Nearby hospitals will be able to share staff to address the shortage of personnel.

BarcelonaIn Catalonia, there are many healthcare centers and a growing number of patients requiring medical attention, but at the same time, there is a shortage of doctors, which could ultimately jeopardize the sustainability of the healthcare system as we know it. The progressive aging of the population will increase chronic illness, dependency, and frailty in the coming years. For example, by 2050, the number of centenarians will increase fivefold, and there will be almost twice as many people over 75. To address the demographic and healthcare challenges of the future, the Committee for Evaluation, Innovation, and Operational Reform of the Health System (Cairos)—the group of experts advising the Department of Health on transforming the foundations of the healthcare system—proposes a "radical change": on the one hand, it proposes dividing Catalonia into thirty distinct health areas; on the other, it proposes promoting networking among healthcare professionals across different centers within the same area. Currently, Catalonia has 68 acute care hospitals, while other regions with similar populations, such as Andalusia and Madrid, have 34 and 32 respectively. In addition to these hospitals, there are also primary care centers (CAPs), day hospitals, sexual and reproductive health care units (ASSIR), and nursing homes, among other facilities that provide social and healthcare services to the public. "We have a hospital every 25 kilometers. It's a good model, but it's difficult to maintain because it's hard to fill all the positions," admit sources at the Catalan Health Department (Salut), who argue that an "organizational effort" is necessary to guarantee its operation. Therefore, they are proposing a new healthcare map divided into thirty integrated health areas (AIS), which will act as umbrella organizations for all the centers in the area to strengthen collaboration between different facilities, avoid duplication, and minimize the shortage of professionals. For example, if an integrated health area includes two hospitals, they will not have to compete to hire a surgeon. Instead, this professional will be hired to perform operations at both centers, depending on patient needs. The same will apply to home care: instead of having one team from the hospital, another from the primary care center (CAP), and another from the nursing home providing home care, there will be only one team responsible for visiting the homes of all patients who need home care within an integrated health area.

This is a new pilot program devised by Cairos, who has been tasked by the President of the Generalitat, Salvador Illa, with considering how the healthcare system should be transformed to guarantee its sustainability. Other projects that are currently being tested have emerged from this committee, such as... the new Comprehensive Health Reference Centers (CSIR) –which are being evaluated to determine whether they will eventually replace the current primary care centers (CAPs)– or a new model for collecting dependency benefitswhich aims to reduce the waiting list to just two months – currently the wait is over a year.

Call for applications and schedule

However, Tuesday's announcement is a call for proposals; that is, integrated health areas that wish to participate can test the new model to see what works and what needs to be changed. Therefore, the centers and hospitals in each integrated area will have to submit a proposal to the department, which will then decide if they meet the requirements to participate in the pilot program. The idea, as explained Tuesday by the president of Cairos, Manel del Castillo, is for the trial to begin in mid-2026 and last for a year. Throughout this year, the model will be evaluated, and any aspects that are not working will be changed. Areas interested in participating must design a home care model that integrates all the centers in the area, a system to reduce hospital waiting lists, a coordination model between centers, and a public and community health program. Del Castillo cited the integrated area between Osona and Ripollès as an example, where some of these initiatives are already being implemented and which will be one of the integrated health areas participating in the pilot program. Del Castillo presented the initiative this afternoon at an event in the Espacio Bital in Hospitalet de Llobregat before more than 300 professionals and stakeholders in the sector. Proposals can be submitted until March 27.