Resultatevaluering av Omsorgsplan 2015. Kommunal planlegging
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With report No.25 (2005–2006) to the Storting, also called Care Plan 2015, the Government introduced four priority areas for municipalities to be able to meet future challenges in long-term care: (1) growth in person-years, (2) skills upgrading, (3) growth in long-term care facilities, and (4) strengthening long-term care in dementia. One of the main strategies in Care Plan 2015 is to ensure that the future challenges in the long-term care services field are one of the municipal sector’s most important planning tasks and are embedded in the overall municipal planning work. The current report presents results from a study that is part of the project “Outcome evaluation Care Plan 2015”, which is a collaboration between the Department of Health Management and Health Economics at the University of Oslo, Center for Care Research, East, at Gjøvik University College and Norwegian Social Research at Oslo and Akershus University College. The aim of the report is to evaluate the extent to which municipalities have developed local long-term care plans and included future long-term care challenges in their municipal planning work. We use a three-way approach by focusing on the quantity of long-term care plans, the quality of the municipal planning work and the experiences of administrative and professional municipal leaders with local care plans. Chapter 2 provides an overview of the data and methods. Chapter 3 describes the quantity of long-term care plans. By 01-03-2013, 41 percent of all Norwegian municipalities have developed a local care plan for long-term care services. When we also include municipalities that have specified the four priority areas from Care Plan 2015 in at least one of the three parts of the municipal planning work (planstrategi, samfunnsdel, handlingsplan), 55 percent of the municipalities have included future challenges in long-term care. Municipalities that have developed a local care plan are somewhat more likely to address challenges in the overall planning work. There are major regional variations in the number of municipalities that have developed a local care plan. Furthermore, priority areas are mainly discussed in the financial plan (handlingsplan), which is revised on an annual basis. Small municipalities (with less than 7,000 inhabitants) are least likely to have included future care challenges in any way in their municipal planning. Fewer needs as well as fewer available resources are the most likely explanations for this. The largest municipalities, with more than 60,000 inhabitants, are likely to have mentioned the priority areas but are also less likely to have specified the associated challenges, the consequences and possible strategies for their municipality. Chapter 4 is based on an examination of the municipal planning work in 67 municipalities based on four indexes: Overview of long-term care in the municipality Future needs and demands for long-term care Capacity and skills in dementia care; and Strategies for recruitment and skills upgrading in long-term care The municipal planning work is most likely to include some kind of overview of long-term care in the municipality (index 1). More than half of the municipalities have included an overview on the number of nursing home places, users of home care and use available statistics to provide a general overview over long-term care services in the municipality. Strategies for recruitment and skills upgrading are least likely to be included in the planning work. Municipalities with a local care plan have a higher score on the indexes compared to municipalities without a care plan. Chapter 5 presents a description of the experiences of municipal staff from 23 municipalities with local care plans. All informants underline the importance of the process of developing local care plans, and indicate that local care plans are a useful strategy for their municipality. An important condition for the success of local care plans is that these are realistic and based on solid knowledge on current and future needs. Chapter 6 summarizes the findings of the report and discusses challenges and research possibilities ahead. All in all the results indicate that Care Plan 2015 has contributed to an increased focus among municipalities to include future challenges in the long-term care services in the overall municipal planning work. There are however large regional variations that suggest a varying involvement of the county administrator. A brief and concise national guide for developing local care plans may constitute a useful tool for some of the municipalities hesitating to develop a local care plan. Another important question for future research is to what extent local care plans and municipal planning lead to subsequent changes in the long-term care sector of the municipalities.Hensikten med denne rapporten er å vurdere i hvilken grad kommunene har utviklet lokale omsorgsplaner, og hvorvidt kommunene har satt de framtidige pleie- og omsorgsutfordringene på dagsorden i det kommunale planverket. Fokus er satt på omfang av og kvaliteten i planverket og erfaringer med lokale delplaner. Rapporten inngår i pro-sjektet «Resultatevaluering av Omsorgsplan 2015». 41 prosent av alle landets kommuner har utarbeidet en lokal delplan for pleie- og omsorgssektoren per 1. mars 2013. Tilnærmet alle delplaner er datert fra etter at OM2015 trådte i kraft, noe som kan tyde på en ekstra innsats i forlengelse av OM2015. Utarbeidelse av lokale delplaner bidrar til at hovedsatsingene i større grad blir del av det helhetlige planarbeidet i kommunene. Kommunale ledere har stort sett gode erfaringer med utvikling av omsorgsplaner, men understreker at disse bør være realistiske og forankret hos kommunepolitikere som legger føringer for det totale tilbudet av pleie- og omsorgstjenester.