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PPP Directive sanctions suspended – is everything good now?

On October 19, 2023, the G-BA announced that the implementation deadlines for the PPP Directive would be postponed again. The sanction regulations will therefore not come into force on January 1, 2024 as planned. What does this mean for the clinics?

27. November 2023

PPP Directive sanctions suspended – is everything good now?

Isabel Bertsch

On October 19, 2023, the G-BA announced that the implementation deadlines for the PPP Directive would be postponed again. The sanction regulations will therefore not come into force on January 1, 2024 as planned.

What does this mean for the clinics?

The suspension of the PPP Directive sanctions has led to a collective sigh of relief in the clinics. Some promptly shift their focus and turn their attention to other topics. Others continue to give the issue top priority. Will the renewed suspension of sanctions mean that everything is suddenly fine or will the pressure to act remain? Where should scarce management resources be focused?

The fact is that psychiatric and psychosomatic care in its current structure will no longer exist in 10 years’ time. The skilled workers required for this will de facto not be available on the market. Although cross-sectoral and networked structures have been established in psychiatric and psychotherapeutic care in comparison to the somatic disciplines, there is still a need for action here too. Although many players promote the quality of care, they do not necessarily promote the efficient use of scarce human resources.

Demanding minimum staffing levels will not solve the problem of the shortage of skilled workers, on the contrary. The PPP Directive was introduced with the aim of ensuring the quality of care. The fact that a concept of quality that is based exclusively on structures and a minimum use of resources is not a target-oriented solution is also underlined by the 8th statement of the government commission on the “mental health subjects”. The result of the treatment must be used more as a criterion. More flexible care structures are needed that are geared to patients’ actual needs and enable creative solutions to the shortage problem. Against this background, it will be interesting to see how this need for transformation is taken into account in the further development of the PPP Directive.

Consequences for the clinics

For the clinics, the extension of the implementation deadlines initially means relief and the facilities can breathe a sigh of relief in view of the impending sanctions. But postponed does not mean canceled. The fact is that the directive is not being completely called into question, at least in the short and medium term, and the G-BA has announced a revision in its statement. In future, there will be some form of minimum staffing requirements for psychiatric and psychosomatic facilities. The specific form this takes could change again in the next two years. This means that there are still many uncertainties despite the relief on the sanctions side. How can clinics make good use of the next two years?

1. Development of a solid database

Many institutions are still struggling to establish a solid database and the necessary processes. In particular, the collection of the personnel data required for the PPP guidelines for verification purposes poses a particular challenge and is still associated with high manual data preparation costs in many hospitals. The aim must also be to move away from the implementation of minimum requirements and towards a well-founded but low-cost data pool for greater transparency regarding the company’s own healthcare provision.

2. Establishment of control instruments

A valid database is the prerequisite for functioning control instruments. Regardless of when and in what form minimum staffing requirements will be introduced, the shortage of specialist staff will force hospitals to proactively manage their human resources. This requires suitable controlling tools that can be adapted to the respective requirements as quickly as possible and also meet the company’s internal requirements. Management can only function under the difficult framework conditions if the necessary data is made available in good time as valid and meaningful indicators and planning parameters.

3. Drive digitization forward

Not very surprising, but always challenging in practical implementation. The documentation and control efforts required to comply with minimum staffing levels are enormous. A reduction in bureaucratic expenses can only be achieved with an increase in automation.

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Summary and outlook

Ultimately, the term PPP Directive highlights problems that affect all areas of hospitals. The challenges of the next 10 years can only be solved if internal organizational structures are questioned and adapted. This includes not only the revision of therapy concepts, but also the flexibilization of job profiles and the qualification and motivation of employees for the new approaches. Infrastructure must be adapted, investment requirements are very likely.

Last but not least, patients must also be picked up and taken along; health education and self-management will inevitably form a component of the care context. In addition, the establishment of digital offerings that actually promote efficiency.

Only if this is successful can a comprehensive pension entitlement be maintained. Many clinics show that this is a very realistic goal.

We support our clients in this process: both in terms of strategic issues and in the identification and implementation of concrete operational solutions. The same applies here: with a strong team, even complex projects can be managed well.

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Isabel Bertsch

Consultant

+49 89 8207516-0
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On October 19, 2023, the G-BA announced that the implementation deadlines for the PPP Directive would be postponed again. The sanction regulations will therefore not come into force on January 1, 2024 as planned. What does this mean for the clinics?