The Highly Specialised Care & Research programme (Topspecialistische Zorg en Onderzoek, TZO programme) is a follow-up to the TopZorg programme. Within the TopZorg programme, the combination of highly specialised care and scientific research was subsidised at three non-academic hospitals for a period of four years. The added value of this grant for the community was evaluated. This evaluation included assessing what the grant was spent on; the effect on patients, public health, education and research; policy adopted to shape the combination of care and research. The evaluation was conducted by the Erasmus School of Health Policy & Management (ESHPM). The TZO programme has a lot in common with the TopZorg programme, but has been designed differently in terms of both content and structure.
The aim of the TZO programme is to continue and to improve the combination of top specialist care, applied clinical research, and education and training, within the existing frameworks of the healthcare system, and to secure sustainable funding to do this.
On completion of the TZO programme, the funding of the top specialist functions by the relevant care providers and health insurers must be sustainably secured within the current healthcare system. Together with the Dutch Healthcare Authority (Nederlandse Zorgautoriteit, NZa), the Care Institute Netherlands (Zorginstituut Nederland), health insurers and other parties involved, the selected hospitals will enter into an outcome and performance commitment to give further shape to this sustainable guarantee for the duration of the entire programme.
Top specialist functions will be determined through two selection rounds. Both selection rounds will be undertaken twice during the course of the programme. In addition to the selection rounds, an external evaluation will be conducted parallel to the programme. The structure of these selection rounds and the external evaluation are defined further in the following paragraphs.
Research in the TZO programme refers to non-fundamental clinical scientific research.
The research involves the combination of education and scientific research that is associated with highly specialised care for patients (often smaller groups of patients), with a demand for complex care that is not provided by every hospital. It could also involve the combination of highly specialised care and research aimed at improving the quality of care and life of patients in the short term, in which case it relates to research on relatively less complex patients with more prevalent conditions, that leads to medical, social and process innovations. This combination is aimed at creating added value for healthcare providers in the region and the sector.
The first selection round will be a round for admission to the TZO programme. An admission committee appointed by the Ministry of Health, Welfare and Sport will assess each application and specific top specialist function to determine whether specific admission criteria have been met and will advise the Minister for Medical Care accordingly. Based on this, the Minister will make a final decision on the institutions with a specific top specialist function that are eligible to be invited to present a detailed application in the subsequent grant round.
Because of the limited financial resources and the importance of achieving a high quality standard, a second ZonMw grant round will take place immediately after the admission round. The TZO programme committee is responsible for the structure of the TZO programme and will assess grant applications in terms of relevance, quality and coherence of the application as a whole. After successfully getting through the admission round, the applicants of the selected functions will receive an invitation to present a detailed grant application for the care function in question.