A new future scenario for Zuyderland
Hospital care in South Limburg (the area around Sittard-Geleen and Heerlen) is under pressure: demand for care is growing while there is a shortage of care professionals. The process of designing a future scenario for hospital care in the region had been running for some time and there was considerable unrest about Zuyderland’s planned proposals. This was an important reason for Zuyderland, together with health insurer CZ, to engage Gupta Strategists and Buro de Bouwmeesters. A complex and sensitive assignment: many different stakeholders with their own interests, significant societal relevance and political pressure. The developments were closely followed by regional and national media.
Analyses refined on the basis of input from the region
The core of our approach? A combination of solid analysis and a careful participation process. With quantitative models, we mapped out which scenarios were feasible. At the same time, we held intensive conversations with residents of the region and other stakeholders, led by Lea Bouwmeester. Those conversations then served as input for refining the scenarios. For example, we calculated the impact: for how many patients does this mean a change? What is the impact on travel time? In this way, an iterative trajectory emerged in which facts and interests kept each other in balance.
An important lesson from this project is that it is not enough to design a careful process. It is equally important that there is explicit support for that process up front. Because of the high level of unrest at the start, this latter step did not happen sufficiently. This gave parties and individuals who were fundamentally opposed the room to call the process itself into question once things became contentious. That distracted from the substance, which is ultimately what it should be about.
A change of course with broad support
After an intensive trajectory of almost a year, the decision was finally made. Based on criteria reflecting what residents and stakeholders in the region considered important, the scenarios were compared and a preferred scenario was selected. The chosen future scenario differs considerably from the original direction. The initial assumption had been a full concentration of hospital care in Sittard with only a limited day-treatment center in Heerlen. The final decision is that the hospital in Heerlen will remain open 24/7. In addition to outpatient and day-treatment care, low-complexity inpatient care will also remain available — think of planned care that requires an overnight stay. There will also be 24/7 second-line emergency care for low-complexity cases. As a result, 85% of current patients in Heerlen will continue to receive care at their familiar location in the new setup.