Afterword

The Nordic countries are built on the principle of democracy and on universal access to high-level health and social services. But the societies we live in have become more complex, and face challenges in the years to come: the demographic is changing with an aging population and lack of manpower. Nordic inhabitants have high expectations of what the health and social services should solve. At the same time the complexity both in service provision, towards the inhabitants, and the society in general has increased.
Integrated healthcare and care that is well coordinated is one of the largest challenges facing modern health- and social care services in the Nordic countries. Research, reports, white papers, and experiences from both healthcare professionals and users show that it is in the transitions between service levels that errors occur: inadequate interaction, communication, and coordination contribute to patient injuries, unnecessary hospitalizations, unnecessary waiting time, and extra strain for patients, relatives, as well as healthcare and social care professionals.
We can therefor see, in all Nordic countries, national initiatives to achieve a more integrated healthcare and social care service model based on the needs of the citizens. Resources have been added and many projects has been carried out. In regions and municipalities, politicians have made decisions to cooperate to a greater degree between healthcare and social care for a more integrated service offer. Regulations have been adjusted to facilitate implementation and there are also agreements entered between the actors. Despite high ambitions and the fact that political decisions have been made, resources added, regulations changed and agreements signed, development is slow in the vast majority of regions and municipalities in the Nordic countries. There is a lack of knowledge sharing, communication, common goals and trust between the actors. The components that the Norwegian Centre for E-health Research highlights in their research as the most significant components for successful implementation of integrated healthcare and care with support of distance spanning solutions.
In this report we have given five examples of regions with cross-sectoral collaboration within health care and social care in focus. The regions are examples of how system structures can be organized to ensure new integrated healthcare and social care services. All regions have components as communication and knowledge sharing, common goals, and trust that strongly contribute to better collaboration between service levels and adopting of digital health services and distance follow-up solutions. The five regions are examples of regions that work to maintain universal access to high level health and social services.
Nordic Welfare Centre and their collaboration partners, Norwegian Centre for eHealth Research and Centre for Rural Medicine have through this publication shed lights on models for cross-sectoral collaboration, involving multi level governance to secure integrated healthcare and social care services. The identified key system componants to make it work are communication, knowledge sharing, common goals and trust. For Nordic Welfare Centre, a publication of this kind is important. More regions and municipalities can be inspired to further develop their service portfolio to become more sustainable and more adapted to the citizens needs. This publication will be followed by additional initiatives during the years 2022-2024, to develop integrated service models for citizens across the Nordics