Territorial medicine, the Legacoop Plan (31/05/2021)

The cooperatives of general practitioners are applying to create – in partnership with the National Health Service, social and residents’ cooperatives, supplementary mutuals and insurance funds – a network of local medical and residential centers, with a total area of ​​about 2.5 millions of square meters, and to take over the management, including that of the staff employed (professional nurses, study collaborators, physiotherapists, psychologists) and diagnostic equipment, also through telemedicine. The goal is to contribute to the strengthening of territorial medicine that the PNRR, allocating 7 billion from the Recovery Fund in 5 years, recognizes as one of the essential objectives for improving the efficiency and responsiveness of the National Health Service to assistance needs. of citizens.

This was announced by Maurizio Pozzi, president of Sanicoop, the association, which is headed by Legacoop, which includes about 100 cooperatives, 75 of which are general practitioners (about 6,000 doctors, who assist 7.5 million patients), and which also employ a support staff of 2,500 employees including administrative figures and nurses.

“Our project, which also provides for the activation of a digital platform to support health and social assistance activities – explains Pozzi – is consistent with the evolution of the health service model outlined in the PNRR and, starting from an approach that focuses on the patient and his clinical picture to build a ‘health path’, intends to exploit the ability of cooperation between doctors, demonstrated even during the most difficult phases of the pandemic, to organize effective territorial safeguards to assist patients who they need primary care and short hospitalizations. The goal is to enhance local care with innovation, organization, first-level diagnostics, management of chronic diseases and polypathologies, guarantee prevention starting from vaccinations, ensure proximity to care and home care. Thus also obtaining the relief of hospitals and, in particular, of emergency rooms “.

Another important element is the direct participation of family doctors, through their service co-ops, which guarantees not only the functioning of the territorial reference centers of the Territorial Functional Aggregation, but also the permanence of the widespread proximity network that integrates with the center itself. “An essential element – Pozzi specifies – especially in Italy, for its orography, for the diffusion of its residential settlements, for the associative heritage and civic participation that is widely present in every corner of the country and represents an essential resource for the development of individual and collective health projects “.

The Sanicoop project: “spoke” offices and “hub” offices, 2.5 million square meters

The project developed by Sanicoop assumes an overall requirement of approximately 2.5 million square meters – even by resorting to the recovery and redevelopment of portions of unused real estate assets of service and commercial activities – for the construction of two types of structures for the type of outpatient clinics and medical centers: “spoke” offices of 500-1,000 square meters, for a catchment area of ​​25/30 thousand inhabitants, which can host general practitioners, family pediatricians, social cooperative activities, nursing services and administrative, diagnostic and specialist extra LEA of the NHS; “hub” offices of 2,000 square meters, for a catchment area of ​​100/200 thousand inhabitants, which, in addition to the performance of the spoke offices, can guarantee heavy diagnostics, laboratory, pharmacy, day surgery, rehabilitation, white code management, proximity to structures residential socio-sanitary. As regards residential social and health care facilities, the project provides for the adaptation and strengthening of the current network (RSA, Day Center, Hospice, Community Hospitals, Alzheimer’s Centers), accompanied by the implementation of new types.

On the financial level, the project, in addition to the establishment of a specific real estate fund participated by the investors, assumes self-financing, with a 30% participation, by the professionals concerned and their pension funds and, for the remainder, the use of credit banking, with loan amortization through facility management.

As in any country with a strong evolution of welfare, the strength of planning is to define clear objectives, even ambitious ones, and then mobilize ALL the resources available to achieve them, ensuring adequate coordination. The cooperative movement has this prerogative in its DNA and offers all its availability and experience to build a territorial health system capable of responding to new health needs.