National Expert in emergency medical services reform implementation / Національний (-а) експерт (-ка) з впровадження реформи екстреної медичної допомоги

Deloitte is seeking qualified candidates for the open position of National Expert in emergency medical services reform implementation in support of the USAID Health Reform Support project. 

Period of Performance: October 1, 2023, to September 30, 2024
LOE: 40 days

Project Description

The purpose of the USAID Health Reform Support (HRS) project is to support a transparent, accountable, and effective healthcare system that is capable of meeting the health needs of the Ukrainian people. Advancing health sector reforms, enhancing transparency, and tackling corruption will reduce out-of-pocket payments and improve access and availability of high-quality, evidence-based healthcare services for Ukrainians. Elimination of corruption is a cross-cutting theme across all objectives to be achieved by this activity, which includes:

1. Improve health sector governance.
2. Support the transformation of the healthcare financing model.
3. Strengthen the health workforce.
4. Enhance transparency, accountability, and responsiveness of the health care system.
5. Improve service delivery system at all levels.

Russia’s ongoing invasion presents significant challenges to the Ukrainian health care system, and HRS has adjusted activities across all five objectives to respond to the current and future needs of the Government of Ukraine (GOU). 

Background/Objective

Ongoing healthcare reform in Ukraine entirely changed the financing approaches – i.e., movement from health subvention to the payments under Program of Medical Guarantees (PMG) contracts signed with the NHSU. Resource allocation in the healthcare network has been changed – from a calculated subvention based on the number of beds for specialized healthcare providers to a pay-per-performance model. With the start of full-scale war in February 2023, the health reform didn’t stop but transformed due to war-related demands and circumstances.

Reforming processes for emergency medicine on a hospital level underwent a few major steps:

• In 2020, the Cabinet of Ministers of Ukraine approved Resolution #612 that former admission rooms of over 200 intensive care hospitals will be transformed into emergency departments up to the newest standards.
• In 2020, MOH approved Order #2179 on emergency department (EDs) functions and roles and Order #1167 on the minimum material provision of EDs.
• In 2021, All-Ukrainian Resuscitation Council partnered with MOH and World Bank and launched a project, “Transforming Emergency Medical Care on Hospital Level” within MOH/WB Serving People, Improving Health Project. During the project, staff of the selected emergency departments were trained with some necessary clinical skills and skills for working at and managing emergency departments.
• In 2022, MOH approved Order #368 regulating medical triage on a hospital level in mass casualties.
• In 2023, NSHU, under PMG implementation, added a contracting requirement to keep an essential bucket of medicines for the hospitals to get contracted for readiness to provide care in emergencies.

In 2023, the next step of the hospital-level reform has been completed due to the Cabinet of Ministers Resolution #174 – each oblast had to select, and then MOH approved plans for the design of the capable health network – three levels of hospitals will form a network of ones where GOU guarantees medical care for the population of a certain level of quality and geographical availability of certain limit of proximity.

While emergency departments are formally considered an essential part of the hospital, where some documents like patients` routes and mass casualties plans must be in place, EDs are counted as supplementary clinical units which do not close cases, hence do not “make money” received per treated case from the NHSU.

Because of the heritage of the Semashko system with the Franco-German model of prehospital emergency medical services, where EDs did not function, and no financial incentives for providers to develop EDs, to date, they are mostly under-capable of delivering high-quality services needed for the population during the war.

National Expert in emergency medical services reform implementation will strengthen HRS’s expertise in the services provided in the emergency departments in Ukraine, focusing on clinical procedures and management routines regarding legislation, regulation, adoption or adaptation of international best practices, barriers, and enablers for EDs empowerment. The Expert will contribute to the final recommendation on approaches for assessing emergency department key functions and parameters.

Responsibilities

Duties and responsibilities will include, but will not be limited to the following:

• Review clinical routines at emergency departments and their interaction with other hospital units and external parties in Ukrainian context.
• Review inventory and medicines/consumables stock requirements for EDs in Ukrainian regulation.
• Review human resources duties and credential requirements for EDs in Ukrainian regulation.
• Contribute to synthesizing some recommendations for selecting approaches for assessing emergency department key functions and parameters.
• Contribute to developing a final technical report(-s) containing results and recommendations.
• Participate in the meetings with the National Health Service of Ukraine (NHSU), the Recovery Project Office of MOH (RPO), Ministry of Health (MOH), develop and deliver presentation materials during these meetings.
• Follow deadlines and communicate regularly with the HRS team on the project status and timeline.

Requirements

• Medical degree (BA in Nursing or higher) with formal specialization in emergency medicine.
• Training in Healthcare Management, Public Health, Healthcare Governance, Health Economics or other related field (preferable).
• Proven experience in in-hospital emergency medicine reform implementation in Ukraine (on clinical practice at healthcare facilities, managerial work at healthcare facilities, health policies, operational or development interventions and/or other levels) – at least 1 year.
• Expertise in Ukrainian healthcare reform policy making and policy implementation – at least 3 years of related experience.
• Overall expertise in Healthcare management, public health, health policies, health governance or a related field – at least 5 years.
• Strong understanding of Ukrainian health reform.
• Strong communication and negotiation skills.
• Ability to work in a team.
• Excellent planning and time management skills.
• Knowledge of English is required.

Deloitte welcomes and supports a diverse, inclusive work environment. As such, our commitment is to promote equal employment opportunities for all applicants. Deloitte makes employment decisions based on organizational needs, job requirements and individual qualifications without regard to age, disability, marital status, sexual orientation, gender identity or expression, etc.

Qualified candidates are expected to send their CVs, cover letters, and list of two professional references [email protected] no later than September 18, 2023. Please indicate the following in the subject field of the email: “National Expert in emergency medical services reform implementation“. Only shortlisted candidates will be invited for an interview.