Frequently asked questions about the establishment of the Western Uusimaa wellbeing services county

The municipalities will continue to organise the services until the end of 2022, after which the wellbeing services county will assume responsibility for organising the services. We will secure the services, and there will surely not be any significant changes in the beginning. We are reforming the services by developing them together so that residents from around Western Uusimaa receive equal, high-quality and timely services.

Founding the wellbeing services counties does not directly impact the rescue services. Western Uusimaa Rescue Department has been operating since 2004. The fire service agreements of the contracted fire brigades will move to the wellbeing services counties as they are. The changes will not affect the operations of volunteer fire brigades, who will remain a key part of the rescue service system. The operations of the emergency response centres will not see any changes: the Emergency Response Centre Agency will continue as a government agency.

Local services will continue to include services that are used intensively and frequently. The local services will not see any substantial changes. For us, it is important to provide services equally throughout the county. Some of the specialised services can also be brought closer to the basic level through remote communications, for example, and the aim is to use mobile services more extensively than now.

Within the wellbeing services county, the services will not be tied to the borders of municipalities. However, we will not yet have such a flexible situation at the start, due to practical reasons. We will look into this matter.

Even now, you are entitled to choose to receive healthcare services in another municipality. The choice remains valid for a year, at the minimum. At the start of 2023, we will still be using various customer and patient data systems. Because of this, the health stations, for example, will initially be unable to offer a complete freedom of choice. In the future, a shared patient data system may allow for new opportunities. Regardless, urgent care will be provided by all health stations.

The joint emergency services will remain as they are, at the hospital campuses of Jorvi and Lohja.

To our current knowledge, the HUS Imaging Centre and HUSLAB will continue to operate as usual.

The aim is to ensure equal services for everyone. However, there will be no major changes to the regional availability of services at the turn of the year.

At the turn of the year, services will continue as before. Over the long term, the Wellbeing Services County will strive to increase remote services and mobile services, which may improve access to care for people living outside urban centres.

The psychologists’ and school welfare officers’ services will continue to be offered at educational institutions. Digital services will also be developed to facilitate access to the services.

Within the organisation of the wellbeing services county, we will have an extensive organisation for seniors’ customer and service guidance which will direct seniors to receive the service or help they need. Outreach senior work is also included in this entity. In customer and service guidance, it will remain of the utmost importance that the service staff know the local service selection.

Strengthening preventive services and early support services will be a key goal in the preparation of the wellbeing services county. We will also develop cooperation with organisations and other third-sector operators.

In Finland, the diagnostics and treatment of rare illnesses are centralised within specialised healthcare (HUS). The health and social services reform will not affect this distribution of responsibilities. The services for persons with rare illnesses will remain as they are.

The wellbeing services county will have better opportunities for maintaining specialised competencies than the municipalities alone. In the long term, it may be possible that some specialised healthcare services can be received more extensively via basic healthcare.

With all changes, the aim is to secure the continuation of people’s services. It is likely that the customers will attend work activities similarly to the current model, even if the responsibilities related to organising the work activities may change. At the moment, work activities for people with intellectual disabilities are implemented by municipalities, joint municipal authorities, such as Eteva, and private service providers, such as Rinnekoti. It is not yet known if the work activities will be a part of the services for people with disabilities or if it will move to employment services, according to law. The new legislation on services for people with disabilities is planned to be circulated for commenting in early 2022.

The municipalities will continue to organise the assistive device services for the duration of 2022. At the moment, some municipalities in Western Uusimaa produce the assistive device services themselves, while others have outsourced the services to HUS. It seems efficient that the wellbeing services county would organise these services consistently in the future, either as its own operations or via HUS. We are looking into the matter.

The service vouchers will remain an option for the acquisition of the wellbeing services county’s services. The county council and county board will decide on the use of the service vouchers at a later date.

The multi-provider model refers to private operators participating in the production of services. In Western Uusimaa, an intensive multi-provider model will continue. No rapid changes will be made to the service production structure.

Question: If a client does not receive treatment within the maximum waiting time guarantee, how will the Wellbeing Services County compensate the client for this? Will the client receive a free ticket to private medical services, monetary compensation, etc. from the Wellbeing Services County for the neglect of their care?

Answer: The aim is that the maximum waiting time guarantee will not be exceeded. The realisation of access to care is monitored by supervisory authorities. In some services, it is possible to issue service vouchers if the services are congested.

In the early stages, we will have several patient data sy0stems, but we will ensure that information is transmitted sufficiently between the systems. The aim is to have a shared patient data system in the future.

In principle, each wellbeing services county will be in charge of its own systems. Some systems may be acquired jointly with other wellbeing services counties.

In the preparation stage, the basic IT solutions and essential IT systems that are currently missing from administration, for example, will be built first. The customer and patient data systems currently used by municipalities will only be changed for the necessary parts. Even the scope of the preparation stage is significant, with a budget of about EUR 61 million.

Once the operations of the wellbeing services county get underway, we will start follow-up development with the aim of making the customer and patient data systems more uniform and to enable digital services. The follow-up development stage will take several years.

The Wellbeing Services County has been preparing for the deployment of Sarastia’s services since the start of the year. The Wellbeing Services County is procuring payroll services as an outsourced service from Sarastia instead of procuring only the software, as Helsinki has done. Furthermore, by the turn of the year approximately 65% of personnel will already be in Sarastia’s system, as the system is already in use in Espoo and Kauniainen. The Wellbeing Services County and Sarastia have also prepared for the deployment at the turn of the year with additional resources.

Current client and patient information systems and other clinical systems as well as the management, alert and client systems used by rescue services will be transferred over to the Wellbeing Services County. A large number of changes will need to be implemented, but the systems themselves will not change at the turn of the year. New information systems will be adopted in administration and basic IT because municipalities need these solutions themselves and they will not be transferred to the Wellbeing Services County. The biggest challenge is financial and personnel administration, which is closely linked to other systems. There is a great deal of work to do, but we believe that we will be able to carry out the most essential transfers. However, there will be plenty of work left to do in 2023 as well.

The Finnish Government collects taxes as a part of the income and capital taxation.

In the long run, reducing, unifying and optimising the data systems will make the operations more efficient, even if this requires investments in the short term. Furthermore, a uniform structure allows for more extensive digital services to complement conventional services.

At this point, we do not yet know what potential organisation grants will be awarded by the wellbeing services county, and what kind of a role the municipalities will have. This will be looked into when the distribution of tasks among the wellbeing services county and the municipalities is decided on. It is essential that the conditions for organisations’ operations can be ensured in the future.

At this stage, we do not yet know the future level of compensation for informal carers. However, it is clear that the level should be the same throughout the county. The county council and board will decide on the level in due course.

The Western Uusimaa Wellbeing Services County is constantly engaging in advocacy to ensure funding that takes into account the special characteristics of our wellbeing services county. Some of the funding deficit is common to all the wellbeing services counties, and part of it is caused by the fact that the differences between regions are currently not taken into account to a sufficient degree in state funding. We are doing our utmost, both independently and in collaboration with other wellbeing services counties, to influence how funding is allocated. As part of a safe transition, it is the task of the Wellbeing Services County to make sure that basic services remain operational.

The county council will be responsible for the services of the county as a whole, and they must represent the entire county, not a single municipality. The aim is to create equal services to all residents of the wellbeing services county.

The county council held its first meeting at Dipoli in Espoo 7 Mar 2022. The county council can decide where they will hold future meetings.

The wellbeing services county will have its own inclusion plan. In 2021, we already heard the opinions of experts by experience and carried out residents’ surveys. Residents, customers and experts by experience will continue to be a vital part of service development, as will organisations and the disability and senior councils. Residents also have access to the community on Western Uusimaa Wellbeing Services County where they can participate in the development work.

A ten-person group of customer representatives has recently been appointed to develop the transport services. Persons who have previously acted as customer-developers of the Transport Services were invited to this group. The group will have its first meeting in January 2022. The disability and senior councils will also be involved in this work.

During the preparation stage, we will hold extensive regional discussion on best operating models. They can gradually be expanded to the wellbeing services counties as a whole. In the beginning, safe adoption must be ensured.

You can subscribe to our newsletter and follow our social media channels on Twitter(external link), Facebook(external link) and LinkedIn(external link). You can also subscribe to receive our press releases directly to your inbox(external link). We are also organising residents’ events, the next one will be held in 22 Sep 2022.

A resident of a wellbeing services county has the option to choose any of the health centres in their county as their own health centre. This means that all non-urgent services will be provided at this same centre. In case of an emergency, you can still go to your closest health centre.

Question: Many of the things treated at a health centre are fairly simple, even routine matters. These clients have no need for a specialist, and sometimes even a doctor’s appointment is unnecessary. Would it be possible to hold, for example, a public health nurse’s reception a few times a week near the residents, where the clients could be referred to a doctor, if necessary?

The current health centre network will largely remain the same. Additionally, we aim to provide more mobile services in the wellbeing services county. Many issues can be reviewed at a nurse’s appointment, and by consulting with a doctor when necessary. We will consider this proposal when designing the wellbeing services county’s health services.

The wellbeing services county will be in charge of health services starting from 2023, and many measures are planned to improve access to treatment. There have been some good experiences in the region regarding e.g. the team health centre model, which has improved access to treatment. Good operational practices can be spread around more efficiently within a wellbeing services county than across municipal borders.

The current health centre network will largely remain the same when the wellbeing service counties are established. It is important that adequate local services are available all across the wellbeing service county, in relation to the service needs.

The objective is that patients can be treated at health centres as long as possible. In certain cases, special medical competence can be brought to basic healthcare by consulting a medical specialist either in an appointment or remotely. The information needed at the appointment should first be collected with an online form whenever possible for the patient. Developing remote services can help reduce the need for reception visits.

Question: If I’m using the Terveysasema health centre service voucher in Espoon keskus, meaning that I have chosen a private service provider in the station area as my health centre, will the use of the service voucher continue also after the turn of the year, when the new wellbeing services county will be established? If this will change, what will the schedule be?

The proportion of private services will remain the same at least in the beginning, and this also applies to the Espoon keskus area. The plan is that the privately produced services in Espoon keskus will be re-tendered by the beginning of 2023. The service users will be notified of a potential change well in advance.

The Helsinki University Hospital will continue to provide the special medical services as well as emergency services outside business hours in West Uusimaa. The cooperation with HUS will become closer to ensure smoother treatment paths in the future.

Various estimates have been presented about the size of the healthcare staff shortage, and its exact size is impossible to determine. The Wellbeing Services County will strive to improve the productivity and effectiveness of work in numerous ways.

The aim is that employees’ job descriptions will not change at the turn of the year.

Question: The Wellbeing Services County’s palliative care is in urgent need of improvement: there is no care coordinator, no service path for patients in need of palliative care and no dedicated ward. When will this matter be made a priority to improve the situation?

Answer: It has been recognised during the preparation of the Wellbeing Services County that palliative care services and their level vary significantly in different parts of the Wellbeing Services County. The assessment of the current situation is in progress, and at the same time work is underway on plans to improve the situation throughout the area. Not all of the changes will happen fast, but development is in progress.

The school year traditionally extends across two calendar years. To ensure the availability of services, municipalities will need to extend their purchase contracts to the end of the school year. Municipalities should also continue their ongoing recruitment efforts for the spring term as well. Responsibility for organising these services will be transferred to the Wellbeing Services County at the turn of the year.

Question: Will people with severe disabilities be assigned their own doctor(s) who can understand their often difficult-to-understand speech, for example? Will the mobile hospital get dedicated doctors so that doctors will no longer need to be consulted via a nurse? The mobile hospital is great, but sometimes it would be good to meet with a real-life doctor face-to-face.

Answer: This kind of arrangement could work. At the start, medical services will remain as they are. However, one of the benefits of the Wellbeing Services County is the harmonisation of services, which includes selecting the best possible ways to organise services.

The Western Uusimaa Wellbeing Services County’s strategy steers the operations of the Wellbeing Services County and describes the objectives of the Wellbeing Services County’s first council term 2023–2025. Service development and the planning of strategic choices are carried out with the input and engagement of various stakeholders – organisations are also important partners for us. As the wellbeing services county is quite large, input and engagement are facilitated in various ways. According to the strategy survey, the most preferred forms of participation and engagement were answering surveys, democratic voting in elections and providing feedback about services. Other forms of engagement that were highlighted by respondents included participation in information and other events for residents, resident panels and engagement through participation in the activities of organisations.

The residents of the Wellbeing Services County’s 10 municipalities have influenced the decision-making related to their home municipalities’ healthcare, social welfare and rescue services matters in the past as well by participating in residents’ evenings, voting in elections, answering surveys, participating in engagement workshops and events held by organisations, engaging in dialogue with decision-makers, the members of influencing bodies and office-holders and by participating in the development of their own treatment and care, for example.

The elected members of the Wellbeing Services County’s county council and influencing bodies, meaning the youth council, the disability council and the senior council, are all locals chosen by the area’s residents. We want to facilitate smooth dialogue and engagement with the wellbeing services county’s residents in the future as well. At present, we are focusing on a safe transition, and in the future we will continue to develop the different forms of engagement and come up with new participation methods as well.

During the administrative building phase of the Wellbeing Services County, which will last until the end of this year, municipalities are responsible for providing services to residents. We monitor the access rates of recordings. In practice, recordings have not had any viewers after one week. Information remains current only for a short time. Recordings will also be subtitled starting from the information event for residents to be held in November.

Question: When will you be organising an open, physical event for residents so that equal, democratic justice is realised? Not everyone has the skills to participate in digital events, please take digitally disabled people into consideration as well. Do not hide in the digital world. Do not hesitate to meet with us “regular people,” we have the answers to your questions, the thousands of solutions to the decisions that you make.

Answer: Our aim with the safe transition is to make sure that services will continue as before at the turn of the year. We will be announcing changes, such as changes in phone numbers, via public bulletins, websites, different media and residents’ events, among other channels. Our Wellbeing Services County has nearly half a million residents. In accordance with guidelines issued during the COVID-19 pandemic, we have organised Teams Live events for residents about the building of the Wellbeing Services County, which have allowed residents to participate and submit questions regardless of whether they live in Hanko, Vihti or Kirkkonummi, for example. We also hold meetings and information events with different operators, such as organisations and influencing bodies. In addition to these, the county council’s groups hold contact events in different municipalities in the area, which residents can participate in.

Private service providers will remain important cooperation partners even after the implementation of the Wellbeing Services County, supplementing the service provided in our wellbeing services county.

Just like private service providers, organisations are important cooperation partners, supplementing our range of services. As regards rescue services, for example, the situation will not change: the area’s 40 contract fire brigades will continue to operate as normal as part of the Wellbeing Services County’s rescue services system, as will regional rescue associations (Uudenmaan pelastusliitto, Finlands Svenska Brand och Räddningsförbund) as providers of training services, among others.