Sweeping changes are to be introduced to the HSE Leadership including the appointment of four new National Directors, with the operations roles of a number of existing National Directors subsumed into the new posts – and new reporting arrangements. Maureen Browne reports.
These changes have been proposed by HSE Director General, Tony O’Brien and approved unanimously by the HSE Directorate.
The Director General said the changes were aimed at further devolving decision making and accountability as close as possible to the front line, streamlining performance and management across the health service with a particular focus on enhancing the integration of services.
The four new National Directors are a Chief Operations Officer, a Chief Strategy and Planning Officer, a National Director of Community Health Service Operations and a National Medical Director.
Three of the new posts are to be filled by open competition and the fourth will be appointed from among the existing National Directors.
The posts of Chief Operations Officer and Chief Strategy and Planning Officer are to be filled by the Public Appointments Commission through open competition as soon as practicable. When these recruitments are completed the current interim Deputy Director General arrangements will cease.
The Chief Operations Officer will be responsible for the overall operational performance management of the system.
The Chief Strategy and Planning Officer will be responsible for strategic planning, including corporate and annual service planning and for overseeing the Programme for Health Service Improvement.
Three of the new posts are to be filled by open competition and the fourth will be appointed from among the existing national directors.
Both the Chief Operations Officer and the Chief Strategy and Planning Officer will deputise for the Director General as required.
An existing National Director will be appointed as National Director of Community Health Service Operations. The current operations role of the existing National Directors for Primary Care, Mental Health, Social Care and Health and Wellbeing will be subsumed into this role. The existing CHO National Executive Management Committee will no longer be required from that point.
The existing posts of National Director Clinical Strategy and Programmes (CSPD) and National Director Quality Improvement will be subsumed into a new role of National Medical Director to be filled by open competition. Mr. O’Brien said the CSPD role was time limited and the current appointment reaches its conclusion later this year. Additional arrangements would be made to facilitate ongoing innovation in improvement approaches.
The post of National Director Acutes will continue as operational head of acute services, reporting to the Chief Operations Officer.
A small team of the “Commissioning” National Directors working closely with the Chief Strategy and Planning Officer will cover the portfolios of Acute Care (including NAS) Primary Care, Social Care, Mantel Health and Well Being. These portfolios will be shared by about three (or at most four) existing National Directors who will be collectively tasked with integrated planning.
The Quality Assurance and Verification post will in time be permanently filled at National Director level through competition and will be part of the Service and Clinical Excellence Team led by the new National Medical Director post.
Functions and persons currently in the relevant national divisions will be assigned appropriately to either the “commissioning” or operations National Directors as part of these changes.
Clinical programmes and discreet clinically led initiatives, such as the new Maternity and Infant Programme and the NCCP, will be “nested” with the new National Medical Director. Mr. O’Brien said these operated largely in the “commissioning” space already and were also central to driving clinical leadership in the delivery system.
The Chief Operations Officer, Chief of Strategy & Planning Officer, National Medical Director, Chief Financial Officer, National Director Human Resources, Chief Information Officer, National Director, Internal Audit and National Director Communications will each report to the Director General.
The National Performance Oversight Group process which supports performance valuation and reporting will continue and will be led by the Chief Strategy and Planning Officer and will be the primary means by which the commissioning function, CPO, National Director Human Resources and Medical Director conduct performance dialogue with the National Operations team. That team will undertake its own performance dialogue and interventions with HGs/CHOs etc. There will need to be some process alterations to reflect changed roles.