According to Saxon Health Minister Petra Köpping, the draft bill for the Saxon Hospital Act (SächsKHG), which has recently been available and has been released for hearing, is intended to ensure that “every patient in every region is well cared for”. According to Köpping, the aim is to have an efficient, efficient and attractive hospital landscape in the Free State of Saxony that is well networked with other service providers and that offers a high quality of care for patients in 2030 and beyond, which is what the new Saxon Hospital Act is intended to achieve , in force since September 1, 1993 and most recently amended by Article 18 of the Law of April 26, 2018, which establishes the legal framework.
>> In July (1) the Saxon cabinet approved the draft for a new Saxon hospital law. This means that the draft can now be submitted to the Saxon state parliament for a vote. Ideally, the law will come into force on January 1, 2023.
The new Saxon Hospital Act primarily contains regulations on hospital planning and financing. Among other things, there is an opportunity to designate health centers, which should ensure medical care for the population, especially in rural areas.
What is also new is a legal basis for model projects, according to which hospital authorities can test new projects. This is intended to bring greater emphasis to the desired cross-sector collaboration, especially between outpatient and inpatient areas. Health Minister Köpping said: “The amendment continues to address topics such as digitalization in hospitals, which is also intended to make work easier for staff. In addition, further quality requirements in individual care areas will be the subject of hospital planning.” The new hospital law is also intended to create the opportunity for regional conferences. These are intended to enable districts and independent cities, hospital authorities, state health insurance associations and the Saxony Association of Statutory Health Insurance Physicians to exchange information and participate in shaping the process.
The present draft bill goes back to the coalition agreement concluded for the 7th legislative period, in which a “future workshop for a new Saxon hospital law” was agreed. This can be imagined as a solidarity of all those responsible for the Saxon health care system - the hospital company, health insurance companies, the state medical association, the association of statutory health insurance physicians, the district, city and municipal association - who have jointly agreed on a "Target Image 2030 - Saxon hospital care landscape in transition". This was a transparent process in which the actors discussed problems and solutions openly and creatively together with the Saxon State Ministry for Social Affairs and Social Cohesion. According to the Saxon State Ministry for Social Affairs and Social Cohesion (SM), such an early involvement of the relevant forces in a reform process is extraordinary, but corresponds to “the pioneering spirit with which everyone involved is meeting this challenge”.
The jointly developed target image was presented to Health Minister Köpping on February 7th of this year with the headline “Rethinking health together” (2). Dresden's health mayor Dr. On the occasion of the presentation of the target image, Kristin Klaudia Kaufmann explained on behalf of the Saxon Association of Cities and Municipalities that Saxony's hospital landscape is facing major challenges: “On the one hand, people in the cities and communities want to receive the best possible medical care in all phases of life. On the other hand, many of the 78 hospitals are having great difficulty finding staff and meeting the ever-increasing demands on quality and digitalization. There is a need for both advanced, cutting-edge medicine and needs-based basic care across the board. In her opinion, this could be achieved through a greater division of tasks between hospitals, cross-sector care with the help of health centers and digital health services.
“In view of the increasing shortage of skilled workers, we must focus on the quality of care and the necessary cooperation,” added Erik Bodendieck, President of the Saxon State Medical Association. And Rainer Striebel, CEO of AOK PLUS, added: “With the target image we have developed, we are jointly setting a direction for what the Saxon care landscape of doctors, hospitals and care will look like in the future. It is precisely in the topic of networking that we see the greatest opportunities to design care in the Free State in a forward-looking, needs-based, sustainable and efficient manner, thereby increasing the quality of treatment and relieving the burden on staff.”
“The focus of future developments is on high-quality and patient-oriented hospital care,” emphasized Silke Heinke, head of the Saxony state representative of the vdek, representing the replacement health insurance funds in Saxony. According to Heinke, the Free State of Saxony must ensure sustainable and adequate financing of investment costs for hospitals. The focus would also be on the points of digitalization, quality and specialization of hospital care.
The managing director of the Saxony hospital company, Dr. Stephan Helm, was convinced on the occasion of the handover of the target image: “The present target image was approved by the hospital company.
initiated and co-designed.” It has the full approval of the Saxon Hospital Association. Helm: “This provides an important basis for the consolidation and further development of the care structures as well as for the creation of the instruments and tools required for this.” It is important to him to emphasize that hospital care – in particular its planning and investment security – “is particularly important responsibility of the Saxon actors”. However, not only does the Saxon Hospital Act need to be amended, but “important impulses towards the federal government” also need to be given.
The Saxony Association of Statutory Health Insurance Physicians (KVS) was also involved in the development of the target image as a representative of contract doctors and psychotherapists. Dr. med. Klaus Heckemann, CEO of KV Sachsen, explained how important it is to secure medical resources in the long term, especially in rural areas: “An important building block for this is a cross-sector, close network of players in the medical sector – also supported digitally.” They are already cooperating today outpatient doctors with clinics in many areas. This will become even more important in the future, especially against the background of increasingly outpatient medicine.
André Jacob, managing director of the Saxon District Council, sees the jointly developed target image as an “encouragement to no longer just talk about the synergies of outpatient and inpatient care services, but to implement them in a model and pragmatic manner in the Free State of Saxony”. Together, the necessary transformation process towards greater sustainability will be initiated, which should also create attractive working environments for medical staff.
Health Minister Köpping summarized the positions of all actors by emphasizing that all actors have a “united responsibility” to guarantee a high medical standard in Saxony. Köpping continues: “Therefore, we must rethink health together now and in the future.” This has been done as an example with the future workshop and proven with the development of the target image. “I would like to thank you for this important work and can assure you that these essential impulses will be taken into account in the legislative process for amending the Saxon Hospital Act,” explained Köpping, who always wants to be one step ahead of general developments in health care in Saxony.
The Saxon coalition factions are completely in line with this. “It is particularly important for us as coalition factions that care in Saxon hospitals in the future is geared even more closely to the needs and needs of patients and that ensuring the quality of care is the top priority,” write the CDU factions , ALLIANCE 90/THE GREENS and SPD in a joint statement (3). In this they ask the Saxon state parliament to decide and state the following:
1. The coronavirus pandemic has presented the German healthcare system with extraordinary challenges in recent months and at the same time has made clear the great importance of an efficient healthcare system and networked health care.
2. Hospitals are an important cornerstone of medical care in our health system and ensuring hospital care is a public task that must also be publicly financed.
3. In order to be able to ensure high-quality care in the future against the background of demographic change, a strained development of skilled workers and digital progress, we must lay the foundation for tomorrow today.
This declaration also asks the state government to further promote cooperation between the different care sectors in order to avoid breaks in the patient's care process and to enable and promote stronger cooperation and the digitalization process between different hospitals. In addition, it should be examined how local actors can be integrated into the strategic planning of medical care in the regions. <<
by: MVF editor-in-chief Peter Stegmaier
Cross-sector care: Even though the regulatory authority for cross-sector care generally lies at the federal level, the Saxon Hospital Act is already providing important impetus. This puts greater focus on the collaboration between service providers. In addition, the “health center” is legally anchored as a subgroup of standard care homes. This is intended to support the guarantee of medical care for the population in rural areas. Model projects can also be funded. This regulation is intended to create a legal basis for special projects by hospital authorities that are not yet covered by standard financing.
Quality: The new Saxon Hospital Act also makes provisions to allow quality to be taken more into account in hospital planning and financing. For example, when drawing up and updating the hospital plan, the planning-relevant quality indicators of the Federal Joint Committee can become part of the hospital plan. Additional quality requirements in selected care areas can also be made part of hospital planning. Their introduction must be carefully examined as part of hospital planning and patient safety and security of supply must be weighed up. Furthermore, flat-rate funding can provide incentives for good quality.
Regionality: The Hospital Act creates the possibility of setting up regional conferences. These can be formed into specific planning priorities and should, in particular, offer the respective districts and independent cities the opportunity to participate in the design at an early stage.
Digitalization: Digitalization in hospitals offers many opportunities to improve and secure patient care in the future, for example with the help of telemedicine. The Hospital Act sets incentives for further digitalization, for example as part of flat-rate funding.
