Published: 23 October 2020
As you will recall I commissioned a review of the HSE Corporate Centre earlier this year in order to put in place more effective structures at the centre to support our services across the country.
I wanted to ensure that our resources were invested wisely and, as far as possible, in frontline health services. We also wanted to be ready for the changes planned under Sláintecare.
In the short time since then, our world has changed, and we are all working in ways we could never have predicted. That said, it is timely that we make the necessary changes to our corporate structure over the coming months so that our operational response to COVID-19 continues to be agile.
Our response this far to the pandemic has demonstrated a more effective way in which the centre of the HSE can work with our services. I am convinced that we all have a valuable contribution to make, whether we work in the public or voluntary healthcare sector, or indeed within private healthcare system.
We have seen:
- Improved decision making and speed of response between the HSE Corporate Centre and services;
- Focused problem solving, with collaboration and innovation across the HSE Corporate Centre;
- Much more open and transparent engagement with stakeholders, which has helped to build trust and confidence;
- The importance of data as a powerful and indispensable tool in the efficient management of the health system;
- The role of telehealth in enabling change, quickly and effectively;
- Public Health playing a more prominent role in healthcare.
Our experience in dealing with Covid-19 has given us huge insight into better ways of working together and has convinced me more than ever that we need to streamline our management processes to allow more decisions to be made by the right people at hospital and community level.
Over the past number of months I along with EMT colleagues, have worked, with the support of EY, to develop revised structures for the centre of the HSE.
Recently I provided an update to the HSE Board, and they have strongly endorsed proposed changes to our structure, and our plan to move to Phase 2 of the programme.
In Phase 2, I want to be clear that we will be:
- Pragmatic and focused on targeted performance improvements in the way we work together - not on fixing everything;
- Taking a simple approach to completing the new design, communications and engagement, business readiness and implementation;
- Focusing efforts, and doing more detailed design, on the functions requiring the greatest level of change;
- Taking a collaborative approach, and involving staff where appropriate and necessary, acknowledging the demands of the Winter period and ongoing Covid response;
- Communicating with staff along the way and particularly with those who may face a higher degree of change.
Given what we have learned through the pandemic the new Corporate Centre structure will involve the creation of two new functions at EMT level, from existing functions at the centre:
- eHealth and Disruptive Technology function to drive our data and analytics capability and ensure system integration;
- A Population Health and Prevention function which will include Test and Trace capability, a key component of public health management.
There will also be a realignment of some corporate activities at the Centre, including:
- Within Operations, we will move away from a management structure that has a tendency to reinforce the hospital/community divide. I am convinced that the changes we are making now will help bring about the integration which we intuitively know is essential to better health outcomes for our population. This is also what Sláintecare envisages.
- Service planning activities, an inherently operational function, is moving under Operations to be closer to services, and to provide clarity for all stakeholders.
- Realignment of teams within HBS to their core functions in the Centre. This will include moving Recruitment into the People function and Finance Services, Payroll and Procurement will move into the Finance function.
- To allow for automation and greater efficiency, all national schemes and reimbursement services will be combined under one function.
- Change management and process improvement activities moving under a Change and Innovation function in Healthcare Strategy.
The next phase of the programme will focus on building detail into the design of the functions. This will help us to address open questions coming out of Phase 1 and ensure that all activities have a home.
Phase 2 will run from now through to December and into the New Year.
Over the coming weeks and months, the Programme Team will be in contact with your function area to get much-needed input to the new design and implementation plans. This will be done through workshops and meetings.
Many areas won’t see any change in structure, or ways of working together, until next year – implementation will be towards the end of Q1 2021.
Since the onset of COVID-19, we’ve seen an increased requirement for us to strengthen and resource new functions, such as Procurement, Testing & Tracing & Public Health. As a result, we have significant recruitment plans approved in Budget 2021 by Government.
We will need more rather than fewer people in the medium term, therefore it isn’t intended to have a voluntary leaving scheme available at this time.
As this next phase of work progresses, you will hear more about the outputs of the programme and how the new structure will impact you and your role.
I want to assure all staff that there are plenty of opportunities for you to contribute your skills, abilities and strengths within the HSE. We will come back to you regularly to give you updates on how things are shaping up.
While a level of corporate reorganisation is in my view essential, I am in absolutely no doubt that the most powerful forces for positive, effective and valuable change are our staff, working individually or as part of a team.
My vision for the HSE is to enable this way of working by trying as hard as I can to remove as many unnecessary obstacles to the integration of care as I possibly can.