Background
The HSE provides a wide range of health and social care services to those who need them each year. It delivers many of these services directly. However, it also relies on non-statutory or voluntary agencies to deliver services on its behalf. Voluntary organisations play an essential role in the delivery of hospital and community-based services and are an essential component of Ireland’s public health and social care system. The HSE provides funding to voluntary organisations, under Sections 38 and 39 of the Health Act 2004, through Service Arrangements and Grant Aid Agreements
Context
The Service Arrangement and Grant Aid Agreement Review began in July 2023. It is being carried out in the context of significant developments in the relationship between the State and the voluntary sector evident in the work of the Dialogue Forum, the development of the Partnership Principles and the findings of the Case Study Programme.
Scope
The review covers the content of the Service Arrangement and Grant Aid Agreement documentation (a ‘Technical Review’) and also the process around engagement and delivery (a ‘Process Review’). Policy, legislative changes and decisions regarding funding are outside the scope of this project.
Governance
A governance structure has been put in place to manage the project consisting of an Oversight Group and a Working Group. Each group includes representatives from the HSE and from voluntary organisations and representative bodies.
Objective
The objective is to review the current Service Arrangements and Grant Aid Agreements in the context of the Partnership Principles. This is part of a wider strategic objective to improve the working relationship between the HSE and the voluntary sector for the benefit of those who use our services.
Recommendations for 2024
As part of the ongoing review, a number of recommendations for the 2024 cycle of funding were put forward in a Service Arrangement and Grant Aid Agreement Review Report. These recommendations were approved by the HSE Executive Management Team on 31 October 2023. Service Agreement and Grant Aid Agreement Review (PDF, 2.27mb 32 Pages)
Technical recommendations included simplifying the schedules and revising certain clauses within the Service Arrangement, as well as reviewing the financial thresholds applicable to Grant Aid Agreements. Recommendations also included the timing of signing documentation, the consultation and engagement framework and reducing administrative duplication.
Next Steps
The recommendations are introductory steps in achieving the overall objective of the review. Implementing these changes in 2024 represents a significant challenge and will require commitment, trust, collaboration and adaptability from all involved. The HSE and its partners in the voluntary sector are fully committed to delivering these changes and supporting the ongoing work of the Review.
Service Arrangements and Grant Aid Agreements
The HSE provides funding to voluntary organisations under Sections 38 and 39 of the Health Act 2004.
For organisations that receive in excess of €250,000 the terms and conditions associated with the funding are set out in a Service Arrangement (SA). For organisations that receive less than €250,000 the terms and conditions are set out in a Grant Aid Agreement (GAA).
The Service Arrangement and Grant Aid Agreement are contracts and operate on the principles of contract law. There is a requirement that they are renewed each year to support the transfer of the very significant sums of public money involved. (For example, the HSE provided over €6 billion to approximately 1,800 voluntary organisations in 2022).
Dialogue Forum
The relationship between the HSE and the voluntary sector is one of interdependence and co-reliance. It is recognised that supporting collaboration, integration and partnership working will have a positive impact on the quality of services provided and the experience of those accessing the services.
The Dialogue Forum was established in 2019 following the publication of an Independent Review Group report which examined the role of voluntary organisations in the delivery of health and social care services. The aim of the Dialogue Forum is to build a stronger working relationship between the State and the voluntary sector with a view to improving the quality of services for service users. More information on the Dialogue Forum (Gov.ie)
Partnership Principles
The Dialogue Forum developed a set of Partnership Principles, which set out the basis for building a new, improved relationship between the State and the voluntary sector. The principles sought to build on the collaborative, integrated ways of working evident during the response to the Covid-19 pandemic. The Partnership Principles (Gov.ie, PDF) were launched by the Minister of Health in April 2023.
Case Study Programme
The Dialogue Forum also commissioned a series of Case Studies to help identify ways to put the partnership principles into practice. The findings highlighted the importance of the Service Arrangement and Grant Aid Agreement Review which was designated an exemplar project. Case Study Process Final Report (Gov.ie, PDF)
