Published: 05 April 2022

HSE to establish six Regional Health Areas

Watch Paul Reid’s update on Regional Health Areas

Government decision to set up Regional Health Areas (RHAs)

This week, the Government decided to proceed with setting up 6 RHAs within the HSE, on the basis of the geographical boundaries agreed by the Government in July 2019. The Cabinet decided that the design of the RHAs will be completed in 2022, there will be a phased introduction of the new bodies in 2023 and they will be fully operational from 2024.

Each RHA will be able to plan, resource, and deliver health and social care services for the needs of its unique population. This will result in improved accountability and governance in terms of finance and performance. It will also empower frontline staff and bring decision-making closer to the frontline.

RHAs will enable and empower staff to provide services that are:

  • Integrated, locally planned and delivered
  • Easier to access and navigate
  • Available closer to home

At the moment, community health and social services are planned, funded, and delivered separately from hospital services. There are 9 Community Healthcare Organisations (CHOs) and 7 Hospital Groups, which provide services to various parts of the country. Hospital Groups and Community Health Organisations (CHOs) serve populations that are grouped in different ways, which makes it challenging for the health system to deliver integrated care.

The creation of 6 Regional Health Areas aims to address this. RHAs are geographically-based units with clearly defined populations. They align community and hospital services within specific areas. The HSE will retain a strong but leaner central organisation, with more service provision developed at a local level.

Regional Health Areas and Community Healthcare Networks

The 6 RHAs will cover the following areas:

  • Area A: North Dublin, Meath, Louth, Cavan, and Monaghan;
  • Area B: Longford, Westmeath, Offaly, Laois, Kildare, and parts of Dublin and Wicklow;
  • Area C: Tipperary South, Waterford, Kilkenny, Carlow, Wexford, Wicklow, part of South Dublin;
  • Area D: Kerry and Cork;
  • Area E: Limerick, Tipperary and Clare;
  • Area F: Donegal, Sligo, Leitrim, Roscommon, Mayo, and Galway.

The 6 RHAs are further broken down into 96 Community Healthcare Networks (CHNs). CHNs deliver primary and community services to an average population of 50,000 people each.

The CHN framework supports multi-disciplinary teams to bring decision-making closer to the point of care. CHNs also function to provide targeted and coordinated care based on the identified health and social care needs of local communities. 39 CHNs have already been established with leadership posts in place and at least 25% staff recruited, with the remainder of the total 96 due to be rolled out by the end of 2022.

The detailed design of the new model of service and associated RHA structures will take place during 2022, and there will be active engagement with the health and social care workforce around the country, all key stakeholders and the public in finalising the design.

RHAs and Sláintecare

This new structure originated in the report of the Oireachtas Committee on the Future of Healthcare (the Sláintecare Report). The report identified that a robust system of leadership, governance and accountability is critical for delivering integrated care.

As part of its recommendations, the report calls for the “geographic alignment of Hospital Groups and Community Health Organisations … to support population-based health planning and delivery” and for the establishment of regional bodies that will “be accountable at a regional level for implementing integrated care”. It also notes that “The HSE in future will become a more strategic “national centre” carrying out national level functions and regional bodies will be established to ensure timely access to integrated care, with regional health resource allocation.” The Government approved the Sláintecare Implementation Strategy and Action Plan 2021-2023 in May 2021, which committed to the implementation of Regional Health Areas.

The Department of Health and the HSE will now progress the development and implementation of a clear plan for the implementation of Regional Health Areas with input from the RHA Advisory Group. The Sláintecare Programme Board and HSE Board will play central roles in terms of oversight of the planning and implementation of RHAs and the stepping down of CHOs and Hospital Groups.

Next Steps

You will see these changes happening over the next 2 years in a planned and evidence-based way. We will provide regular updates on the progress of each stage of the design and implementation plan.

We also want to give you the opportunity to share your feedback so we can address any areas of concern as implementation progresses. We will be planning workshops, webinars, townhalls and sharing information across all our communications channels to keep you informed at every step of the process.