THE REVIEW OF PUBLIC ADMINSTRATION

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

2. WELCOME & INTRODUCTION Dr Denis McMahon Director of Modernisation

3. RPA UPDATE Paul Simpson Deputy Secretary

4. 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.

5. 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

6. HPSS Decisions (1) • Smaller, more tightly focussed Department • Serving the Minister • Strategic health policy • Driving performance management

7. HPSS Decisions (2) • A Health and Social Services Authority to manage performance • Seven Local Commissioning Groups to ensure a strong devolution of responsibility • Five HSS Trusts bringing together the provider function for all services • NI Ambulance Trust

8. LCG CONFIGURATION

9. HPSS Decisions (2) • A Health and Social Services Authority to manage performance • Seven Local Commissioning Groups to ensure a strong devolution of responsibility • Five HSS Trusts bringing together the provider function for all services • NI Ambulance Trust

10. NEW TRUST CONFIGURATION

11. 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

12. Patients & Clients Agencies Blood Transfusion Agency, Guardian Ad Litem, Social Care Council Primary Care/GPs/other Independent Primary Care Providers 5 Health and Social Services Trusts plus the Ambulance Service 1 Patient & Client Council 7 Local Commissioning Groups 1 Health and Social Services Authority RQIA Minister DHSSPS The New Structures

13. 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.

14. Current Programme Structure Reconfiguration Programme Board (Chaired by Perm Sec) Project Teams Management Structures Public Health Functions Human Resources Performance Management HSSA Shared Services Social Services Finance ICT Departmental Restructuring Comms Legis- lation Patient Client Council Planning and Commissioning (LCGs) Accomm-odation

15. 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

16. 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

17. Management Structures, DHSSPS, HSSA Challenges: • 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

18. 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

19. 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

20. 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