individual and community health problems in the life context. The services are provided by multi-professional teams, in collaboration with patients and their caregivers, in the contexts closest to the community and individual families, and play a central role in ensuring the coordination and continuity of assistance to people".

The WHB-GHA NNHS therefore pursues this vision through provincial activities, planning, strengthening and valorisation of territorial services, in particular through:

• development of local structures, such as “Senior Community Houses & Clinics” and “Block Nurse Assistant Units” in large towns and cities, “Junior Community Houses” and “Family Counselor Units” in medium and little size towns, “First Aide Units” in the littlest villages and hamlets, as a point of reference for responding to health and social-health needs of health relevance for the reference population;
• strengthening of home care so that the home can become the privileged place of assistance;
• integration between health and social care and the development of multi-professional teams that take care of the person in a holistic way, with particular attention to mental health and conditions of greater fragility ("GHA Planetary Holistic Health");
• systematic logic of initiative medicine and taking charge, through the stratification of the population by intensity of needs;
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• enhancement of co-planning with users;
• valorisation of the participation of all community resources in different forms and through the involvement of the various local actors (Local Health Authorities, Municipalities and their Unions, professionals, patients and their caregivers, Third Sector associations/organizations, etc.).

GHA National Bureau - Each GHA National Bureau consists of several departments other than its internal management ones, which deals with the coordination of all its networks.

The National Bureau of the Global Health Alliance constitutes a starting point for the growth of community care and for an innovative approach to reducing health inequalities. For this reason, it proceeds forcefully so that the GHA Regional and Provincial Bureaux become stable structures, homogeneously interpreted, organised, acting throughout the national territory. The WHB does not require "a single NNHS Regional or Provincial Bureaux model" other than with regards to management structure, since the suggested direction is to find a uniform balance point between what is "essential" for everyone and what is appropriate for the specific local context, certainly starting from knowledge of needs.

GHA Regional Bureaux - It has been made a priority to implement the offer of territorial proximity facilities to the citizen and coordinate the integration between the various health, social-health and social-welfare structures present in the area, in order to ensure a coordinated and continuous response to the needs of the population, as well as uniformity of levels of assistance and plurality of the offer.

The introduction of these WHB multipurpose structures is therefore aimed at providing citizens, within a single healthcare network with the hospital system, the set of Essential Levels of social and healthcare assistance in their unity of prevention, treatment and rehabilitation. These structures represent points of reference for primary care with characteristics of extensive care and integrate the hospital system characterized by care intensity, orientation towards performance productivity, efficiency and excellence. The main mission of these structures is to take care of people from the moment of access, through welcoming citizens, collaboration between professionals, sharing holistic care paths, autonomy, professional responsibility and the valorisation of skills, even with the aim of eliminating improper access to hospitals and/or improper treatments and drugs. Furthermore, the adoption of a model based on functional integration between the different health service providers allows for a more positive use of human and professional resources for the success of the structure itself.

GHA Provincial District Bureaux - Each district has approximately 100,000 inhabitants, with variability according to population density criteria and orographic characteristics of the territory. The organization of the GHA Provincial District Bureau has three clear and precise guarantee objectives:

• primary care,
• coordination of general practitioners and pediatricians,
• provision of health services of social relevance, as well as social services of health importance in connection with local social services if delegated by the Municipalities.

The vision of the GHA Provincial Bureau as the centre of gravity of all territorial assistance, respects the need to ensure the progress of WHB-GHA territorial assistance in this direction. The GHA Provincial Bureau, correctly planned, set up, made to grow with active and vital elements, ensures true integrating capacity between services and people, between bodies and institutions, between subjects and agencies, with strong coordination capacity obtained with leadership, not with hierarchical force. It creates real possibilities of offering unitary, coordinated and continuous responses, in a multi-offer with solid global management, not only providing fragmented "basic services", with the ultimate aim of satisfying the NEEDS OF THE PEOPLE AND THE ENTIRE RESIDENT POPULATION, OR OF THE COMMUNITY.

The main mission of these structures is to take care of people from the moment of access, through welcoming citizens, collaboration between professionals, sharing holistic care paths, autonomy, professional responsibility and the valorisation of skills, even with the aim of eliminating improper access to hospitals and/or improper treatments and drugs. Furthermore, the adoption of a model based on functional integration between the different health service providers allows for a more positive use of human and professional resources for the success of the structure itself.

The Provincial-District has approximately 100,000 inhabitants, with variability according to population density criteria and orographic characteristics of the territory.

WHB-GHA Local Bureaux - A GHA Local Bureau manages:

• the development of local units and structures based on the catchment area and the topography of the territory, such as “Local Units”, "First Aid Nursing Outpatient facilities/Cabinets" in the more isolated hamlets, "Community Houses Snr/Jr" in the more populous hamlets and villages, “Community House Hubs” in towns and cities, as a point of reference for responding the health and social-health needs of relevance to the reference population;
• the strengthening of home care so that the home can become the privileged place of care;
• the integration between health and social care and the development of multi-professional teams that take care of the person in a real holistic way, with particular attention to mental health and conditions of greater fragility ("Planetary Holistic Health");
• the enhancement of co-planning with users of the path to restore optimal health;
• adding value through the participation of all community resources in different forms and through the involvement of the various local actors (Local Health Authorities, Municipalities and their Unions, professionals, patients and their caregivers, Third Sector associations/organizations, etc.).

GHA Home Care support policies are characterized by offering citizens a variety of interventions:

• at home and family support: home social, health care (including the supply of prostheses and aids) and integrated socio-health care, tele-monitoring and tele-help, of the solidarity networks of the local community;
• economic support: care allowances and economic contributions to individuals and families, differentiated according to the burden of care, the type and methods of assistance provided, and the economic situation;
• relief for the family: day centers, temporary shelters, climatic stays, etc., for people in situations of welfare dependency.

The GHA Local Bureau and its Units and Sub-Units manage the GHA Initiative Healthcare sector and the First Aid actions.

The GHA Initiative Healthcare is a care model for the prevention and management of simple and chronic diseases oriented towards health promotion, which does not wait for the patient in hospital or other healthcare facility, but takes care of him proactively already in the early stages of the onset or evolution of the morbid condition. The aim of the GHA Initiative Healthcare is:

• the prevention and improvement of the management of simple and chronic diseases at all stages, from primary prevention, to early diagnosis, following the GHA Integrated Holistic Medicines Protocols; 
• clinical and healthcare management; 
• the prevention of complications, through proactive and supported follow-up from telemonitoring and telemedicine tools;
• the global management of multimorbidity. 

The tools of the GHA Initiative Healthcare are:

• early proactive management for the identification of people at risk of disease, 
• holistic education on correct lifestyles, 
• patient care in the initial stages of pathologies, 
• multidisciplinary holistic integrated approach to therapies, 
• medium-long term planning of assistance activities, 
• booking of services, 
• support and control of patients' compliance with diagnostic-therapeutic programmes, 
• involvement of interested figures in the assistance process (e.g. family members and so-called caregivers), 
• streamlining of bureaucratic authorization activities.

GHA Local Units - The GHA Local Units Network is made up of all the general practitioners, specialists, health personnel and holistic operators who have joined the WHB-GHA Community, are present locally and constitute the main source of data collection from patients and use of data from international databases that provide the appropriate research, therapies, protocols, medicines and remedies also deriving from traditional medicines, holistic practices and techniques originating globally, based on the information produced with the introduction of patient data.

GHA City Units - In each large metropolis there is a Chief City Office which heads all other City Offices. A metropolitan Chief City Office acts as a Regional Bureau, while the other City Offices act as Provincial Bureaux and District Offices as Local Bureaux.

GHA City-District Units - In a large metropolitan area, the City-District Office is like a Local Bureau and has its own Block Units as Sub-Local Units.

GHA Communications Coordination Units - The Territorial Operations Center (TOC) is an organizational model that carries out a coordination function in taking care of the person and liaison between services and professionals involved in the different care settings: territorial, health and social-health, hospital activities, and communicates with the network of the emergency-urgency. 

Standard: 1 Territorial Operations Center per 100,000 inhabitants or in any case at District level, if the District has a larger catchment area.

GHA Emergency-Urgency Communications Units - The GHA Territorial Emergency System (GHA-THES) is a fundamental part of the New GHA National Health Service, with high management complexity and is responsible for the management of medical aid on the national territory. The latter refers to multiple clinical situations of increasing complexity. The GHA Territorial Health Emergency System is based on two structural and functional elements, fundamental and indispensable for carrying out its mission:

• the Health Emergency Operations Centre; 
• the Territorial Station Unit.

GHA Health Call Center Units - It is a tool available to the community with the function of taking into account the burden of requests for social support, social-healthcare and specific healthcare, coming from members, their family members and citizens in general, also for the purpose of promoting freedom of choice and care.

Further details of the purpose and services of the GHA Local Bureaux and their Units and Sub-Units is provided on request sending an email to INFO@WORLDHEALTHBOARD.NET

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