by Marianna Castelluccio – Copywriter PHD Lifescience
Public-private partnerships (PPPs) have emerged as a strategic means of combining the strengths of the private sector—speed, capital, and innovation—with the public sector’s capacity to manage healthcare services for the benefit of the community.
A Clinical Support Program (CSP) serves as a critical testing mechanism to assess the feasibility and sustainability of such collaborations before formalising them. Here’s an exploration of what CSPs are, how they work, and their role in the evolution of PPPs in healthcare.
What Is a Clinical Support Program?
A Clinical Support Program is essentially a beta test for an organisational and management model within the healthcare sector. It is a temporary, cost-free initiative for public healthcare, supported by a private pharmaceutical company that funds the project, and facilitated by a healthcare provider acting as a designer and project manager.
During its defined trial period, CSP enables healthcare organisations to test innovative service models without financial risk. The focus is on measuring the effectiveness and sustainability of these models using predefined Key Performance Indicators (KPIs). If successful, CSP can evolve into a full-fledged, long-term public-private partnership.
The Rise of PPPs in Healthcare: Understanding PPPs Meaning
In Italy, public-private partnerships meaning collaborative actions that unite public and private sectors to achieve shared goals, have gained traction through evolving legislative frameworks aimed at modernising infrastructure and improving service delivery. The concept of PPP was first formalised under Legislative Decree No. 163/2006, which introduced a structured approach inspired by European Directives. Subsequent updates, such as Legislative Decree No. 50/2016 and the recent Legislative Decree No. 36/2023, have enhanced the regulatory landscape, focusing on transparency, competition, and sustainability.
In healthcare, PPPs provide an opportunity to leverage private-sector resources and expertise, reducing the financial and operational burden on public health organisations. However, the complexity of procedures, the need for specialised expertise, and the potential for litigation highlight the importance of testing such models through CSPs.
Advantages and Challenges of Public-Private Partnerships in Healthcare
Advantages:
- Access to Private Funding: Reduces the financial strain on public healthcare organisations.
- Risk Sharing: Encourages efficient management by distributing risks between public and private entities.
- Expanded Services: Facilitates the introduction of innovative solutions and services driven by private-sector input.
Challenges:
- Complexity: PPP projects require specialised knowledge and expertise, which may not always be available within public institutions.
- Risk of Litigation: Disputes over contractual terms and outcomes can delay or derail projects.
- Uncertain Outcomes: Long lead times and intricate processes can make results unpredictable.
CSPs provide a structured yet flexible approach to address these challenges. By allowing public healthcare organisations to test new models in a controlled environment, CSPs enable stakeholders to evaluate their effectiveness and make data-driven decisions.
Key aspects of CSPs include:
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- Data Management: Collecting and analysing healthcare data to develop tailored organisational solutions.
- Referral Networks: Building and refining networks to streamline patient referrals and follow-ups.
- Chronic Care Monitoring: Developing systems to ensure consistent and effective monitoring of chronic patients.
How CSPs Work
- Design and Facilitation: The healthcare provider designs and implements the initiative, ensuring alignment with both public and private stakeholders’ objectives.
- Testing and Measurement: The project’s performance is evaluated through KPIs, focusing on effectiveness, efficiency, and sustainability.
- Evaluation and Transition: Upon successful completion, the CSP model can be transitioned into a permanent PPP arrangement, with the public and private sectors assuming shared responsibilities.
How Can PPP Be a New Tool for Italian Healthcare?
We asked Lawyer Silvia Stefanelli of the Stefanelli&Stefanelli Law Firm.
“The PPP is a model of cooperation between the public and private sectors that has been introduced into our legal system for a long time but has always had little application. However, the recent Public Contracts Code has reversed the perspective of this collaborative model to facilitate its implementation. To be more precise, the PPP is not a legal institution in its own right, but an economic operation that can take on various legal forms (all the more so now that Article 8 of the Public Contracts Code itself allows the establishment of “atypical” contracts); More precisely, the PPP aims to establish a long-term “contractual relationship” between the public administration and private parties to achieve a result of public interest through a joint project, to which the private parties contribute by providing a significant part of the resources necessary for its implementation and by assuming its management and operational risk, while the public party defines the objectives and verifies its implementation.
These contracts allow public administrations to undertake costly interventions, even in situations of budgetary deficit, by calling on the contribution of private entrepreneurs, both as financiers and as technical partners able to offer their know-how for the implementation and management of a work or service of public interest”.
What are the possible areas of application for PPPs in the Italian health sector?
“Certainly all those where the public administration needs a contribution from the private sector in terms of planning, organisation, staff or equipment: think, for example, of home care or the monitoring of people undergoing treatment. The real challenge will be to come up with innovative models of cooperation that meet a need in the public interest, but for which the private sector can assume not only the management but also the business risk.”