To meet tomorrow’s need for care, the County Council is currently carrying out one of the largest investments in healthcare ever. In total, SEK 41 billion extra is being invested over the period 2017-2026, in part to technically improve and expand the County’s hospitals, provide conditions for new ways of working and offer more care episodes.
In Solna, the New Karolinska Solna project is being completed, which will result in Karolinska University Hospital gaining entirely new modern healthcare buildings. Karolinska University Hospital Solna will be a highly specialised hospital for the most severely ill and injured.
Other healthcare buildings are being renovated or extended to create more care capacity and make room for more modern ways of working. The expansions are taking place throughout the County. At the same time, research is being linked more closely to daily healthcare, which improves the possibilities of preventive healthcare.
Healthcare outside the emergency hospitals is becoming more extensive at the same time that the emergency hospitals are given the task to streamline their operations and focus more on the patients who really need the emergency hospitals’ resources. In 2016, for example, the County’s breast cancer care was concentrated to St. Göran Hospital, Södersjukhuset and Karolinska University Hospital.
But not everything is about creating more care capacity. It is also important to make sure that the patients receive the right care at the right time and right place and for this, new ways of working are needed. Rapid development of IT support and e-health are two fundamental prerequisites for the new approaches. With e-health services, the residents can become more active in their own care, by themselves creating a referral for testing and receiving the test results at the same time as the doctor.
In 2016, the introduction began of the e-service Journal online. The patient gains access to parts of his or her medical records over a secure log-in on the 1177 Vårdguiden healthcare guide website. More than 40 health centres and one hospital were connected to the service in 2016. In December 2017, the service will be available at all County Council-owned and private care providers that use the medical record systems TakeCare and Obstetrix (for obstetrics).
The GP clinic will be the patient’s hub
The general practitioner (GP) clinic will gain a stronger role in the healthcare system now growing forth. Healthcare at the GP clinics will be organised based more on the patients’ needs and demands, with regard, for instance, to opening hours and various contact routes in to healthcare. In the future, for example, more patients will contact their clinic by video call.
The GP’s role will be to support the patient through care and treatment. The GP will also contribute to coordination of the patient’s care when treatment is provided by other care providers. In 2016, the GP mission and compensation model were revised to better clarify the mission mainly for the elderly and multiple ill.
For example, the County Council measures whether the GP clinics conduct active disease prevention work. To be considered to work with health promotion and disease prevention, at least 3 per cent of the visits to nurses should entail advice according to the principles established by the National Board of Health and Welfare for advice regarding an individual’s health situation. The percentage of clinics that meet this target increased every month in 2016.
New local urgent care clinic structure
Several new local urgent care clinics are also growing forth. There, patients will get help for basic problems or afflictions, many of which will be fully treated on site.
In 2016, planning was under way for the new local urgent care clinics that will open in 2017 and 2018. Together with the health centres, local urgent care clinics will become important for receiving many people who turn to the emergency wards of the major hospitals today.
All local urgent care clinics will have a similar offering, opening hours, operational content and resources to treat patients with urgent health matters. They are also planned to have access to radiology services during the opening hours, which will be 8:00 a.m. to 10:00 p.m.
The local urgent care clinic at Karolinska University Hospital Solna will open in 2017. The other local urgent care clinics will be located at or near Danderyd Hospital, Karolinska University Hospital Huddinge, Södersjukhuset, Handen Hospital, Järva Hospital, Nacka Hospital, St. Göran Hospital, Sollentuna Hospital and Södertälje Hospital.
The first four local urgent care clinics will open in 2017. The remaining eight are scheduled to open in 2018 and 2019.
Care of the elderly and chronically ill
Care of the elderly is a large and important part of the healthcare of the future. This care will be better integrated with other specialist care, which in turn provides greater opportunities to conduct research and education in elderly care.
An expanded coordination will contribute to the patient not needing to move around between different care providers, but that care can be provided closer to the patient. This may mean that care is provided in the home, via Advanced medical care in the home (ASiH) or via a GP clinic that makes house calls.
The number of inpatient care episodes in geriatrics increased by 7 per cent in 2016 compared with 2015. New care capacity has gradually been added. The average period of care decreased by 3 per cent, which is due in part to changed ways of working at some clinics. Access to geriatric care capacity is assessed to be good.
The number of individuals admitted to ASiH during the year increased by 14 per cent. This increase is due in part to the care providers taking in more patients and in part to new care providers being added. This is entirely in line with the intentions of the Future Plan.
New Karolinska Solna
In autumn 2016, the first patients were welcomed to New Karolinska Solna (NKS). The hospital is being given a completely new mission. It will be a smaller, more highly specialised hospital than today’s Karolinska University Hospital in Solna, with a focus on the most complex diagnoses.
By gathering care of rare and complex diseases and injuries in one place, the conditions improve for better treatment of the patients. It is also efficient from a financial perspective where a concentration of care also means a concentration of advanced technology, equipment and expertise. Construction continued during the year. On 1 June, the first part of the hospital building was turned over to Stockholm County Council and at the end of November, the first part of the new hospital will be in operation.
The emergency ward at the new hospital will also be given a new mission. The adult emergency ward will only take in the most severely ill. Patients will arrive here by ambulance or helicopter, or with a referral from another care provider. Patients who already receive treatment at the hospital can also be admitted to the emergency ward.
Beside the ambulance bay, the hospital will have two helipads – something that will facilitate rapid intake in the event of major accidents in the Stockholm area or the rest of Sweden. The hospital also has capacity to receive patients from abroad. The hospital is scheduled to be in full operation in 2018.
Renovations and new construction of various healthcare and treatment buildings are under way. A newly built treatment building that will house the emergency ward and obstetrics was being prepared to open. The operations in the premises will begin in 2017.
St. Göran Hospital
A new emergency ward that can accept 100,000 patients a year opened its doors in spring 2016. This means that 20,000 more patients a year can be treated at the emergency ward. At the same time, plans are being made to further modernise and expand the hospital.
Work continued on a new building for the emergency ward. The hospital’s southern and central structures will be joined to create efficient flows and modern care wards. The hospital’s existing premises are also undergoing technical improvement.
The hospital is being renovated and expanded to make room for a larger emergency ward, operating theatres and care wards.
An extensive renovation of Sollentuna Hospital is under way. There will be outpatient and inpatient care at the hospital for the elderly and a GP clinic, local urgent care clinic, rehabilitation and extensive outpatient care services with several different specialities.
Karolinska University Hospital Huddinge
In 2016, new construction and renovations began on premises for surgery, radiology and obstetrics. Psychiatric care is being expanded and is gaining modernised care capacity with more single rooms.