We're currently transitioning to the new health regions structure. Interim arrangements are in place.
The next phase of implementation will begin in 5 out of 6 health regions from Monday 3 March. This phase focuses on implementation of the Integrated Healthcare Area structure and will be completed within 6 months. Implementation in HSE Mid West will begin at a later date.
During this phase, our main priorities are still:
- maintaining existing levels of service for our population
- maintaining quality and safety
- communicating these changes in a timely way
The mapping of the approved structure is underway and will be applied consistently across the health regions.
This page provides the latest information about the changes happening throughout the year.
In this latest update, we share important updates 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 posts are now filled in the 6 regions.
Access the current regional EMT leadership details
Integrated Healthcare Area managers started in their posts on Tuesday 1 October. The other senior leadership roles in health regions are being filled.
View the advanced design of the HSE EMT model (PDF, 167KB, 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 will take account of local geographies, population size, needs and services.
Integrated Healthcare Areas bring together both acute and community services as well as other non-HSE providers. This will be 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.
Integrated care
The new health region structures will 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 will clarify roles and responsibilities at all levels of the organisation. It will create the conditions for more integrated working.
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)
The next phase of implementation will focus on the IHA structure. It will begin from Monday 3 March.
Throughout this phase, there will be ongoing communication in each region to keep you informed about upcoming changes to the structures in your area.
Changes will happen gradually over the coming months, while maintaining services at both the HSE Centre and across the health regions, to ensure a safe transition. Comprehensive change impact and risk assessments will be carried out to make sure the impact of these changes on services is understood.
Staff and managers will work together to plan the transition to the new structure. REOs, IHA Managers and local implementation teams will be supported by local project management offices and Change and Innovation Hubs during this phase.
Networks of care
What does Networks 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?
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.
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 infrastructure and capital delivery
- Internal audit
- Planning and performance
View the HSE Senior Leadership team
New HSE Centre structure with appointed national directors (PDF, 112 KB, 1 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 to 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 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.
The HSE is committed to engaging and supporting staff during this time of significant change.
The following points outline key elements of the HR approach:
- Reassignment Principles (PDF, 121 KB, 7 pages) have been agreed with the National Joint Council and were circulated to HSE colleagues in January.
- The final number of operational management posts in each IHA Management Team, when confirmed, will be filled by a combination of Heads of Service and General Managers, depending on the associated level of responsibility.
- Proposals are currently being drafted by National HR in relation to the process for filling the IHA Management Team roles at Head of Service and General Manager level.
- The process will be centrally coordinated by the National Recruitment Service. The process will be consistent, transparent and fair and will be managed in a number of phases.
- Engagement continues with the Staff Representative Groups.
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 are consulting on draft re-assignment principles with staff representative bodies via the national joint council.
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.
Staff transition arrangements will include:
- making changes in line with the CEO Centre design published by the CEO (PDF, 170 KB, 7 pages)
- supporting the REOs in setting up the health regions in the short term and the Executive Management Team (EMT) structures
- ongoing engagement with staff representative groups via the National Joint Council and other staff representative engagements
Maximum staff numbers approved
The maximum number of Whole Time Equivalent (WTE) staff in the HSE is now 129,753. This figure was approved as part of the 2024 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.
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:
- filling direct reports of the REOs and completing the recruitment of health region EMTs
- filling other roles on a function-by-function basis
- keeping some current systems in place to make sure we transition safely and always maintain services to ensure minimal disruption to patients and service users
- planning to implement the new agreed structures from Monday 3 March 2025
Regional health profiles
Health regions will prioritise and plan services that meet the regional population's needs. This means it is essential to have good information on the populations they serve.
A range of public health resources have been developed. They include:
- a regional population profile for each health region
- community healthcare network population profiles,
- the framework for health needs assessment
- a strategic framework for population-based planning
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 in February 2024. A plain English version of this proposal was completed in July 2024.
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 in 2023. 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.
Regional Patient and Service User Lead
Recruitment for 6 Regional Patient and Service User Lead roles is currently underway.
The purpose of these roles is to:
- implement the agreed approach to patient and service-user partnership within and across the health regions
- build a strong partnership between patients, service users, healthcare providers and other key stakeholders in designing and delivering care across their region
- focus on measuring, tracking and improving the patient and service user experience
- set up and manage processes where patients and providers can work together to improve care
- work closely with patients and service users to shape the goals and operations of the Regional Patient and Service User Partnership (PSUP) office
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 prepared a slide deck presentation. The presentation includes a general overview of the health regions and an update on implementation.
The slides are intended for delivery 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 (PowerPoint, 8.89 MB, 29 pages)
Health regions webinar series
The health regions programme team completed a series of webinars in 2024. These webinars provided an update on the implementation of health regions and focus on key objectives of the programme.
The latest webinar, Supporting Teams for Integrated Working, took place on Thursday 12 December.
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. 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. 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)
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.