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Nigel Carson Director of Equality and Public Safety. Strategic Context. 16 th March 2007. Background to Reform Programme. 1998/99 – Fit for the Future 2001 – Acute Hospital Review 2002 – Developing Better Services 2005 – Appleby Review
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Nigel CarsonDirector of Equality and Public Safety Strategic Context 16th March 2007
Background to Reform Programme • 1998/99 – Fit for the Future • 2001 – Acute Hospital Review • 2002 – Developing Better Services • 2005 – Appleby Review • 2005 – 20 Year Strategy for Health and Wellbeing – A Healthier Future • 2005 – The Review of Public Administration
Vision for Change • Health and well being, not just health services • Making the system respond to the patient and client, rather than the person to the system • A self-organising system, benefiting from strong internal motivation and performance management
Vision for Change • Integrated acute, primary and community care services supporting people to live independently • Structures and control procedures that will delivery against key policies • Quality and safety • Patient/Client experience and involvement
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 • Strong performance management • Strong incentives and sanctions • Much clearer accountability- All this should ensure improvement for patients, clients and carers.
Real Reform: How to Recognise it • Effect is to make public services more responsive and effective • Requires expertise – because the world and the tasks are difficult • Challenges complacency and inertia • Recognises that the citizen is in charge, not the provider
The Model Patients & Clients 5 Trusts plus Ambulance Service Primary Care/GPs/other Independent Primary Care Providers Patient Client Council RQIA 7 Local Commissioning Groups HEALTH AND SOCIAL CARE AUTHORITY Minister DHSSPS
Rationale • Strong patient voice –new Patient and Client Council • Regulator - RQIA to test quality against recognised standards and promote improvement • HSCA – regional service planned by health and social services specialists • DHSSPS – smaller Department focussed on strategic policy and supporting Minister
Health and Social Care Authority Four main areas of responsibility:- • Implementing government policy • Performance management • Workforce planning and development • Commissioning
A Local Commissioning Group is: • Committee of the Health and Social Care Authority (HSCA) with delegated power to commission services • Primary care led with 15 members, two of which are lay people from the local community • Lead and decision maker for commissioning health and social care services • Accountable to the HSCA Board
Where are we now? • Joint committee established • Appointments – HSCA Directors • LCGs – appointments next week • New Trusts operational from April 2007 • Trust non- executives; announcement next week
Northern HSS Trust (includes) Causeway United Hospitals Group Homefirst Belfast HSS Trust (includes) Belfast City Hospital Greenpark North & West Belfast Mater Infirmorum Royal Group of Hospitals South & East Belfast Western HSS Trust (includes) Sperrin Lakeland Altnagelvin Hospital Foyle South Eastern HSS Trust (includes) Ulster Community & Hospitals Down & Lisburn Southern HSS Trust (includes) Craigavon Area Hospitals Group Craigavon & Banbridge Community Newry & Mourne Armagh & Dungannon
Looking Ahead • Accommodation - locations initially on a temporary basis • Trust legislation in place • Draft reform bill for consultation, closing date 11th April 2007 • HSCA operational by April 2008
But more than structure… • New structures do not of themselves create new behaviours • Success will be better services for the public through • Strong leadership • A spirit of cooperation • Relentless focus on improvement • A culture of learning and innovation