1. Northern Ireland Health and Social Care Reorganisation Mr Paul Simpson Deputy Secretary DHSSPS

2. HPSS REORGANISATION  Need for Change  RPA Consultation  Responses  Summary of proposals  New HSS Agencies  Regional Services  Public Engagement  Implementation

3.  Present structures set up for internal market  Public and political support for change  Commitment to change from the HPSS Need for Change

4. RPA CONSULTATION  Seven guiding principles for HPSS change  Should support hospital modernisation  HPSS should remain integrated  Strong coordination needed across the public sector and particularly at local level  Primary care should have a central role  New structures must be efficient & effective  Clear lines needed on accountability  Commissioning & delivery need not be separated organisationally

5. RESPONSES TO RPA CONSULTATION  38 HSS bodies and individuals from 180 overall  Good degree of consensus  Guiding principles accepted  Reduction in number of bodies  Continued integration of health and social services  Combined commissioning and delivery  Combined hospital and community care  Local Gov role in service planning  Co-terminosity with Local Gov desirable

6. SUMMARY OF PROPOSALS  Combined commissioning and delivery role  5 to 8 new HSS Agencies to replace current 4 Boards and 18 Trusts  Non-statutory Regional Forum  Reduction of HPSS Regional Service bodies  NI regional body to replace four HSS Councils  Overall reduction from 33 to 9-11 bodies  At least £11m savings

7. NEW HSS AGENCIES  Balance to be struck on optimum size for commissioning and for delivery  Compromise around 5-8 bodies  HPSS favour 5-6 bodies based on hospital catchments  A number of models for composition of Agency Board with District Council nominees  Position fluid on internal management structures

8. REGIONAL SERVICES  Two options  One super Agency  Selective reduction  One super agency  Potentially greater savings  Governance issues  Selective reduction  Continued separate existence? Central Services Agency Health Promotion Agency Ambulance Service (with changed status) Blood Transfusion Agency  Merge into other bodies? Medical Physics Agency Guardian Ad Litem Agency

9. PUBLIC ENGAGEMENT  New HSS Agencies to be proactive in engaging public  Developing plans  Delivering services  Handling complaints  NI regional body to replace 4 HSS Councils

10. IMPLEMENTATION  Primary legislation needed  1 April 2007 tentative date for handover  New Agencies in shadow form at least six months before go-live date  High level HR Steering Group  HR principles to be agreed with TUs