We are working to establish 6 health regions from February 2024.
Health Regions Executive Management Teams and Integrated Health Areas are being developed to go live by the end of 2024. Health regions will be supported by our Hospital Groups and Community Health Organisations during this time.
Progress has been made in important areas and will continue over the coming months.
Regional Executive Officers
Recruiting 6 regional executive officers (REOs) is an important step in the implementation of health regions.
- be responsible and accountable for regional health and social care services
- contribute to the design of health region team structures, along with roles and responsibilities
- report directly to the CEO
- form part of the core Senior Leadership Team
Applications for these posts are now closed and the recruitment process is underway.
This will be followed by the recruitment of health region senior leadership teams.
High-level responsibilities have been agreed for:
- roles within Health regions
- HSE Centre
- Department of Health
- Department of Children, Equality, Disability, Integration and Youth
CEO Bernard Gloster has begun a review of the HSE Centre. This review has been shared with HSE teams and is due to be finalised in November 2023.
The HSE Centre review outlines changes to the structure of the organisation. There will be 2 components of the HSE at a national level:
1. HSE Centre
The HSE Centre will be the overarching governing unit of the HSE, but with a redefined relationship with the health regions. Its only operational function will be through the CEO to the Regional Executive Officers and the National Director of National Services.
2. HSE National Services
National services include the Primary Care Reimbursement Service (PCRS) and the National Ambulance Service. There will be one National Director for National Services.
National Services will be viewed and represented as one operating unit. The National Director will be part of the revised HSE national senior leadership team (SLT).
Geographical realignment to Health Regions
Interim names for the health regions have been agreed. These have been communicated through staff and public channels.
The 6 health region interim names are:
- HSE Dublin and North East
- HSE Dublin and Midlands
- HSE Dublin and South East
- HSE Mid West
- HSE South West
- HSE West and North West
Planning for the geographical realignment from Community Health Organisations (CHOs) and Hospital Groups (HGs) to health regions is currently underway. The Health regions team are working with National Operations to carry out this realignment.
In order to avoid disruption to service delivery during this realignment, an impact assessment has been completed. The results of this assessment will inform how the realignment is carried out.
In addition, HR are looking at the potential impact of the new structure on staff. This work will continue over the coming weeks in partnership with staff representative bodies.
Progressing the Integrated Service Delivery Model
The Health Regions Programme Team are developing a model for Integrated Service Delivery (ISD) in the health regions.
In May 2023, an ISD workstream group was set up. This group is made up of representatives from across health and social care services, including:
- patients and service users
- healthcare staff and managers
The aim of this group is to recommend organisational arrangements to enable and support integrated care.
The Health Regions Programme Team has been engaging with a range of stakeholders as part of this work, including:
- Community Health Organisation Chief Officers
- patient and service user partners
- Voluntary Healthcare Forum
- Irish College of General Practitioners
- Department of Health
In addition, a workshop on proposed ISD structures was held with HSE clinicians and operational managers.
Engaging with stakeholders
Engagement with a wide range of stakeholders is still a key priority for the ongoing design and establishment of Health Regions.
Key stakeholder groups include:
- patient and service user representatives
- staff representatives
- voluntary organisation representatives
- service delivery and multi-disciplinary groups.
A series of workshops have taken place with patient partners in recent months. The outputs from these workshops have helped to formalise the inclusion of patient partners in health regions structures and processes.
Working with the Department of Health
The HSE Programme Management Team is being supported by the Department of Health (DoH) with all aspects of the health regions programme.
As part of this support, a proposal to set up Change and Innovation Hubs within each health region is being developed. This will help optimise resources, support programme development and regularise the existing Project Management Office (PMOs) posts in both acute and community services. This will be crucial in delivering the benefits of integrated care.
What happens next?
Building on the work completed so far, the next steps for the implementation of health regions include:
- carrying out a training needs analysis and a phased learning plan to support and upskill staff
- completing a Health Needs Assessment within each health region
- agreeing Health Region governance and partnership arrangements for non-HSE providers (Section 38 and Section 39 organisations)
- defining critical Digital, ICT and data requirements for health regions
- updating the performance accountability framework to reflect the new structures
- agreeing the revised process for developing the annual service plan and capital plan
- identifying the location of each health region headquarters
Integrated care allows patients and service users to access health services more easily, no matter where they live. It also makes it easier for our staff to respond to patients’ needs and make improvements to care. It is a system of care where patients’ needs come first.
Health regions are a crucial step in reducing barriers to integrated care, and improving health outcomes for everyone.