“The pace of implementing the new HSE regional structures was a critical consideration and not without its risks,” said Tony Canavan, HSE Regional Executive Officer for the West and North West, speaking at an HMI Regional Seminar during the summer. “Moving too quickly risked destabilising services, disrupting governance arrangements, and diverting focus. On the other hand, taking your eye off the ball moving too slowly could create an atmosphere of uncertainty, making it challenging for staff to deliver services effectively.”
“Undoubtedly, we have made progress, but it is probably slower than most of us would be happy with. But, you need to give sufficient time to consult, to engage, to understand and then to build, based on that understanding.”
He said some of the progress was evolutionary and was progressing incrementally over time. This was particularly true of working arrangements at national level.
Mr. Canavan, who is a former HMI President said that by the beginning of September, it was hoped that the management structure at Integrated Healthcare Areas (IHAs) would be established. They would then be in a position to manage service delivery at that level and the interim arrangements could be stood down.
IHAs are substructures within each of the six health regions. There are 20 IHAs which serve a population of between 150,000 and 450,000 and take account of local geographies, population size, needs and services.
In the course of his presentation, Mr. Canavan looked at the work which had been done on establishing the new structures and what lay ahead.
The progression from 9 CHOs and 7 Hospital Groups to 6 regions based on the geographical boundaries had been agreed by the Government in July 2019.
The period from October 2024 to March 2025 was referred to as the interim period.
On July 31 2023, theHSE Health Regions Implementation Plan had been approved and its geographic impact assessment completed.
The first REO had been appointed in December 2023, the second in January 2024, the third, fourth and fifth were appointed in March 2024 and the final REO appointed in???
In 2024, the Centre Mapping of Activities/Functions had been initiated and this was still ongoing. A New Programme Steering Group was established, theIHAs agreed and Integrated Service Delivery (ISD) Design Commenced. This was also still ongoing.
A Revised HSE Centre Senior Leadership Team (SLT) was put in place and thePlain English Patient/Service User Partnership Approach published. Executive Management Team structures were approved, (EMTs) were recruited and appointed and IHAs went-live underinterim arrangements.
The HSE Centre Structure Issued, thePatient/Service User Partnership Approach was co- designed and approved, the REOs took up their posts and theVoluntary Engagement Proposal Approved.
October 2024 was an important date as it marked the start of the interim arrangements at IHA level and the appointment of 20 IHA Managers across the country.
Mr. Canavan said that at national HSE level, there were changing relationships. SLTs were now up and running, working relationships developing between and among REOs and between members of SLTs.
“There has also been progress at regional levels. If we look at my own region, in the last 12 months, we have filled all IHA Manager posts, Finance and HR, E Health, Communications and public affairs and Regional Clinical Director. We are in the process of filling the RDONM and RD P+P posts. We expect that the RD Disability post will progress over the coming months. We don’t have agreement about the inclusion of a Regional HSCP director but I also expect that to be decided over the coming months.
A key priority throughout this process is creating and sustaining a culture of collaborative working and leadership across the region, one that supports and empowers our high-performing teams and health care staff in continuing to deliver high-quality services and care.
Looking ahead, Canavan outlined the next steps in the regional transformation:
- Complete the RHA Management Teams.
- Develop and implement the IHA Management Structures, including the critical roles of Heads of Service (HoS) and General Managers (GMs) within the delivery system.
- Develop PSU structures and engagement processes.
- Establish new ways of working with voluntary service providers as part of the revised structures.
- Develop Networks of Care.
- Advance pilot initiatives for Children’s and Older Persons’ Services.
- Define and enhance the roles and relationships between the Centre, the Department of Health (DoHC), the Department of Children, Equality, Disability, Integration and Youth (DCEDIY), and the regions.
