THE REVIEW OF PUBLIC ADMINSTRATION REFORM OF THE HEALTH & SOCIAL SERVICES MAY/JUNE 2006.

THE REVIEW OF PUBLIC ADMINSTRATION

REFORM OF

THE HEALTH & SOCIAL SERVICES

MAY/JUNE 2006

WELCOME & INTRODUCTION

Dr Denis McMahon

Director of Modernisation

RPA UPDATE

Paul Simpson

Deputy Secretary

No 10 Principles of Reform

• national standards to ensure that people have the right to high quality services wherever they live;

• devolution to give local leaders the means to deliver these standards to local people;

• more flexibility in service provision in light of people's rising expectations;

• greater customer choice.

Key Policy Goals

• Separation of commissioning and providing• Delegation of a strong commissioning role to

local level – but within the framework of regional standards and targets

• Strong performance management• Opportunity for financial arrangements to

provide strong incentives and sanctions • Much clearer accountability• Opportunities for better integration of services

HPSS Decisions (1)

• Smaller, more tightly focussed Department

• Serving the Minister

• Strategic health policy

• Driving performance management

HPSS Decisions (2)

• A Health and Social Services Authority to manage performance

• Seven Local Commissioning Seven Local Commissioning Groups to ensure a strong Groups to ensure a strong devolution of responsibilitydevolution of responsibility

• Five HSS Trusts bringing together the provider function for all services

• NI Ambulance Trust

LCG CONFIGURATION

HPSS Decisions (2)

• A Health and Social Services Authority to manage performance

• Seven Local Commissioning Groups to ensure a strong devolution of to ensure a strong devolution of responsibilityresponsibility

• Five HSS Trusts bringing Five HSS Trusts bringing together the provider function together the provider function for all services for all services

• NI Ambulance Trust

NEW TRUST CONFIGURATION

AGENCIES

• CSA - Functions transferring to new health and social services organisations

• NIPEC & MDTA - Functions combined and transfer to new Health and Social Services Authority

• MHC - Functions transferring to new Regulation and Quality Improvement Authority

• Fire & Rescue Service - Transfer to local government as a regional service

• Health Estates Agency - Functions transferring into the new HPSS organisations

• RQIA - Remaining• Social Care Council – Remaining• Guardian Ad Litem Agency - Remaining

The New StructuresPatients & Clients

Agencies

Blood Transfusion Agency, Guardian Ad Litem,Social Care Council

5 Health and Social Services Trusts plus the Ambulance Service

Primary Care/GPs/other Independent Primary

Care Providers

7 Local Commissioning Groups

1 Patient & Client Council

1 Health and Social Services Authority

MinisterDHSSPS

RQIA

Timeframes

• June 2006 - Appoint HSSA Chief Executive• June-Sep 2006 – Appoint Trust Chairs and Chief

Executives• September 2006 – Establish 7 Local

Commissioning Groups within Boards• April 2007 – Current Trusts dissolved and New

Trusts running• November 2007 – Legislation in place• April 2008 - HSSA, LCGs and PCC formally in

place.

Current Programme Structure

Reconfiguration Programme Board (Chaired by Perm Sec)

Project Teams

PerformanceManagement

Human Resources

ManagementStructures

Shared Services

DepartmentalRestructuring

Public HealthFunctions

Planning and Commissioning

(LCGs)

Comms

ICTFinance

PatientClient Council

Social Services

Legis-lation

HSSA

Accomm-odation

All this to:• Secure high quality, safe services

• Improve health and reduce inequalities

• Improve the effectiveness and efficiency of providers

• Improve the impact of commissioning

• Improve public involvement

• Manage financial balance and risk

• Improve the integration of services

• Deliver £25-30m savings in management costs to be redirected to front line services

Planning & Commissioning, Performance Management, Finance/Shared Services

Challenges:

• Role of LCGs, relationship with HSSA• Central drive to manage performance vs. local

autonomy• Which measures to focus on• Ensuring financial systems support continuity of

services • Ensuring PBR does not lead to adverse

incentives/bankruptcy• Setting challenging but achievable targets for shared

services – what services, how many centres

Management Structures, DHSSPS, HSSAChallenges:• Accountability Partnership• Trust management structures• Professional leadership• Strategy, policy and standard setting in the Department• What HSSA structures to achieve strong

• Health and social care outcomes• local commissioning • performance management • financial control

• How do we manage the transition

Public Health, Social Services, Legislation, PCC

Challenges:

• How to build on existing networks (eg. IfH) while exploiting new opportunities (ie. community planning)

• How to establish accountability arrangements for social services which are acceptable to the courts

• How to establish new relationships in legislation while also providing flexibility

• How to distinguish the public engagement role of the PCC from that of the HSSA and Trusts

ICT, Communications, Accommodation

Challenges:

• How to ensure current and new ICT systems will meet the needs of the new HPSS structures

• How to ensure effective communication on the RPA process/effective communications systems in new structures

• How will overall accommodation needs be met across the public sector

Communication with Staff

• “Making it Happen” will continue on an at least monthly basis for the duration of the reconfiguration

• Road shows in May & June and we will be holding more of these in the future

• In the meantime, managers should continue to provide their staff with opportunities to discuss this process and raise any concerns they have.

• Feedback on concerns raised would be welcome • Web site & dedicated email address