The Health Service Executive is to introduce significant rationalisation of its central corporate structures following a review ordered by chief executive Paul Reid and lessons learned from dealing with the Covid-19 pandemic.
However the HSE said that no voluntary redundancy scheme to reduce staffing levels on foot of the changes was seen as required at this point. This, it said, was "due to extra demands in areas such as testing, vaccination and public health as well as the current need to recruit significantly into key areas".
As part of the reforms, various national schemes operated by the HSE will be brought under a single administrative function which, it said, would reduce the requirements on applicants for various supports to supply similar information to different parts of the organisation.
Mr Reid said the HSE was a very large organisation providing a huge variety of services and that its governance structures “had become quite complex with some areas of overlap within and across various corporate functions”.
The main areas affected by the new reforms, which came into effect on Monday, are the HSE’s integrated operations, clinical, human resources, finance and healthcare strategy areas.
HSE national director for human resources Anne Marie Hoey told staff that management believed the changes would lead to its "main activities being in the best place within its central structures".
‘Greater clarity’
She said this would allow them to give better support to hospitals, community services and national services. She said the changes would also drive better performance and accountability.
“People who deal with us will have greater clarity as to how things work. For example bringing national schemes and reimbursement services together under one function will make it much easier for people to engage with those services.”
As part of the new changes, the unit dealing with HSE service planning and several programmes relating to the experience of patients and service users are moving to its integrated operations section.
“The new structure will bring various national schemes into a single identity, reducing requirements on applicants for various supports to supply similar information to different parts of the HSE,” the review said.
It said the integrated operations section provided leadership and oversight of all service delivery across the HSE.
“The clinical function will now include all matters related to quality and patient safety, innovation in and design of clinical car, clinical professional development and the national trauma programme,” it said.
‘Patient expectations’
“The clinical function is responsible for providing clinical leadership across the healthcare system, creating a healthcare system informed and shaped by care pathways which meet patient expectations.”
The HSE said its healthcare strategy division set the strategic direction for the organisation and was to the front in dealing with the delivery of large-scale transformation programmes including Sláintecare. It said this function would now include governance and risk, strategy and research, capital and assets, and change and innovation.
The review of the centre was commissioned by Mr Reid in late 2019 “to determine how well the HSE’s corporate services are geared to support the operational services such as hospital groups, community healthcare organisations and related services”.
The HSE said the overall work of the review would continue and other changes would be phased in.
“For example, over time a new population health and prevention function will include the areas of testing and tracing, public health, environmental health, and health and wellbeing. “
