We are currently transitioning to the new health regions structure. This page provides the latest information about the changes happening throughout the year.
In this latest update, we share progress on:
Structure of health regions
HSE Centre
The HSE Centre will operate as the HSE's governing body, with a newly-defined relationship with the health regions. The purpose of the HSE Centre will be to resource and support health regions, fulfilling the functions of Planning, Enablement, Performance Management and Assurance (PEPA).
The Regional Executive Officers (REOs) will be accountable and responsible for the operational service delivery within their respective regions. They will report directly to the CEO.
The Health Region Programme Steering Group meets monthly to oversee and support the transition to, and implementation of, health regions. The group membership includes:
- REOs
- national directors
- patient and service user representatives
- representatives from partner and voluntary agencies
CEO memo about HSE Centre changes issued on 9 February 2024 (PDF, 170 KB, 7 pages)
Senior Leadership Team
The HSE Senior Leadership Team will include the 6 Regional Executive Officers (REOs) and national directors for the following areas:
- National services and schemes
- Access and integration
- Clinical
- People
- Finance
- Technology and transformation
- Communications and public affairs
- Major capital infrastructure
- Internal audit
Organogram showing new HSE Centre assignments (PDF, 724 KB, 3 pages)
Regional Executive Officers
REOs have been appointed in each health region. REOs will be accountable for health and social care services in their areas.
All 6 REOs are now in place and have assumed responsibility for their regions.
The REOs are becoming familiar with their respective Health Regions and are meeting with managers, teams and service users as part of this process.
The REOs are:
- Sara Long, REO, HSE Dublin and North East
- Kate Killeen White, REO, HSE Dublin and Midlands
- Martina Queally, REO, HSE Dublin and South East
- Sandra Broderick, REO, HSE Mid West
- Dr Andy Phillips, REO, HSE South West
- Tony Canavan, REO, HSE West and North West
Transition to the new health region structure
There is a transition period from 1 March to 30 September 2024 as the new HSE Centre structure is implemented and the organisation switches to the new health region structure. Current systems will remain in place as necessary during this period to ensure safe transition and to make sure services are maintained.
The target date for full completion of the following changes in structures and assignments is 30 September 2024:
- The first wave of transition will prioritise the fulfilment of senior roles across the health regions and HSE Centre. The current focus is on fulfilment of direct reports of the CEO, and direct reports of the REOs (which will extend to Q3 2024).
- The second wave of transition will focus on other roles within the structures. These will be filled on a function-by-function basis from Q2 2024.
The health regions team is working with HSE Centre teams to design how functions and roles will operate and transition to the new structures. This process is ongoing.
Integrated care
Health regions will support and further enable integrated care. This includes integration between:
- primary care and community services like GPs, pharmacy and voluntary organisations and across community service divisions
- acute hospitals and community services
- the HSE and wider public service organisations
While structural change alone will not deliver integrated care, it will clarify roles and responsibilities at all levels of the organisation and create the conditions for more integrated working.
Learn more about why we’re integrating health and social care services
Integrated Service Delivery (ISD) model
The health regions programme team are developing an ISD model to support integrated care in the health regions.
In May 2023, an ISD workstream made up of health and social care service representatives was set up. The group carried out a series of engagements, including interviews and workshops in 2023. This extensive stakeholder engagement led to the development of structural options for Integrated Healthcare Areas (IHAs).
IHAs will be the substructures within each health region. They will serve a population of around 300,000 and will take account of local geographies, population size, needs and services.
The ISD workstream used the Health Services Change Guide as part of the design process. This process was also informed by the International Foundation for Integrated Care’s 9 pillars of integrated care.
A detailed appraisal process of the IHA structural options was completed and an emerging IHA structure has been identified.
View the emerging high-level IHA structure
The Health Regions Programme team were invited to present work to date on the co-design process at the International Conference on Integrated Care in Belfast in April 2024. The team received the best poster award for their presentation on the design work undertaken in 2023.
The next steps are to:
- continue with the detailed design of the ISD model for health regions and IHAs, which will include structures, processes and ways of working
- continue to engage with a wide range of stakeholders throughout the co-design process
People
People transition planning
HR will lead on people transition activities. They will also provide guidance to health regions and the HSE Centre throughout the period of transition.
Many staff will have questions about when changes will happen, why they are happening and who will be affected.
National HR are developing a staff ‘Q and A’ document to address questions about the transition to health regions. This will be finalised and available shortly.
HR will continue to engage directly with staff and their representative organisations through each stage of the process.
Staff transition arrangements
For a large percentage of staff, there will be no significant change as we transition to health regions apart from perhaps a change in the person to whom they report. It is important to note the reform programme is not an attempt to downsize the HSE. There will be a meaningful role for everyone in the new structures.
Staff transition arrangements will include:
- making changes in line with the new CEO Centre design published by the CEO (PDF, 170 KB, 7 pages)
- enabling departments to support the REOs in setting up the health regions in the short term and the new Executive Management Team (EMT) structures over the coming months
- moving hospital group and CHO teams to the new health region EMT and IHA management structures
- ongoing engagement with staff representative groups via the National Joint Council
Staff transition principles
The move from the current structure to the new HSE Centre and health regions will be achieved through:
- redeployment
- confined competitions
- some promotional opportunities
We aim to transition with fairness and consistency. Key principles around the restructuring have been agreed with the Department of Health.
One of the key principles (agreed by Government) is that the revised structures are Whole Time Equivalent (WTE) neutral and grade neutral. This means that they must be achieved within the current level of HSE resources. There may be some exceptions where formal sanction is provided to fill posts at higher grades than are currently in place.
Next steps
Next steps as we continue this transition include:
- the first wave of transition, from Q1 2024, fulfilling direct reports of the CEO and REOs
- the second wave of transition, from Q2 2024, fulfilling other roles on a function-by-function basis
- keeping some current systems in place to make sure we transition safely and that services are always maintained
- aiming to complete these changes by 30 September 2024
Regional health profiles
For health regions to prioritise and plan services that meet the regional population's needs, it is essential to have good information on those needs.
Population profiles for each HSE region are now available. These profiles provide an overview of the key demographic features of the population. They will be essential for prioritising and planning health services and will inform resource allocation in the longer term via Population Based Resource Allocation (PBRA).
The regional population profiles provide summary information about each region, and for the Community Health Networks within each region. This includes:
- population trends
- deprivation levels
- self-reported health status
- smoking incidence
- disability rates
- education levels and broader determinants of health
Regional Departments of Public Health developed the profiles with:
- the HSE Population Based Planning Group
- the National Health Intelligence team
- the National Health Service Improvement team
- the Department of Health, Health Regions Planning Group and Statistical Analysis Unit
Access the 6 regional population profiles
These population profiles are the first chapter of more comprehensive population health profiles. These profiles will be co-designed with key stakeholders, including patient partners and community representatives over the coming months. They will include further information on the health status, mortality and morbidity of each regional population. They will also include information on the health assets and services in each region.
Communications
Discussing health regions in team meetings
We are encouraging managers and staff to:
- educate yourself about the health region reforms
- engage with your colleagues about what the health region reforms mean for you and your service
- use opportunities like team meetings to consider new health regions as you plan and deliver your services
To support these discussions, we have prepared a slide deck presentation. The presentation includes a general overview of the health regions and an update on implementation.
The slides are intended for delivery at team and department meetings by line managers, heads of service or heads of department.
Suggested speakers’ notes are included to support managers delivering the presentation.
Download the health regions slide presentation (PowerPoint, 8.89 MB, 29 pages)
Contact
If you have a question about any of the information on this page, or want more information about the health region implementation programme, email healthregions.team@hse.ie.