A considerable number of major decisions had already been implemented in the transitioning from nine Community Healthcare Organisations (CHOs), and six Hospital Groups (HGs) to six Health Regions, Mr Liam Woods, HSE National Director, Organisational Change, told a HSE webinar to provide an update on implementation and the specific key strategic objectives of the Health Regions.
- The HSE Centre and Health Regions structures had been agreed.
- Health Regions would use the HSE logo and be under the governance of the HSE Board.
- The Regional Health Forum structure would remain but would be aligned to Health Regions.
- Following a transition period, the Health Region management structure would replace existing CHO and HG management structures.
- Operational focus would move from HSE Centre to the Health Regions and Integrated Healthcare Areas (IHAs). Twenty IHAs had been agreed as geographic sub-components of the Health Regions. The IHAs would have responsibility for operational service delivery and driving integrated care for patients and service users.
- The HSE Centre would develop and oversee standards and guidelines for implementation at regional level.
- The focus of the HSE Centre would be supporting Health Regions on planning, enabling, performance and assurance.
He said in addition progress on the Health Regions Programme implementation in the first six months of 2024, included:
- Co-design and approval of the Patient/Service User Partnership Approach
- The appointment of Regional Executive Officers (REOs).
- Co-design and approval of the Voluntary Engagement approach.
- Approval of the Regional Executive Management Team (EMT) and Integrated Healthcare Areas (IHA) structures.
- Commencing IHA and Integrated Service Delivery (ISD) model detailed design.
- Recruitment of EMT posts.
- Revision of HSE Centre Senior Leadership Team (SLT).
- Ongoing engagement with CHOs, Hospital Groups, Patient /Service User representatives, HSE staff and staff representative bodies, Voluntary Organisations etc.
Mr. Woods said the vision for Health Regions, was to “deliver person-centred health and social care services that were informed by the needs of the people and communities in each region, better serving people at all stages throughout their lives”.
He said further information on the roll out of Health Regions could be viewed on the Health Regions webpage (https://www.hse.ie/eng/about/who/health-regions/). Staff email updates and Health Matters could be accessed on the HSE staff website (https://healthservice.hse.ie/staff/). The Health Regions team welcomed contact via: healthregions.team@hse.ie
Public Health
Dr Jennifer Martin, Director of National Health Service Improvement, Public Health, HSE, Dr Naomi Petty-Saphon, Consultant in Public Health Medicine and Dr Declan McKeown, Consultant in Public Health Medicine in the HSE’s National Health Intelligence Unit presented an update on progress and future directions on the Population-Based Planning Workstream.
Population-Based Planning Workstream: An Update on Progress and Future Directions
The HSE Health Regions Implementation Plan, published in July 2023, delineated the foundational steps for establishing Health Regions. Central to this plan was the adoption of a population-based approach to health planning and resourcing, essential for addressing the diverse needs of populations within these regions. Population-based planning (PBP) was a holistic method that assessed health needs at multiple levels, thereby informing health service planning aimed at enhancing overall population well-being.
Population Based Planning integrated data analysis and community engagement to prioritise and design health services. Key tools in this process included Population Profiles, Strategic Needs Assessments, and Population Health Management. These tools, alongside local insights, were integral to HSE strategic planning, ensuring that population needs were effectively met. Additionally, the outputs of this approach would support Population-Based Resource Allocation (PBRA), a key initiative led by the Department of Health
Dr. Jennifer Martin, Director of National Health Service Improvement at HSE Public Health, emphasised the importance of a strategic approach. “The core of population-based planning is all with the aim of designing and redesigning our services to meet the needs and expectations of our communities.”
Population-Based Planning Outputs (Oct 2023 – June 2024)
Programme Established
Under the leadership of the Director of National Health Service Improvement, Public Health, a robust framework for population-based planning had been established.
The governance structures and processes developed included:
- PBP Based Planning Steering Group: This group provided strategic direction for integrating PBP into service planning.
- PBP Expert Advisory Group: This group offered expert insights and stakeholder perspectives to guide PBP development.
- PBP Working Group: This group was tasked with implementing the regional and national work programs as identified in the HSE PBP Operational Plan.
Population Profiles
Population Profiles served as a fundamental tool, detailing demographic, deprivation, and geographical data, essential for all PBP activities. Achievements to date includes:
- The creation of Six Regional Population Profiles, encompassing key indicators, maps, and public health interpretations.
- The development of a National Comparative Report on Population Profiles, which provided a comparative analysis across the six regions.
- The generation of 96 Community Health Network (CHN) Population Profiles, each including key indicators and maps, accessible via the Health Atlas Ireland (HAI) Application.
- The introduction of a ‘Quick Pick’ dashboard function within HAI, facilitating the creation of profiles at various levels.
Health Needs Assessment Framework
The HSE Health Needs Assessment (HNA) Framework outlined a systematic six-step approach, ensuring consistency in service planning. This framework, referred to as the 6P HNA Framework, supported HNA processes for any population segment defined by geography, characteristics, or health conditions. The 6P HNA Framework comprises:
- Prepare: Initiating a full HNA, identifying resources and partners, and securing leadership support.
- Population: Defining the specific population of interest.
- Partnership: Collaboratively engaging stakeholders to ensure inclusive and effective needs identification and implementation.
Picture: Gathering and analysing data to develop a comprehensive understanding of local needs.
- Prioritise: Identifying and ranking priorities based on impact, changeability, acceptability, and resource feasibility.
- Plan: Developing detailed implementation, monitoring, and evaluation plans with clearly defined responsibilities and timelines.
.Resources produced by the PBP workstream were available at: https://www.hse.ie/eng/services/list/5/publichealth/publichealthdepts/population-planning/
Next Steps for the PBP programme:
The PBP Programme would continue to advance by:
- Articulating the approach and components within the Population-Based Planning Cycle for health regions.
- Developing a comprehensive toolkit to support PBP efforts and establish a core national data set.
- Creating best practice data visualization standards for population-based planning.
By embedding these processes and tools into strategic planning, the HSE aimed to enhance the effectiveness and responsiveness of health services, ensuring they were closely aligned with the needs of the populations they served. This approach promised to support equitable resource allocation and improved health outcomes across Ireland.
Over 1,000 people registered to attend the webinar, and, over 500 people joined the live event. Attendees were from across the system, including patients / service users, members of the public, staff and managers from within the HSE and from agencies outside of the HSE.
Polls were conducted during the webinar, along with an evaluation as attendees left the workshop. Overall, feedback was overwhelmingly positive, with more than 96% of attendees indicating that they would recommend the webinar to others. Attendees were also invited to suggest topics for future webinars. In order of popularity, the top five suggestions were: Integrated Care/Integrated Service Delivery, Corporate and Clinical Governance, Partner Organisations, Population Based Resource Allocation and Patient and Service User/Public Partnership.
