1. The organizational changes of the Swedish Health and Social care inspectorate Tove Gemzell - Head of unit- Health and Social Care Inspectorate, Sweden Helsinki EPSO - September 29, 2015

2. Public sector in Sweden –three levels State legislation, supervision, foreign policy, public order, higher education and research, labour market, social insurance and transfer payments County councils health care, but also regional development and support to cultural activities and public transport Municipalities social services, elderly care, care of people with physical or intellectual disabilities, schools, spatial planning and building, health and environmental protection, refuse collection and waste disposal, rescue services, water and sewerage, order and security

3. Brief facts about IVO IVO is a state ruled agency and comes under the Ministry of Health and Social Affairs Annual budget is about 650 million SEK IVO has a staff of about 700 Started June 1 in 2013 and is led by director Gunilla Hult Backlund

4. North Middel East and the Department for permits Central functions South West South East South The Swedish inspectorate! Sweden has an area: 450 000 km2, third largest country in Western Europe

5. Organization

6. What’s new? What changed? Diffrentiating regulation/norm setting and inspection – trend in Sweden Deregulation of the Swedish health care sector Looking at performance instead of structure Better feedback for learning

7. Our new declaration – a supervision policy The aim of supervision Supervision shall contribute towards ensuring that health and social care is both safe and of high quality, and works to best serve its recipients. The supervision's focus Supervision is carried out from a user- and patient perspective, and must focus on matters that are important for individuals or groups. Unless laws or ordinances state otherwise, supervision should be risk-based and only review matters that are essential to ensure a health and social care service which is safe and of high quality. Supervision must be effective.

8. Some inspection-tools to foster learning Platform for analysis of performance indicators Feedback at different levels for enhanced learning Warnings of risk-areas to consider – Prevention Improvement of the many, inspection of the few – feedback to all

10. Thank U! www.ivo.se

11. Inspection to foster improvement? Does not work! Says Don Berwick in his speech Because the main harvest of inspection is on learning – it is fear!

12. Questions How can we design our inspection-work in such a way that it supports continues improvement of the healthcare system? How can we contribute to leadership to be a driver for improvement and change, and how do we reduce negative effects from inspection.