HSE designing ‘new operating model’ for health service

The HSE is continuing to design a new operating model for the health service, which forms “a central component” of the wider reform agenda.

The initiative is expected to be completed in the current quarter of this year, according to a spokesperson. “This work outlines how services and functions will be delivered across both the HSE centre and the newly established health regions to ensure a cohesive and system-wide approach,” they stated.

The reform programme is being implemented in a phased manner to ensure a “focus on continuity” of service delivery and governance.

The HSE centre is moving away from “operational accountability” as this resides with the health regions. The role of the HSE centre will be to support the regions in “planning, enabling, performance and assurance”.

In April, the Sláintecare programme board heard that the HSE was advancing implementation of an integrated service delivery model for the health regions and “streamlining the HSE centre”.

Work was underway in defining the updated governance operating models for the HSE centre, including how it interacts with the Department of Health and the health regions, according to meeting minutes. The regions were introduced in March 2024.

In December 2024, concerns were raised by officials from the Department of Public Expenditure, Infrastructure, Public Service Reform and Digitalisation (formerly DPENDR) over the “complexity” of the HSE’s governance structure.

The matter arose during a presentation at the health budget oversight group. Following the presentation, a discussion took place on what the Department termed the “complexity of the governance structure” within the HSE. The Department noted that the existing structure has several layers. “This could negatively affect the communication of targets to hospital managers as well as the escalation processes in the HSE.”

Earlier this month, the Medical Independent reported that HIQA has encountered recent challenges in implementing escalation measures arising from the health service’s new regional structure.