– We believe that the matter is serious. This means that it can have consequences for patients. That’s what the county doctor in Innlandet, Harald Vallgårda, says. The state administrator has looked at the follow-up of a total of eight patients who received treatment from Speare AS. In six of the cases, the health care has not been good enough. The state administrator concludes that Speare AS has broken the health legislation. Speare AS, for its part, admits a certain failure, and says that they take the findings very seriously. At the same time, they say that they do not agree with all the criticism from the county doctor. Read more about the response from Speare AS further down in the case. The crux of the matter: Deadline-breaking patients The Norwegian healthcare system is organized so that patients must receive help within a given deadline, if they are entitled to healthcare from the specialist healthcare service. If the health service is unable to meet the deadline, they must notify Helfo patient information. Helfo must then find another treatment offer. Speare AS is one of the private companies that receive assignments from Helfo. They provide children and adults with mental health care. Among other things, this has been given to patients from Innlandet Hospital. The deadline breach scheme Everyone who is entitled to health care in the specialist health service is given a deadline for when the health care must be provided at the latest. If the specialist health service does not meet the deadline, the deadline has been breached. The specialist health service must notify Helfo patient mediation if they are unable to meet this deadline. In the event of notification of a deadline breach, Helfo will try to find another treatment location for the patient. The specialist health service is responsible for the expenses. If the patient accepts an offer from Helfo, the patient is taken off the waiting list at the original treatment location. There is a new therapist who will be responsible for health care. In Helfo’s assignment to private actors, it is specified: “Investigation and treatment must take place in line with national professional guidelines in the field and “good practice”, including following the guidelines and recommendations given in the package procedures.” Helfo’s social mission is to safeguard users’ rights and provide professional service to practitioners and residents through guidance and information about the health service. Source: Helfo Gave psychological treatment via screen It was in November last year that the hospital notified about what they believe are deficiencies in the offer from Speare AS. The reports of concern to the State Administrator concern both the content of the processing and the manner in which the processing is provided. Among other things, the hospital questions whether Speare AS is able to look after children and young people in emergency situations. And whether the company has the necessary expertise to treat elderly patients. They also asked the State Administrator to assess whether too much of the processing takes place digitally. STATE ADMINISTRATOR NOTIFIED: Innlandet Hospital states that they had a large increase in referrals to the Mental Health Care division during the pandemic. This led to long waiting times and missed deadlines, which were reported to HELFO. Photo: Ole Martin Sponberg / news Mener Speare AS differs from BUP “The state administrator also notes that the health services offered to children and young people in Speare differ markedly from the health services offered by BUP”, the inspection report states. And with one exception, the State Administrator summarizes that the health care for the elderly patients has “major deviations from what is expected”. The state administrator believes the failure comes from a lack of governance in Speare AS. – We do not point to individual personnel. We believe that it is the overall professional management that is not sufficiently good, says county doctor Harald Vallgårda. He says that all healthcare personnel have their own responsibility for offering proper treatment. And it is the company itself that is responsible for ensuring the quality of daily operations. There is thus no systematic, public control of the healthcare provision from private actors. – It doesn’t. Apart from us who supervise when there is a report of concern or a complaint, says the county doctor. What is included in the term “responsibility”? Health and care services that are offered and provided must be sound. This means that the quality of the services must be at a certain level. The liability requirement applies at all levels in health and care services in both the private and public sector for the individual health personnel and the business. The requirement for soundness that is directed at businesses includes a duty to arrange the services so that personnel who perform the services are able to comply with their statutory duties, and so that the individual patient or user is provided with a comprehensive and coordinated service offer. The concept of reasonableness is a legal standard. By legal standard is meant that the content of the legal rule can vary over time, and does not link the decision to specific and unequivocal criteria, but gives instructions on a specific yardstick to be used in the assessment. For the individual healthcare personnel, the soundness requirement basically entails a duty to act in accordance with the professional norms and statutory requirements for professional practice that apply at all times. This includes the expectation that national guides and guidelines are followed. The term’s content therefore varies with professional development, value perceptions and the like. It is not an absolute requirement that one should do everything possible for the individual patient, for example by using all available resources. What is required for a healthcare professional to be considered to be acting in a professional manner must be judged on the basis of what can be expected based on the healthcare personnel’s qualifications, the nature of the work and the general situation. Source: State Administrator in the Interior LACK OF GOVERNANCE: – They have probably not made arrangements for those who carry out the health services to do so in a proper way, says county doctor Harald Vallgårda. Speare AS has now been given a deadline to assess the offences, and come up with a plan for how they will ensure that similar things do not happen in the future. Photo: Lars Erik Skrefsrud / news Speare AS: – Somewhat surprised Head of Department John Vegard Lenslie at Speare AS writes to news that they take the findings of the inspection very seriously. At the same time, the management of the company wants further clarification with the State Administrator. – We have former BUP and DPS managers employed in the company’s professional management, and do not recognize that our offer differs markedly from the health offer BUP offers. Speare AS writes that they were “surprised” that Sykehuset Innlandet notified the State Administrator. They indicate that the adult patients needed a service in geriatric psychiatry. – Geriatric psychiatric patients are not mentioned in the framework agreement, writes Lenslie to news. He then refers to the framework agreement with Helfo. According to Lenslie, Speare AS therefore agreed with Helfo that they “would have to make a holistic assessment of each individual case based on referral, and only took parts of the patient history”. With this background, the professional management is “somewhat surprised” that the State Administrator has come to a general conclusion regarding patients over 18, he writes. WERE OPEN: Head of department at Speare AS, John Vegard Lenslie, believes they were open to Sykehuset Innlandet that they did not have an equivalent offer to the geriatric psychiatric offer in the public healthcare system. The professional management at Speare AS found the interaction with the hospital challenging in the summer of 2022. Photo: PRESSEFOTO / Speare AS It is not a given that failure in health care has consequences. It is therefore Helfo that enters into agreements with private companies that offer health services to patients who have waited too long for the public. Helfo cannot confirm that there is a special agreement for Speare AS when it comes to elderly patients. They point out that the agreement is divided into health services for patients under and over 18 years of age. – Helfo does not have concrete agreements relating to which patient groups the supplier should or should not follow up, writes department director of Helfo, Kristin Bøgseth, in an e-mail to news. Helfo does not control the offer from the suppliers they have entered into an agreement with – and to whom they send the patients. – In our role, we are not authorized to enter into assessments of the health care that is provided, writes Bøgseth. She points out that it is the Norwegian Health Inspectorate and the State Administrator who supervise, but also says that the results of their work are relevant for Helfo. However, it is not a given that failure in health care will have consequences. – Whether a breach of health legislation qualifies to trigger sanctions from Helfo must be concretely assessed. DOES NOT ASSESS THE HEALTH CARE: Helfo monitors that the suppliers fulfill the obligations in the agreement. Department director at Helfo, Kristin Bøgseth, writes to news that the suppliers themselves are responsible for providing sound healthcare services. Photo: PRESSEFOTO / HELFO Does not comment on the inspection Sykehuset Innlandet does not wish to comment on the inspection against Speare AS. The inspection is not aimed at the hospital, and they are therefore not familiar with the content of the report. Innlandet Hospital has been submitted by news to the criticism from Speare AS. Divisional director for Mental health care at Innlandet Hospital, Benedicte Thorsen-Dahl, writes to news: – This is an inspection by Helfo’s service provider Speare, which Innlandet Hospital is not covered by. We assume that the supervisory authorities have carried out a thorough review of the cases as a basis for their conclusion.
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Speare AS broke the law when they treated overdue patients from Sykehuset Innlandet – news Innlandet – Local news, TV and radio
