We're currently transitioning to the new health regions structure. Interim arrangements are in place. We aim to implement the agreed new structure on 3 March 2025.
This page provides the latest information about the changes happening throughout the year.
In this latest update, we share progress on:
Health regions
Regional Executive Officers
Regional Executive Officers (REOs) are accountable and responsible for the operational service delivery in their respective regions. They report directly to the CEO.
All 6 REOs are in place and have assumed responsibility for their regions.
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
Learn more about the REOs for the 6 health regions
Regional Executive Management Team (EMT)
The regional directors of the EMT in each health region report to the REOs.
The majority of the posts are now filled in the 6 regions.
Access the current regional EMT leadership structure
Integrated healthcare area managers started in their posts on Tuesday 1 October. This will not result in an increase in senior management staff numbers in the HSE. They are being funded and organised by restructuring existing senior management positions.
The other senior leadership roles in health regions are being filled.
View the advanced design of the HSE EMT model (PDF, 167KB, 1 page)
Healthcare areas
Healthcare areas are the substructures within each of the 6 health regions. There are 20 healthcare areas in total. They serve a population of around 300,000 and will take account of local geographies, population size, needs and services.
Healthcare areas bring together both acute and community services as well as other non-HSE providers. This will be crucial to supporting and enabling integrated healthcare.
Details and maps of the healthcare areas will be shared in the coming weeks.
View the high-level Integrated Healthcare Area structure (PDF, 112KB, 1 page)
Integrated healthcare
The new health region structures will support and strengthen integrated healthcare. This includes integration between:
- primary care and community services, including GPs, pharmacies and voluntary organisations
- acute hospitals and community services
- the HSE and wider public service organisations, such as local authorities
While structural change alone will not deliver integrated healthcare, it will clarify roles and responsibilities at all levels of the organisation. It will 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 is progressing the detailed design of the ISD model. This includes structures, processes and ways of working. It builds on the design work already undertaken and involves engagement with a wide range of stakeholders. The high-level structure has been agreed by the health regions steering group.
We aim to implement the agreed new structure on 3 March 2025. We will publish further details in January 2025.
Networks of care
To support the ISD model, a blueprint for networks of care is being developed.
Networks of care will support:
- integrated and patient-focused care within the region
- quality and safe patient care through continuous improvement
- consistency and collaboration
HSE Centre
Mapping and reorganising the HSE Centre
As we move to a new structure with health regions, changes have been made to the HSE Centre to support the health regions. The mapping of the HSE Centre to the new structures will be completed by the end of December.
Read more about staff transition arrangements
HSE Centre and Senior Leadership Team
The purpose of the HSE Centre is to support health regions to deliver health and social care services for patients and service users. The centre will fulfil the functions of Planning, Enablement, Performance and Assurance (PEPA).
The HSE Senior Leadership Team includes 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
- Strategic infrastructure and capital delivery
- Internal audit
- Planning and performance
View the HSE Senior Leadership team
New HSE Centre structure with appointed national directors (PDF, 112 KB, 1 page)
CEO memo about HSE Centre changes issued on 9 February 2024 (PDF, 170 KB, 7 pages)
Transition to the interim health regions structures
Health regions will be fully established by 3 March 2025. Until then, an interim structure will replace the existing Hospital Group and Community Healthcare Organisation (CHO) structures.
This interim structure is in place in 5 of the 6 health regions from Tuesday 1 October 2024 until Monday 3 March 2025. In HSE South West, all existing arrangements will stay the same until Monday 3 March 2025.
During this time, our main priorities will be:
- maintaining existing levels of service for our patient population
- maintaining quality and patient safety
- making sure only necessary changes are made
- communicating these changes in a timely way
- concluding the future state design
For most staff, there’ll be no change to roles and responsibilities. For some staff, there will be a change to the person they report to.
Each REO is updating staff about the details of the interim structures that are in place in their health regions.
Watch an update on health regions from CEO Bernard Gloster on YouTube
People
People transition planning
HR is leading on people transition activities. It is also providing 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 has developed a staff ‘Q and A’ document to address questions about the transition to health regions.
HR will continue to engage directly with staff and their representative organisations through each stage of the process. Draft re-assignment principles are in consultation phase with staff representative bodies via the national joint council.
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
Safe transitioning will require a phased approach over the coming months to maintain services, both at HSE Centre and across health regions.
Any changes to current roles and responsibilities will be communicated through line managers. Staff should continue with their usual tasks and responsibilities in the meantime. This is important in maintaining service delivery.
Staff transition arrangements will include:
- making changes in line with the CEO Centre design published by the CEO (PDF, 170 KB, 7 pages)
- supporting the REOs in setting up the health regions in the short term and the new Executive Management Team (EMT) structures over the coming months
- ongoing engagement with staff representative groups via the National Joint Council and other staff representative engagements
Maximum staff numbers approved
The maximum number of Whole Time Equivalent (WTE) staff in the HSE is now 129,753. This figure was approved as part of the 2024 Pay and Numbers Strategy.
Each of the 6 health regions and each national service has been provided with its own specified number of WTEs. They can replace, recruit and prioritise staff within this number. This makes it easier to respond effectively to the needs of the population.
Staff transition principles
The move from the current structure to the new HSE Centre and health regions is being achieved through:
- confined competitions
- some promotional opportunities
- redeployment
One of the key principles (agreed by government) is that the revised structures and transition approach must be achieved within current resources. This means WTE neutral and grade neutral.
Next steps
Next steps as we continue this transition include:
- filling direct reports of the CEO and REOs and completing the recruitment of health region EMTs
- filling other roles on a function-by-function basis
- keeping some current systems in place to make sure we transition safely and always maintain services to ensure minimal disruption to patients and service users
- planning to implement the new agreed structures from Monday 3 March 2025
Regional health profiles
Health regions will prioritise and plan services that meet the regional population's needs. This means it is essential to have good information on the populations they serve.
Population profiles for each HSE region are now available. These profiles provide an overview of the key demographic features of the population. In the future they will also inform how resources and budgets are allocated through Population Based Resource Allocation (PBRA).
Access the 6 regional population profiles
Population-Based Resource Allocation
The 6 health regions will use a population-based approach when planning and funding services.
The population-based resource allocation (PBRA) model has 3 strategic objectives:
- Fairly distribute available healthcare funding to regions according to their populations’ health needs and the cost of providing services to meet those needs.
- Address health inequalities by providing each region with the resources to meet the health needs of their populations equally.
- Facilitate the efficient and effective use of resources to support the delivery of person-centred integrated care.
The Department of Health has set up a PBRA Expert Group to develop and monitor the PBRA methodology. The needs-based approach takes account of:
- demographics like population size, age and sex
- level of deprivation
- distance to services
PBRA will apply to existing healthcare resources and will not influence the size of the overall Health budget. This remains the responsibility of the Minister for Health and the Minister for Children, Equality, Disability, Integration and Youth, along with their respective government departments.
Patient and service user partnership
A patient and service user partnership proposal was finalised in February 2024. A plain English version of this proposal was completed in July 2024.
Read the patient and service user partnership proposal - Plain English version
Read the patient and service user partnership proposal
This proposal has been informed by submissions from patients and service users. It has also been informed by patient and service user partnership workshops in 2023. The proposal mainly focusses on:
- patient and service user representation
- improving the patient and service user experience
- improving governance and accountability
The implementation of this proposal will keep the voices of patients and service users at the centre of health regions’ design.
Regional Patient and Service User Lead
Recruitment for 6 Regional Patient and Service User Lead roles is currently underway.
The purpose of these roles is to:
- implement the agreed approach to patient and service-user partnership within and across the health regions
- build a strong partnership between patients, service users and healthcare providers in designing and delivering care across their region
- focus on measuring, tracking and improving the patient and service user experience
- set up and manage groups where patients and providers can work together to improve care
- work closely with patients and service users to shape the goals and operations of the Regional Patient and Service User Partnership (PSUP) office
HSE Patient and Public Partnership Conference
The HSE Patient and Public Partnership Conference took place on 24 September 2024.
The conference included a presentation on the design of patient and service user structures within health regions. Ray Bonar, General Manager, Health Regions Programme and Joan Johnston, Patient and Service User Partner gave the presentation.
They described what:
- worked well
- was learned from the process
- changes could be considered if undertaking a similar process again
View the ‘Restructuring Health Regions’ presentation (PDF, 1MB, 20 pages)
Next steps include:
- implementing the agreed structures
- advertising and appointing 6 regional patient and service user partnership leads
- setting up patient and service user partnership offices and councils at a regional level
Communications
Discussing health regions in team meetings
It is important that all staff are aware of the changes that are underway and the reasons for these changes. We are asking managers and staff to:
- educate yourself about the health region and HSE Centre 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)
Health regions webinar series
The health regions programme team is running a series of webinars in 2024. These webinars will provide an update on the implementation of health regions and focus on key objectives of the programme.
The latest webinar, Supporting Teams for Integrated Working, took place on Thursday 12 December.
The speakers at the webinar:
- provided an update on health regions implementation
- focused on leadership competencies that support delivery of integrated care
- shared relevant resources and first-hand experiences of using these resources
Watch back the health regions webinar from Thursday 12 December on YouTube
The second webinar in the series took place on Thursday 26 September. The purpose of this webinar was to:
- provide an update on health regions implementation
- focus on managing change in the HSE as we move towards more integrated care
- share relevant resources and first-hand experiences of implementing change
Watch back the health regions webinar from Thursday 26 September on YouTube
The first webinar in the series took place on Thursday 27 June. It included a focus on population-based planning. The webinar also covered:
- implementation of the health regions
- regional health profiles
- Health Atlas
Watch back the health regions webinar from Thursday 27 June on YouTube
View presentation slides from the health regions webinar on Thursday 27 June (PDF, 6.62MB, 53 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 organisationalchange@hse.ie.