HSE unveils new structure for local services

Patients can expect easier access to more responsive and uniform health services across the State, the Health Service Executive has promised in relation to major structural changes unveiled today.

The Executive plans to establish nine Community Healthcare Organisations across the State, to replace the 17 Integrated Service Areas under which non-hospital services are currently grouped.

Each Community Healthcare Organisation will comprise 10 Primary Care Networks, each one with a population of about 50,000, to provide access to services such as social care, mental health and health promotion.

“In effect, every large town and hinterland and every large district of a city will be supported through a Primary Care Network,” according to the review group which has drawn up the report recommending the changes.

For the first time, “an identified, accountable person” will be responsible for delivering services to local populations within the network. Greater involvement of family doctors in primary care will be encouraged through the employment of part-time GP Leads within each network.

The move is a natural sequel to the decision last year to create regional groups for all hospital services. Progress on forming hospital groups has so far been slow, largely because of difficulties recruiting qualified staff to take up chief executive roles.

The report acknowledges many people have difficulty “navigating” the health system because of its complexity and scale. “What must be improved is how these parts fit together so that the services are integrated and people can move smoothly through the system. Staff must be organised in a way that enables joined-up teamwork, responsive to the assessed needs of the local people.”

It stresses the importance of developing “a new integrated model of care, which is responsive to the needs of local communities”.

HSE chief executive Tony O’Brien said the new arrangements would facilitate a further move to treating patients locally at the lowest level of complexity possible. “For the first time, we have clarity on the management and leadership required in the collection of services we call primary care. In addition, we have clarity on how specialist community services in disability, older persons, mental health and health and wellbeing interface with primary care.”

The HSE says the new structure will make it easier for people in local communities to access services, navigate from community care to hospital service and discharge back to the community. Links between the health service and local authorities, Garda Siochana and the Child and Family Agency will also be improved.

Patients with complex care needs will have a named “key worker” from their local primary care team assigned to them, whose job it will be to ensure they get access to day care, meals on wheels, respite, hospitals and other services.

The HSE plans to have the new structures in place early next year, after consultation with unions in line with the Haddington Road Agreement. It says the move from 17 local bodies to nine will see a reduction in management structures at senior level. The creation of 90 networks will be achieved through the reorganisation and re-assignment of existing resources and staff.