We're continuing to transition to the new health regions.
From Tuesday 4 November 2025, the health regions will move to the next stage of implementation. This will involve appointing staff to new roles and the rollout of the approved Integrated Healthcare Area structure in 5 out of 6 health regions. HSE Mid West is preparing for implementation, which will begin at a later date.
During this phase, our main priorities are:
- maintaining existing levels of service for our population
- minimum disruption to patients and service users
- maintaining quality and safety
- communicating these changes in a timely way
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.
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 in the EMT in each health region report to the REOs.
The majority of the EMT posts are now filled in the 6 regions.
Access the current regional EMT leadership details
View the advanced design of the HSE EMT model (PDF, 140KB, 1 page)
Integrated Healthcare Areas
Integrated Healthcare Areas are the substructures within each of the 6 health regions. There are 20 Integrated Healthcare Areas in total. They serve a population of between 150,000 and 450,000 and take account of local geographies, population size, needs and services.
Integrated Healthcare Areas bring together both hospital and community services as well as other non-HSE providers. This is crucial to supporting and enabling integrated health and social care.
Demographic details and maps of the Integrated Healthcare Areas are now available on both the Health Atlas Finder and the HSE Area Finder.
Community Healthcare Areas
A Community Healthcare Area (CHA) serves the population of a Community Healthcare Network (CHN). Each CHA covers the same area as a CHN but with a broader range of services. There are 96 CHAs in total.
The health and social care services in the CHA can include:
- CHN services
- Children’s Disability Network Teams
- Home Support services
- Child and Adolescent Mental Health Services
- Adult Mental Health Services.
CHAs bring more community services together in an integrated way. Each CHA will be led by a General Manager. They are responsible for making sure these services meet the needs of the local population.
Integrated care
The new health region structures support and strengthen integrated care. 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 care, it clarifies roles and responsibilities at all levels of the organisation. It creates the conditions for more integrated working.
Preparing for change
We’ve developed a booklet to help staff and their teams prepare for and lead change initiatives. ‘Creating the Conditions for Change and Integration’ is designed to support integrated working. It is part of our Change Guide programme of work, which focuses on building change capacity and capability across the system.
Read the ‘Creating the Conditions for Change and Integration’ booklet
Learn more about why we’re integrating health and social care services
Integrated Service Delivery (ISD) model
The ISD model sets out how health regions and the Integrated Healthcare Areas operate. It includes the structures, ways of working and processes designed to make our services easier for people to navigate. It is also designed to support:
- more integration
- stronger accountability
- greater transparency
REOs and their teams have worked with staff and stakeholders on how best to apply the ISD model in each Integrated Healthcare Area. The structure of the management team in a standard Integrated Healthcare Area has been agreed and will be applied consistently in each IHA.
View the ISD model (PDF, 759 KB, 1 page)
View the IHA structure (PDF, 174 KB, 1 page)
From Tuesday 4 November 2025, the Health Regions will move to the next stage of implementation. This will involve appointing staff to new roles and the rollout of the approved Integrated Healthcare Area structure in 5 out of 6 health regions. HSE Mid West is preparing for implementation, which will begin at a later date.
There will be ongoing engagement and communication in each region to keep you informed about upcoming changes to the structures in your area.
Changes will happen gradually, while maintaining services at both the HSE Centre and across the health regions, to ensure a safe transition. Comprehensive change impact and risk assessments are being carried out to make sure people understand the impact of these changes on services.
Staff and managers are working together to plan the transition to the IHA structure. REOs, IHA Managers and local implementation teams will be supported by local change and innovation hubs, the Organisational Change Unit and National HR during this phase.
Networks of care
What does Network of Care mean?
Networks of Care (NoC) are groups of multidisciplinary healthcare teams working together to improve how care is delivered. Their goal is to make sure that people get the right care, at the right time, no matter where they live. These teams ensure care is consistent, equitable and based on best available healthcare evidence.
What will a NoC do?
A NoC will help plan and deliver high-quality care across the six Health Regions. It will connect services across hospitals, community and social care, ensuring patients have a seamless healthcare journey. The NoCs will also help plan future services, ensuring they meet the needs of the population.
Who will be involved?
Each NoC will include professionals from different parts of the healthcare system, such as doctors, nurses and health and social care professionals and patients, service users and carer partners. The team will work together to ensure services are well-coordinated, high-quality and safe. Each NoC will also identify key people and groups they need to work with, such as hospital teams, community services and patient and service users.
What is different about a NoC?
In line with the establishment of the IHAs and Integrated Service Delivery, NoCs will bring together hospital, community, clinical and social care, ensuring patients experience a more joined-up approach. NoCs will also play a key role in shaping how healthcare services develop over time. Patients will benefit from coordinated end-to-end care and a seamless healthcare journey.
When will NoCs be in place?
NoCs are in place in some health regions. NoCs will evolve further once the Clinical Governance Framework has been updated in early 2026.
Clinical Governance Framework
The HSE 2012 Clinical Governance Framework is currently being reviewed. The current framework has provided practical and effective guidelines for clinical governance in Irish healthcare. However, with new care models, digital health technologies and integrated regional structures, a modern, inclusive and future-ready framework is required.
What will the updated Clinical Governance Framework do?
The Clinical Governance Framework will apply to all publicly-funded healthcare services, including acute and community services, within both statutory and voluntary sectors. It will guide best practice and can be adapted across organisations.
How will the framework be updated and who will be involved?
The project to co-design the framework is underway. It involves 4 connected phases:
- Discovery
- Design
- Implementation
- Review and Assess
The discovery phase is now complete. It involved desk-based research with national and international experts. The design phase is now underway and a working group has been established. A series of engagement sessions with subject matter experts are underway and information webinars about the project are planned.
When will the updated framework be available?
The aim is to publish the framework by the end of March 2026.
Operating models
We are currently designing new operating models for the HSE. This work identifies the functions, services, roles and activities that are changing in the HSE Centre or moving to health regions. It also sets out how the HSE Centre and the health regions will work together. The goal is to align future ways of working with the organisation’s restructured models.
Our HSE Centre divisions continue to work closely with health region teams to finalise these models. They are being shared with key stakeholders, including the Senior Leadership Team and the Department of Health.
A number of operating models are in the final phases of development. The remaining models are scheduled to be finalised in November 2025.
Voluntary partnership
Each health region is setting up a Regional Voluntary Forum. These forums will give voluntary organisations a voice in service delivery and planning.
A new central HSE function is also being proposed to coordinate partnerships across the regions. This will ensure consistent and strategic engagement with voluntary organisations.
Service arrangements
The health regions team have been working closely with health region forum leads, along with the Coalition of Voluntary Organisations and Representative Bodies, to progress the agreed health regions forum structure. This will be reviewed after 12 months. All health regions will aim to have their first forum meeting before the end of 2025.
HSE Centre
Mapping and reorganising the HSE Centre
As we move to the new structure, changes have been made to the HSE Centre to support the health regions.
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 health infrastructure and capital delivery
- Internal audit
- Planning and performance
- Public involvement, culture and risk management
View the HSE Senior Leadership team
New HSE Centre structure with appointed national directors (PDF, 288 KB, 2 page)
CEO memo about HSE Centre changes issued on 9 February 2024 (PDF, 170 KB, 7 pages)
Implementation of the health regions structures
For many staff, roles and responsibilities will not change. For some staff, there will be a change in the person they report to.
Each REO is updating staff about the details of the implementation phase in their health regions.
Watch an update on health regions from CEO Bernard Gloster on YouTube
People
People transition planning
HR at national and regional level 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. We agreed reassignment principles with staff representative bodies via the National Joint Council. These principles are included in appendix 1 of the HR FAQ document.
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.
Maximum staff numbers approved
The maximum number of Whole Time Equivalent (WTE) staff in the HSE is now 133,306. This figure was approved as part of the 2025 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 at local level.
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:
- completing filling direct reports of the REOs and completing the recruitment of health region EMTs
- ensuring we transition safely and always maintain services to ensure minimal disruption to patients and service users
- planning and implementing the new agreed structures from Monday 3 March 2025
Population-based planning
Health regions will prioritise and plan services that meet the regional population's needs. It is essential to have good information on their populations, along with structures and processes in place to make data-driven decisions.
The Population Based Planning programme provides tools, resources and information to help the regions make decisions to improve their population’s health.
A range of resources have been developed. They include:
- a strategic framework for population-based planning
- population profiles for each health region
- a ‘quick pick’ function in the Health Atlas Finder
- a framework for health needs assessment
Find the new public health resources
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 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 as part of the reform programme. A plain English version of this proposal is available.
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. 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 and implementation.
The recruitment of the National Patient and Service User Lead is progressing. The successful candidate is due to take up the position later in 2025.
Regional Workshops
The Patient and Service User Engagement National Office held a series of workshops in July 2025, attended by REOs, staff and patient partners and service users from various services.
The workshops were designed to make sure Regional Patient and Service User Participation Councils are set up in a consistent way.
The workshops also looked at themes and objectives for a Patient Partnership Strategy, in line with the National Service Plan 2025.
Better Together resources
Development of a Better Together resource on the right to partnership is ongoing, along with a learning resource to help give people the tools they need to be effective partners. Focus group sessions are underway to include as many voices as possible in its development.
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've updated our slide deck presentation. The presentation includes a general overview of the health regions and an update on implementation.
The slides are intended for sharing with staff and teams. They should be presented 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, March 2025 (PowerPoint, 15.3MB, 47 pages)
Health regions webinar series
The health regions programme team is running a series of webinars. These webinars provide an update on the implementation of health regions, the supports available for teams and the key objectives of the programme.
The next webinar will take place on Wednesday 19 November from 1pm to 2.15pm. It will focus on planning and delivering change in the context of integrated care. Participants will:
- gain practical insights into leading and creating change readiness across teams and services
- understand what matters most to patients and service users to inform meaningful change
- hear leadership perspectives on implementing new ways of working aligned with Sláintecare
- get an introduction to the HSE-adapted Model for Integration (SCIE), including updates from pilot demonstrations across national, regional and voluntary services
- learn about the range of resources and supports available to staff
The registration link for this webinar will be shared here when registrations are open.
Continuing professional development (CPD) for Nursing and Midwifery Board of Ireland (NMBI) is available for attendees of the live event. CPD for Royal College of Physicians of Ireland (RCPI) is pending.
Health regions webinar series 2024
The health regions programme team completed a series of webinars in 2024.
The third webinar in the series, Supporting Teams for Integrated Working, took place on Thursday 12 December 2024.
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 2024. 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 2024. 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)
HSE National Guideline: Visual Identity and Naming
This HSE guideline defines the rules for the visual identity and naming in the HSE. Our visual identity includes a logo, font, colours, imagery, and content styles that work together, delivering our communications in a clear and consistent way for everyone.
The Visual Identity and Naming rules must be followed so HSE staff can make more consistent design and language decisions. It also means we comply with our legal duties on the Irish language and accessibility.
Using HSE branding as outlined in the guidelines, we: `
- standardise how our communications look and feel
- create consistency across our different services
- build trust and confidence with our patients, the public, and stakeholders
- reduce the mental load on people who use our services and information
Access the HSE Visual Identity and Naming Guideline
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.