Leverage strategy: Norrtälje, Sweden

TioHundra

One example of how integrated care has facilitated coping with COVID-19 is TioHundra, an organisation that practices integrated care in Norrtälje, Sweden. Compared to other municipalities in the Stockholm Region, the Norrtälje municipality has so far handled the challenges of COVID-19 better than others. One possible explanation might be the integrated care model (also called the Norrtälje model) they use[1]. In Sweden, health and social care are funded and controlled by different levels of government. The regions are responsible for healthcare and the municipalities for social care (e.g., elderly homes). In Norrtälje, the care organisation TioHundra is responsible for coordinating all health and social care and thus bridging the gap between these two facets of care[2]. 

By promoting vertical and horizontal cooperation, the Norrtälje model aims to better respond to the needs that arise across the entire healthcare value chain—operating cross-silo. The main characteristics of the Norrtälje model are[2]:

• Funding responsibility for a single population
• Increased focus on health promotion for the population
• A common and integrated health and social care organisation to achieve greater patient and user benefit

 The model is particularly focused on caring for older adults with complex needs and supporting them to be able to live at home as long as possible. Moreover, the Norrtälje model aims to bridge the gap of the otherwise poorly integrated systems with which these patients would need to deal (e.g., being in contact with multiple providers from different organisations with different management systems, cultures, traditions and procedures).

The Norrtälje model has proven significant for the elderly in the case of COVID-19. The Norrtälje municipality could quickly respond to the sudden challenges that COVID-19 posed on the system. This meant, for example, being able to relocate doctors and other members of staff—also from private care providers. Moreover, they tripled the number of intensive care units and increased the hospital-connected mobile team to three mobile teams. The coordination and reallocation of protective equipment were also uncomplicated through joint distribution[1].