THE REVIEW OF PUBLIC ADMINISTRATION

1. THE REVIEW OF PUBLIC ADMINISTRATION REFORM OF THE HEALTH AND SOCIAL SERVICES:AN UPDATE Andrew McCormick 21 March 2006

2. 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.

3. Patients & Clients Support Services Shared Services (eg. Procurement, legal, estates), NIGALA, Blood Transfusion 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

4. 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

5. Strengths of Locality Commissioning • partnership working by the key groups of professionals and other agencies • tangible benefits for people in their localities by bringing together key stakeholders and local communities in a partnership arrangement

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. Programme Structure (1) Reconfiguration Programme Board (Chaired by Perm Sec) Project Teams Human Resources Performance Management Management Structures Public Health Functions HSSA Shared Services Social Services Finance ICT Departmental Restructuring Comms Legislation Patient Client Council Planning and Commissioning (LCGs)

12. An update… • Reconfiguration Board has met 4 times – all project teams have met • First draft of primary legislation instructions underway • Trust legislation out for consultation – closing 9 April • Key decisions on human resource issues (e.g. open/closed appointments under discussion) • Public Service Commission has met

13. REVIEW OF QUANGOS • Announced by SoS on 22 Nov 2005 • Way forward decided 21 March 2006 • Health bodies affected • CSA • NIPEC • MDTA • Mental Health Commission • Fire & Rescue Service • Health Estates Agency • RQIA • Social Care Council

14. WHY? • Streamlined organisational structures – new opportunities for promoting multi-professional synergies • Clarity about roles mean we need to realign functions to reflect the commissioner / provider split • Need to explicitly build structures which promote accountability and responsiveness in the delivery of regional and shared service functions • structures need to reflect the whole system changes we are implementing and... • Efficiencies with redirected savings into front line services

15. 21 March Announcement • 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

16. HEA Health Estates Agency - Functions transferring into the new HPSS organisations • key service support function which, under the new arrangements, can be managed more effectively within the new HPSS structures • how this relationship will work will depend on a review of DHSSPS functions... • and a review of the potential for shared services in the HPSS

17. Departmental Restructuring Team will make recommendations to the Departmental Board in respect of: • functions and posts that will transfer initially to the Chief Executive Designate and ultimately out of the Department • functions and posts that will remain in the Department • the appropriate future organisation and structure of the Department in order that retained functions are delivered efficiently and effectively, and: • the implications for staff in the core Department and Health Estates.

18. Departmental Restructuring So far: • all branches have produced pro forma estimating % work Dept/HSSA • Interviews with key Directorates and Heads of Branches • Following which we will have the cost envelope to work within • Then we can begin to design the new Department

19. In conclusion… • Appreciate your support and patience • Lot of work underway but we don’t have all the answers • Look out for “Making it Happen” • Give us feedback • Further presentation before summer