Published: 07-12-2016 15:50 | Updated: 07-12-2016 15:55

What is needed for the regional ALF agreement

What form might collaboration between Karolinska Institutet (KI) and Stockholm County Council (SLL) take? This was one of the questions discussed at a joint kick-off at Nalen in Stockholm the day after the new research bill, with its strong emphasis on interaction, was presented.

“60 per cent of our activities are focused on health and medical care already today, but I would like to have a more distinct feeling that we are together, that we are jointly contributing to improve people’s health,” KI’s acting Vice-Chancellor Karin Dahlman-Wright said.

More precisely, she was referring to the collaboration agreement between Karolinska Institutet and Stockholm County Council on basic education of doctors, workplace-based education for other health professions and clinical research, and development of health and medical care. The agreement is commonly referred to as ALF.

The foundation is the national ALF agreement that has been complemented with regional agreements between concerned county councils and the university.

Now some forty representatives from KI and SLL were to discuss how the regional ALF agreement can be filled with human content. The agreement was approved by the County Council Assembly on 15 March this year.

University Healthcare a key concept

The kick-off was opened by KI’s acting Vice-Chancellor Karin Dahlman-Wright and acting County Council Director Anne Rundquist. Anna Humble, who heads KI’s County Council Collaboration Unit, then told delegates that the national ALF agreement, that came into effect on 1 January 2015, contains quite a few new things compared to its predecessor.

“Among other things, the concept of university healthcare has been introduced, since the intention is to not restrict clinical research to a particular building (university hospital) but instead show that there are other places that conduct good research and provide good education outside the major hospitals. A further intention is to evaluate the quality of clinical research to redistribute part of the ALF research funding on the basis of results,” Anna Humble says.

She also mentioned that the regional ALF agreement in Stockholm differs from other regional ALF agreements in that Stockholm has chosen to include all education programmes at KI that require the participation of the care sector, in other words programmes that contain workplace-based learning and not only the education of doctors.

Topics discussed in groups later in the evening included how the way can be paved for new research to be implemented in health and medical care more quickly, how research can be organised in the new care structure, with a continued focus on national diseases, and how a good foundation can be laid for education in the new care structure.

The 4D project as a model

Martin Ingvar, KI’s Deputy Vice-Chancellor with responsibility for coordinating issues concerning the healthcare of the future, sees a number of challenges with the new collaboration agreement.

“Research in clinical environments demands stable forms of collaboration and both management teams must be focused on the collaboration. Health and medical care must seek its own development and KI has to seek patient benefit. When we do so, we accomplish fantastic things like the 4D project where we absolutely lead the world. When we don’t, we point to the other organisation and blame them. A formal ALF agreement is important in this respect, because we have to consider interaction when we organise our own activities,” he says.

The 4D project in particular was mentioned several times as an example of successful collaboration.

When the two opening speakers summed up the discussions at the end of the evening, County Council Director Anne Rundquist presented her analysis of the 4D project:

“It represents a well-defined project with a strictly imposed framework for the work to be done. It is planned beforehand and has a beginning and an end. It’s quite simply a project – something that lies outside everyday operations. That’s probably been the most significant success factor,” she says.

Other important elements that were emphasised were leadership, having trust, humility and respect for different professional roles and – as regards education – better supervisory skills and time to supervise care.

Text: Stina Moritz