Moving to a new structure with health regions

Our health service is being restructured into 6 health regions

Find out about each health region's geographical area

Health regions will provide the structures to:

• allow you to deliver more integrated care closer to patients’ homes
• allow you to plan and deliver services around the needs of local populations
• improve governance and accountability at all levels
• strengthen local decision-making
• provide consistent quality of care across the country

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 deliver more joined-up care. It is a system of care where patients’ needs come first.

Health regions are a crucial step in an ongoing process to reduce barriers to integrated care. By improving our structures and working more closely together, healthcare providers, public health professionals and community organisations can address the challenges our system faces and improve overall health outcomes for everyone.

The structure of health regions within the HSE

Each health region will plan, fund, manage, and deliver healthcare to suit the needs of the local population. The HSE Centre and the Department of Health will support each health region to do this with national guidance, services, policies and models of care.

Each health region will be divided into a number of Integrated Health Areas. Within each Integrated Health Area, Community Health Networks will deliver community services to populations of around 50,000 people.

Integrated Health Areas will deliver all of the acute, primary and community care that people in the area may need. They will also provide access to specialist mental health, disability or older persons’ services. Each Integrated Health Area will have primary access to at least one hospital.

The structure and delivery of this model will be developed further throughout 2023 with key stakeholders in partnership with patients, clinical and other key staff groups.

Resourcing our health regions

The Department of Health will establish a Population-Based Resource allocation (PBRA) model with representatives from the HSE and each health region. This model will make sure that resources and budgets are provided to meet the needs of the local populations and promote fair access to services across the 6 health regions.

An advisory group made up of these representatives will look at how to fund each health region based on the needs of their unique population. Using the PBRA model, the advisory group will:

• agree on the objectives and design of the funding model
• set timelines for its development

Along with developing and testing the PBRA model, work will continue on the HSE’s Integrated Finance Management System (IFMS) to support each region with effective financial management.

Governance and leadership

Health regions will strengthen governance and accountability at all levels. Throughout 2023, the programme team will work to:

• increase public accountability by working closely with local populations
• improve collaboration between local teams and services and build strong links between health regions and national support structures
• allow local teams and services to make timely decisions as close as possible to where patients’ care is happening

What happens now in 2023

We have started to transition to health regions this year.

To begin this transition, the CEO decided to expand the HSE Centre Executive Management Team and create a Senior Leadership Team. This team is made up of Hospital Group CEOs and Community Healthcare Organisation Chief Officers. This paves the way for the further transition to health regions.

Key programme activities for 2023 will include:

• ongoing engagement with stakeholders, including patients, staff, voluntary organisations, GPs and others
• recruitment of health region's CEOs
• creating 6 integrated pods that reflect the new geographical structures
• developing the Integrated Service Delivery Model in more detail
• agreeing how clinical and corporate governance will operate in the new structures
• agreeing how population-based funding will operate
• agreeing the digital, ICT, and capital needs of each region
• gradually aligning Hospital Group (HG) and Community Health Organisation (CHO) responsibilities and boundaries with the new boundaries
• agreeing on a transition approach to support future structures
• agreeing on a framework and conducting a population needs analysis within each health region

What happens in 2024

From February 2024, we expect to begin the transition to the new structure. This will include:

• appointing new health region CEOs
• CEOs becoming accountable for the delivery of all services within their health region boundary
• appointing members of each health region's Senior Management Team
• implementing a transition approach and options for staff consideration to support future structures
• CHO CEOs and HG CEOs remaining in place and reporting to health region CEOs until a Senior Leadership Team (SLT) is appointed

After the new health region structure has been set up, we will:

• recruit health region's senior teams
• transition to the Integrated Service Delivery Model
• move towards a more advanced state of integration in 2024
• continue to engage with patients, staff and other key stakeholders throughout all phases of the programme
• address requirements under key areas: Workforce, Data and Information, Infrastructure (including Capital / Estates), Governance, Integrated Processes, and Service Delivery / Clinical Pathways
• stand down HG and CHO structures by the end of 2024