Hospital Groups (HG) and Community Healthcare Organisations (CHOs) serve populations that are grouped and managed separately. This makes it challenging for our health system to deliver integrated care.
The HSE is creating six new health regions. Each health region will provide integrated health and social care services for the people in that area. These regions were signed off by Government in July 2019.
About integrated care
Integrated care offers a patient-centred approach to healthcare which is more responsive to service user needs.
Services, patients, their families and carers work together to meet the needs of patients.
Services that work together include:
- Acute hospitals
- Primary care services
- Community services
- Social care services
- Public and private providers
- Health and social care professionals
- Voluntary sector services
Working together makes communication between services easier. Services, funding and governance are co-ordinated around patient needs. International evidence tells us that integrated care delivers improved quality of care to patients, providing rapid access to the care they need, when they need it.
Benefits of health regions
The structure of health regions will enable staff to provide services that are:
- integrated
- locally planned and delivered
- easier to access and navigate
- available closer to home
Patient benefits include:
- care closer to home
- services based on the region’s population
- consistent quality of care
- patient involvement in their own care and treatment
- strengthened governance and accountability
Health regions will continue to build on recent developments to help deliver Sláintecare and health regions' objectives. This includes establishing:
- Community Healthcare Networks (CHNs)
- Enhanced Community Care Programmes (Chronic Disease Programme)
- Integrated Care Programme for Older Persons
Sláintecare and health regions' objectives include:
- improving access and performance
- ensuring timely implementation
- building public confidence
Vision
Health regions will function as part of a strengthened regional health and social care service, with their own budget, leadership team, and increased local decision-making.
Overview
The HSE will remain a single HSE organisation with six health regions. Services will integrate across hospitals and community organisations in these health regions.
- six geographical boundaries agreed within the HSE - health regions are not separate statutory bodies
- Health regions will use the HSE logo and operate under the governance of the HSE Board
- Health regions management structure will replace existing CHO and Hospital Group management structures
- Regional Health Forum structure to remain but will reflect health regions' structure
- operational focus to move to health regions from HSE national
- HSE national will oversee standards, and guidelines for implementation at regional level
To ensure health regions are designed to deliver the best outcomes for local populations, and in line with Sláintecare, the programme team is working closely with the following key groups:
- patients and service user representatives
- staff groups within and beyond the HSE
- voluntary partners
Geographical areas
The six health regions will cover the following areas:
- HSE Dublin and North East - North Dublin, Meath, Louth, Cavan**, and Monaghan
- HSE Dublin and Midlands - Longford, Westmeath, Offaly, Laois, Kildare, and parts of Dublin South and Wicklow*
- HSE Dublin and South East - Tipperary South, Waterford, Kilkenny, Carlow, Wexford, Wicklow, part of South Dublin
- HSE Midwest - Limerick, Tipperary and Clare
- HSE South West - Kerry and Cork
- HSE West and North West - Donegal, Sligo, Leitrim**, Roscommon, Mayo, and Galway
*West county Wicklow: West county Wicklow continues to be aligned with Kildare for health services
**West county Cavan: A small portion of west county Cavan continues to be aligned with Sligo/Leitrim for health services
Timelines
The health regions' Implementation Plan, providing a high level roadmap for programme implementation, is in final development stage. The plan, being developed by DoH and HSE, is due to be signed off by Government in early June. This is a major and complex change programme that will take time to implement.
Key milestones and programme activities included in the plan:
April – Mid October 2023 (prior to recruitment of health regions' CEOs)
Transition to the new geographical groupings (six regions), recruit the health regions' CEOs and implement activities to stand up the six health regions in early 2024
Complete the future design of the:
- Health regions (including team structures and roles and responsibilities)
- Integrated Service Delivery Model
- HSE Centre and the allocation of activities to the departments
Mid October 2023 – February 2024 (health regions' CEOs in place to health regions go-live)
- Health regions' CEOs take ownership for implementation planning in their own region, with the support of the health regions' programme team
- Secure approval for the health regions senior teams, begin recruitment, agree transition plan for 2024 from CHO and HG to health regions
- Continue activities required to stand up the six health regions in 2024
February 2024 onwards (post health regions go-live)
- Recruit health regions' senior teams and transition to these teams
- Transition to Integrated Service Delivery Model and future team structures across the system
- Continue required activities to move towards a more advanced state of integration in 2024
- Ongoing communication and engagement with staff, patients and other key stakeholders throughout all phases of the programme
Managing change resources
The Health Services Change Guide is a step-by-step guide to help lead and bring about change. This will provide the basis for the health regions' programme planning and implementation. It features advice from practitioners, leaders, service users and staff.
Health Services Change Guide
Implementation Plan
The Implementation Plan outlines the approach to health regions' planning and design in line with Sláintecare’s design principles and objectives. The plan will be available once approved by Government in early June. It sets out a high-level programme of work for 2023, with a view to establishing health regions from 1 February 2024.
