Lombardy health reform approved, slogan is to strengthen territory


Therefore, it is understandable that the reform intervenes first to correct this shortcoming: it does so by envisaging the construction of 64 community hospitals and 216 community homes by 2024, of which 40% by 2022, with the associated staff costs. resources from the NRP (National Resilience and Recovery Plan, from European funds) for EUR 576 million. Multidisciplinary teams will operate in the community homes: they will be the reference point for the chronically ill and will be the single point of access to health services. Community hospitals, on the other hand, will face short-term hospitalization and “medium / low-intensity” interventions, mainly with nursing management. The management of community houses can be entrusted to general practitioners, even to a cooperative.

The cornerstone of the reform is the approach a health “Objective to ensure global protection and health promotion, taking into account the close link between human health, animal health and the environment”, with great attention to prevention and physical activity such as “Basic elements of a good lifestyle”. Along with the strengthening of territorial medicine, the Lombardy reform seeks to promote technological innovation and strengthen digital medicine.

The plan is to reorganize the hospital supply network within two years, with the possible establishment of new hospitals in the metropolitan city of Milan, and then move on to the rest of Lombardy. The different roles of Ats and Asst will be further defined: Ats will deal with the planning, purchasing and control functions, while Asst will provide services and be divided between the hospital pole (the “classic” hospital) and the ground pole. (with neighborhoods, community homes, community hospitals, mental health, addiction and prevention). The districts will be one for every 100,000 inhabitants (at least), except in mountainous areas. They should plan for the integration of all health professionals according to local needs. The area will have a clearly recognizable natural location.

The reform envisages greater integration between general practitioners and specialists (outpatients or hospitals). The activity of general practitioners will be “preferably” in hospitals and community homes. Two committees were set up: the policy committee for primary care (consisting of health directors, doctors and nurses) and the representative committee for health professions (with representatives of the Region, the orders and the schools). The doctors who decide to join will comprise the territorial socio-health clinics, which will have as their primary task the care of the chronically ill. In this case they will have funds to purchase diagnostic equipment. The local authorities that will allocate spaces for these clinics will in turn have regional funds.

A historic building block of Lombardy health has been confirmed, which is the equivalence and integration of public and private accredited healthcare delivery. His Department Welfare of the Lombardy Region, headed today Letitia Morati (in the picture), acquires greater directing functions to Ats and service providers, both public and accredited private. The main functions of the department include the regional socio-health plan, the development of technology in health, the epidemiological observatory, the accreditation of structures, the strategic planning. From the point of view of scientific research, the center for prevention and control of infectious diseases is established, which will also be able to deal with the development of new vaccines: it will be a body of public law with organizational autonomy. The Region will be able to draw up its own five-year pandemic plan.


The neighborhoods are expected to be established within ninety days. Within six months, community homes and hospitals will be set up and the Infectious Diseases Center will be set up. Investments from the NRP will be divided into 300 million for community housing, 150 million for community hospitals and 17.8 million for local centers. The infectious disease center will cost 85 million in regional funds. Five million will be allocated for the establishment of the telemedicine fund.

Auxiliaries will be assigned liaison functions to the conference of mayors of the territory to which they belong. Permanent boards are also created such as the forum for discussion with patient associations, the forum of the third sector and others. General Managers and Medical Directors will always be appointed politically, but with some changes in appointment procedures.

These, in short, are the contents of the reform. And the pharmacies? According to the development course of the “pharmacy services”, they will not be assigned only to pharmaceutical aid and drug distribution, but health devices of a capillary network in the service of citizens with new tasks and services. Paragraph 2 of Article 5 of the reform reads for example that “Pharmacies contribute to the care of chronic patients by ensuring synergy with distributors and patients by guaranteeing pharmacological compliance and the provision of services provided by the pharmacy service.” And later art. 7 finds that it is establishing community homes; “In collaboration with affiliated pharmacies”, provide outpatient and in-home health and social services of medium and low intensity, promote health care, prevention and health care initiatives, guarantee the connection of hospital and territory through the presence of technological infrastructure and multidisciplinary integration. A role is also provided (art. 10) in distance medicine, ie telemedicine, teleconsultation, tele-monitoring and tele-rehabilitation), of which the Region “favors the use by primary care physicians, family nurses and health professionals, in relation to their skills and in synergy with pharmacies, also in order to enhance and improve the care of patients suffering from chronic pathologies“.

The responsibilities recognized in pharmacies during the pandemic emergency regarding vaccination in pharmacies have been identified and strengthened. In fact, the reform of the Lombards adds to the tasks of fView source imagearmakies “Adherence to population vaccination campaigns in accordance with national legislation and in relation to mmg, Ats and Asst“, as “The provision of health activities with the participation of health professions, in accordance with the provisions of national law“.

Measures that satisfy pharmacists, as he was able to state a few days ago Annarosa Racca, President of Federfarma Lombardia (in the picture): “We are satisfied with the interventions made in the reform text, because they accept the proposals that we have presented to the Commission in recent months and which push for even deeper integration of the pharmacy in the primary care system. “With these interventions, the houses of the community are organized in order to develop a full and fruitful cooperation in the interest of the Lombards”.

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