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Department highlights need for swift evaluation of health regional structure

By Paul Mulholland - 19th Nov 2023

health regional structure

The Department of Health has warned that “waiting too long” to evaluate the proposed health regional structure “will make it difficult to identify any specific impacts of the approach”.

The Department issued the warning in a recent tender document seeking an independent evaluation of the process and impact of the structural reform programme.

While implementation of the six health regions is due to commence in February 2024, the Department expects it will take “some time” before they are fully embedded and operational.

“However, waiting too long to evaluate will make it difficult to identify any specific impacts of the approach amidst other changes and reforms,” according to the tender.

“It would also prevent us from rapidly identifying and addressing any barriers and enablers to success that may emerge during the implementation period.”

Following a scoping and planning phase, the tender request states the evaluation process will be separated into two stages.

The first stage will focus on gaining insight into the process of implementing health regions and developing specific recommendations for any operational changes to the approach.

This will cover the period from February 2024 to February 2029.

“Research questions for this will be derived from a logic model created by the supplier during the evaluation scoping phase,” according to the Department.

The second phase will aim to gain an initial insight into the impact of the policy across the same five-year time period.

“It will aim to understand how health regions have progressed against the policy vision,” according to the tender.

“Research questions will again be derived from a logic model created by the supplier during the evaluation scoping phase.”

The Department states an interim impact evaluation should be conducted in July 2027.

To allow the health regions to become embedded, it is estimated the final analysis for this work will not be conducted until 2029.

“The successful supplier will scope, plan, and deliver a mixed methods process and impact evaluation of the reform.

“Providers should explore methods to assess the causal impact of the health region approach, including quasi-experimental techniques and theory-based evaluations.”

There may also be opportunities to “exploit the phased roll-out of the reform”, including variation in timings across regions.

The Department stipulates the evaluation should triangulate evidence from quantitative administrative or survey data with qualitative insights.

Where there is no existing data collection approach which addresses “high-level questions”, the supplier will work with the Department and HSE to agree an appropriate metric, according to the tender.

“For example, there may not be a currently agreed approach to measure the extent to which the healthcare system currently uses a population-based planning approach.”

The deadline for interested parties to respond to the tender request is 29 November.

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