The six new HSE Health Regions (formerly Regional Health Areas or RHAs) are in line with recommendations made in the Oireachtas Committee on the Future of Healthcare Sláintecare Report (2017), that regional bodies should be responsible for the planning and delivery of integrated health and social care services.
Integrated care is where services, funding, and governance are co-ordinated around the needs of the patient, encompassing both acute and community care.
HSE Health Regions will ensure the geographical alignment of hospital and community healthcare services at a regional level, based on defined populations and their local needs. This is key to delivering on the Sláintecare vision of an integrated health and social care service.
As well as enabling the integration of community and acute care, Health Regions aim to empower local decision-making and support population-based service planning. This will ultimately strengthen our health service and lead to improved patient experience as well as access to healthcare closer to home.
HSE Health Regions recognise the value of geographical alignment for population-based resource allocation and governance to enable integrated care. There are currently nine Community Health Organisations (CHOs) and six Hospital Groups (HGs) plus Children’s Health Ireland. As these do not align geographically nor overlap in terms of geographies, management, clinical oversight, or budgets for defined populations, this significantly hinders the delivery of integrated care.
HSE Health Regions aim to facilitate comprehensive integrated, person-led, community-first health and social care through the alignment of acute and community-based services. Health Regions will enable an alignment of services where:
- patients and staff feel safe, supported, and well-informed at all points in their care journey
- care is provided as close to home as possible; and
- health and social care services are planned and funded around the needs of the population
Health Regions involve the full alignment and better integration of health and social care services within each specific region. This is a key component of how the HSE will organise and deliver integrated health and social care services into the future. The objectives of HSE Health Region implementation are aligned with Sláintecare’s overall aims and objectives and are intended to:
- increase the integration of community and acute services
- introduce a population-based approach to service planning
- improve clinical governance; and
- improve corporate governance and accountability
The geographies of the six HSE Health Regions are based on population data including how people currently access health services and how disruption to patients could be minimised, as well as a public consultation. A government decision approved the Health Region geographies in July 2019, a map of which can be found below.
Further information can be found in the press release.
A public consultation on the process of Geographic Alignment of Community Healthcare Organisations (CHOs) and Hospital Groups was conducted by the Department of Health in April-May 2018.
The HSE Health Regions Advisory Group provides guidance, support, and advice on the design and development of a clear implementation plan for HSE Health Regions to the Department of Health and HSE officials charged with implementing this work programme under Sláintecare.
The commitment to establish Health Regions was first outlined in the Oireachtas Committee on the Future of Healthcare - Sláintecare Report 2017. It was reaffirmed in the Sláintecare Action Plan 2019, the Programme for Government 2020, the Sláintecare Implementation Strategy and Action Plan 2021-2023, the HSE Corporate Plan 2021-2024, and the Department of Health’s Statement of Strategy 2021-2023.
As well as approving the geographies of six new regional health areas, the government decision of July 2019 directed the development of a detailed business case and change management programme outlining proposals for HSE reconfiguration to align with the regional geographies.
While the government decision of July 2019 set a definitive direction of travel, the RHA Business Case provides clarity on the next steps needed to fully implement HSE Health Regions.
The Business Case was developed by the Department of Health in partnership with the HSE and other stakeholders, including frontline input from the HSE Health Regions Advisory Group , and outlines the proposed policy direction for Health Regions, its key enabling workstreams, and their associated timelines.
In line with the Public Spending Code (PSC), it also details the selection process for the proposed policy option and the criteria by which it was evaluated, a demand analysis, risks, the rationale for change, monitoring and evaluation considerations, and the overall objectives of Health Regions.
The aim of this work is to facilitate an achievable and manageable transition towards local, integrated Health Regions that are both empowered and accountable.
Business Case for the Implementation of Regional Health Areas
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The HSE Health Regions Implementation Plan sets out a high-level programme of work with objectives, critical actions, and timelines to transition to the six Health Regions. This is with a view to standing up the Health Region approach from February 2024, in line with the Programme for Government’s Universal Healthcare Mission and the overall design principles and objectives of Sláintecare.