Improving responses to complex healthcare needs and misunderstood behaviour

“It is reassuring to see that considerable advancements have been made in recent years for individuals with complex care needs and misunderstood behaviour,” remarks Jeroen Housmans, Programme Leader of the Centre for Consultation and Expertise (CCE). “Nonetheless, many factors can influence the results in this complex care environment. A major concern is the current staffing issues within healthcare. We are dealing with the most vulnerable populations, and these individuals are especially affected by staff turnover, which is unfortunately prevalent in the current context. Financing also plays a significant role. There has been a long-standing debate over the rates for VG7, the care profile applicable to these individuals. Care providers report facing financial challenges in effectively organising care for all their clients.”Another important aspect is that the guiding principle of care has traditionally been: we take over. “

This approach is no longer sustainable,” Housmans states. “The simultaneous rise in care demands and staffing shortages necessitates new organisational methods that place greater emphasis on the roles and knowledge of relatives.”

Marly Kiewik, Partner in Healthcare at Deloitte, concurs that an increasing variety of collaborative efforts are essential: “The ageing population is making the intersection between disability care and elderly care more apparent. Individuals with disabilities are also living longer and are increasingly developing age-related illnesses, such as dementia. It is crucial to create connections between these two sectors. In recent years, a lot has been initiated to improve care for individuals with intensive care needs and misunderstood behaviour. Nonetheless, providing appropriate care for these clients remains a challenge. As a result, the Ministry of Health, Welfare and Sport (VWS) has now launched the Development Programme for Complex Care, as part of the Future Agenda for care and support for people with disabilities. Enhancing our responsiveness to the needs of individuals with complex care requirements and misunderstood behaviour. This is particularly important because care is organised into distinct pillars. We must now seek out ways for various care providers to strengthen one another.”

Achieving breakthroughs

Through the Development Programme for Complex Care, Deloitte seeks to contribute to the breakthrough that has been pursued for an extended period. “When VWS approached us for assistance in this area, our immediate thought was: we should not tackle this issue solely from a consultancy perspective,” says Kiewik. “This matter encompasses change from various angles. We must honour the target group and integrate the nationally developed knowledge, thus linking care content, change management, and an external perspective. Our approach should focus on solutions rather than problems. We need to find ways to create integrality and avoid viewing the issue solely through the lens of healthcare. It is essential to discover how we can act cohesively and implement the initiatives that will have the greatest impact.”

Kiewik recognises that changing the system cannot occur in the short term. “However, much is possible within the collaboration among parties—relatives, healthcare professionals, and care offices. We should also examine whether staff members are being properly trained to engage with this complex target group, so they do not leave their roles quickly. Additionally, appreciation and scheduling are vital components. These are backend considerations that need to be taken into account alongside the front end, which involves the client’s living environment. What are the needs and characteristics of each individual?”

The importance of this collaboration is immense, Housmans adds. “It is crucial to focus not just on the client but also on their support worker. They need assistance and guidance in their professional roles. For this, the entire organisation must be involved, from the technical department to the board of directors. Every aspect contributes to the quality of care and, consequently, to the quality of life for these people.”

Specialised expertise from key parties

The participating care providers in the Development Programme are supported by a coach, and a flexible support network has been established to guide them in the execution of the programme.“

Among the involved parties, CCE possesses the most experience in the field of misunderstood behaviour,” says Kiewik. “CCE can engage not only at the individual case level but also in terms of developing a broader vision. The Institute for Positive Health is the solutions-focused organisation aiming to achieve positive health for the client in the widest sense. This encompasses much more than just care; it is also about facilitating breakthroughs in various aspects of daily living. Tactus is the organisation with expertise in addiction care. The link between disability care and mental health care is becoming increasingly prominent, making it imperative to include this element in the programme.”

Deloitte contributes through change coaching and design thinking. “Additionally, we are in charge of the national programme management,” explains Kiewik. “Our goal is to provide organisations with insights into the development plan that can enhance the quality of life for the client. As such, we monitor their current situation and the progress they are making. Of course, we will also utilise the digital tools available in healthcare to support this effort. However, these tools will be supplementary. The primary focus remains on social innovation.”

Commitment required

The Development Programme primarily demands commitment from the participating care providers, states Kiewik. “Everyone—from the board of directors to the frontline staff—has a part to play in this transformation initiative. Moreover, clients and their relatives need to have a voice in the process. We want to understand: what can assist you? By involving them alongside the other stakeholders in the programme, we can arrive at the best subsequent steps.”

Housmans adds: “The programme provides care providers with the chance to intentionally step away from the day-to-day routine and approach the challenges with a fresh perspective. This is what we ask of them. They must maintain the urgency with which they begin this journey, as the programme will run for ten to eighteen months, depending on the level of support required. It is explicitly not our intention to take over the issues from them. The guiding principle is: demonstrate, collaborate, and take ownership. They need to learn to take up their roles and responsibilities throughout the programme.” 

Everyone involved in the programme, including design thinkers, must grasp how complex care functions in practice. “That’s why everyone who hasn’t yet done so will spend time shadowing staff on-site,” explains Kiewik. “Diving into the practical environment and witnessing what is happening there is crucial.”

Knowledge sharing

To facilitate the sharing of knowledge gained in the Development Programme, a three-tiered approach is employed. The first tier involves knowledge sharing among the participating care providers who are focusing on the same themes. The second tier encompasses knowledge sharing among all participating care providers. The third tier involves broad knowledge dissemination, reaching out to care providers who are not part of the programme.“

"We accomplish this last aspect in collaboration with knowledge partners in the sector,” explains Kiewik. “We also establish contact with care offices to ensure that the knowledge is implemented in the various regions. Additionally, we align ourselves with existing initiatives and the developing knowledge infrastructures surrounding these groups.”

This article was previously published on the ICT&health website on 29 January 2025.