Question 1: Why is the HSCB closing?
In November 2015, the decision was taken by the then Health Minister, Simon Hamilton to close the Health and Social Care Board (HSCB). This was confirmed by Michelle O’Neill in October 2016 as part of the wider transformation agenda, with the intention of enhancing strategic system leadership, improving integration and making the decision making process more streamlined.
In February 2020 Minister Swann endorsed the decision to migrate functions and staff from the HSCB by 31 March 2022. Social Care and Children functions and staff were planned to migrate to the Public Health Agency (PHA) and all other HSCB functions to the Department and associated staff to Business Services Organisation (BSO) under a hosting arrangement.
In October 2020 Minister Swann endorsed a change to the initial operating model; migrating all HSCB functions (including Social Care and Children) to the Department and all HSCB staff to BSO under a hosting arrangement.
Question 2: Why has the decision been taken to migrate responsibility for the functions of SCCD to the Department?
As work has progressed to finalise the legislation to give effect to the closure, the decision to transfer the Social Care and Children functions to the PHA has come under review and, through engagement with the policy leads and the Chief Social Worker, it has become apparent that the reasoning behind the initial decision was based on a number of assumptions which are less relevant today and understandably did not take account of the impact that Covid-19 would place on the operation of the PHA.
The migration of responsibility for Social Care and Children functions will, in effect, bring responsibility for all of the HSCB’s functions into the Department. This will result in strengthened governance and organisational structures and more joined up delivery of our health and social care services.
This change to the operating model reflects the changing environment in which we now operate, a key factor of which is the need for the PHA to focus its attention both in the immediate and longer term on dealing with the issue of public health and the management of the Covid-19 pandemic. The transition of Social Care and Children functions to the PHA during this critical period would not only have the potential to distract from this key objective but could also detract attention from social care provision.
Question 3: What happened to the functions of the HSCB?
Responsibility for all the existing functions moved to the Department on 1 April 2022. The functions are now undertaken by the new Strategic Planning and Performance Group within the Department, which was established for this purpose. Staff are hosted by the BSO, enabling them to retain HSC terms and conditions (see below for further detail). The BSO became the employer for these staff. Staff of e-Health migrated to BSO and continue to be line managed by Dan West.
Question 4: How was the work progressed?
Eight Design Groups brought teams together to propose how the new structures will work in their area, building on the model agreed by the Oversight Board.
The groups covered the 8 key functional areas of the HSCB and were co-chaired by a representative from HSCB and the Department. In developing the proposals from design groups, staff and key stakeholders from the impacted organisations worked collaboratively on how the future system would work. The focus is not on re-engineering existing processes but instead to focus on improving integration between our organisations and teams.
At a meeting in May 2019 the Oversight Board reviewed and approved the preliminary proposals from the design groups and progress was shared with staff via the HSC Restructuring Update – July 2019.
To complement the work of the Design Groups, eight Workstreams were established to identify and action the activities necessary to ensure a managed closure of the HSCB and the smooth transition of staff and functions from the HSCB to the Department.
Business Partners were identified to represent the Design Groups and Workstreams in project checkpoint meetings and workshops. The Business Partners provided the facility to ensure close working relationships during the transition phase through to migration on 31 March 2022.
Question 5: What governance arrangements have been put in place?
An Oversight Board was established to provide the strategic oversight and leadership to the Project. The Board is chaired by Richard Pengelly, Permanent Secretary and the members are:
- Sharon Gallagher, Chief Executive, HSCB and Deputy Secretary (DoH)
- Aidan Dawson Chief Executive, PHA
- Karen Bailey, Interim Chief Executive, BSO
- Jim Wilkinson, Deputy Secretary, DoH
- Deborah McNeilly, Deputy Secretary, DoH
The Migration Project also established a Governance Steering Group to provide strategic oversight and decision-making on issues of accountability and governance relating to the implementation of the new operating model. Membership comprises of senior officials from each of the impacted organisations.
Question 6: When did this change take effect?
In February 2020 Minister agreed a date of 31 March 2022 to migrate HSCB functions to the Department and staff to BSO, subject to legislative provision. The Health and Social Care Act (Northern Ireland) 2022 became law on 2 February 2022 and the HSCB closed on 31 March 2022.
Question 7: What transitional arrangements were in place?
In many areas, before Migration, we were working differently and more closely together than ever before. In some areas this had taken a more formal approach for example Performance Management and Service Improvement (PMSI) and Digital Health and Care NI as explained below.
PMSI is an example of a transitional arrangement put in place to support new ways of working. The PMSI team is now the single resource across HSCB and the Department undertaking this role. The PMSI team are responsible for service improvement and all performance monitoring, reporting and management, including to the Minister and the Departmental Board. This is a tangible and positive signal of the new approach and feedback indicated it is working well with more streamlined and integrated working practices.
The Department also appointed a Chief Digital Information Officer (CDIO) to bring strategic leadership and vision to the digital agenda in the HSC, at a time of unprecedented challenge and opportunity. The CDIO’s role includes oversight of the Digital Health and Care NI and Connected Health teams in the HSCB and the PHA, as well as Information Analysis Directorate, Information Management Branch and responsibility for eHealth policy within the Department. Working arrangements including a Memorandum of Understanding have been developed to support this new model for Digital Health and Care NI.
More recently, Sharon Gallagher was appointed Chief Executive of HSCB and Deputy Secretary (designate) in the Department. HSCB functions migrated to the new Strategic Planning and Performance Group within the Department on 1 April; Sharon is the Deputy Secretary responsible for the new Group. Sharon’s appointment provided continuity of leadership throughout the transition period and beyond Migration.
Question 8: What was the Risk Assessment and how were the recommendations taken forward?
In August 2018, the Department completed a risk assessment of the transition period to HSCB closure, following extensive engagement with staff and endorsement by the NI Audit Office. The Report set out potential risks as the period of considerable change and transition continued, and made recommendations to help to mitigate those risks. These were taken forward in partnership with impacted organisations. In recognising the importance of a stable and supportive workplace during this period of change, there was an ongoing commitment to recruitment at all levels of the HSCB subject to normal scrutiny processes and substantive funding. Progress was made with several appointments to key HSCB posts
Question 9: How does the hosting arrangement with BSO work?
The Strategic Planning and Performance Group was set up to undertake the current functions of the HSCB. Sharon Gallagher, as Deputy Secretary for the Group, has responsibility for directing the Group’s staff. Staff of e-Health also migrated to BSO and continue to be line managed by Dan West.
In the main, staff continue to perform the same functions but working much closer with Departmental colleagues. BSO as employer is responsible for matters such as pay and conditions and providing support such as IT, accommodation etc.
Question 10: were TUS consulted with?
Engagement and consultation with staff and their representatives was critical. A Staff Side Forum was been established to provide a mechanism for this. Membership included both staff (TUS membership is drawn from NIPSA, Unison, Unite, RCN and BMA) and management side representatives, ensuring a broad representation from the most impacted organisations.
Any matters which would normally be subject to negotiation will be taken forward through existing Joint Negotiating Forums in HSCB, PHA, BSO or the Department as appropriate to the affected staff group(s).
Key messages were shared with staff in all impacted organisations after each meeting of the Staff Side Forum.
Question 11: What are the benefits of closing the HSCB?
Closure of the board was an important first step on a wider transformation journey that will look at how we plan and manage our services differently. It will streamline our structures, reducing bureaucracy and will allow for better coordination of our resource enabling the system to operate more effectively and efficiently. Other benefits include:
- enhanced strategic decision making and planning
- making best use of the skills of staff
- promoting the “one system” ethos
- provides clarity on strategic leadership and increased accountability
- supports a continued focus on public and population health.
Question 12: What happened if there was a similar function already in existence at the Department?
Each of the main functions of the HSCB was represented by a Design Group. Each Design Group was chaired by a HSCB lead and a Department lead. These Design Groups have worked to determine how the HSCB’s current functions will operate in the Strategic Planning and Performance Group whilst ensuring enhanced integration between teams.
Amendments to the Health and Social Care Bill (2021) – October 2021
Question 13 – what did the proposed amendments to the Bill mean and did they impact on HSCB Closure?
The proposed technical amendments to the HSCB Bill sought to underpin local input by,
- include provision for legislative powers placing a statutory duty on the Department to bring forth regulations on the new Area Integrated Partnership Boards to be laid in the Assembly and be approved by way of the affirmative procedure; and
- to allow for the continuation of Local Commissioning Groups until such time as the Department brings forward the regulations outlined above.
The amendments were considered and accepted by the Health Committee at their 4 November 2021 meeting. The Bill has subsequently completed all stages through the Assembly, and The Health and Social Care Act (Northern Ireland) 2022 became law on 2 February 2022. Local Commissioning Groups are to continue until the regulations on the new AIPBs are laid.
Question 14 - When can we expect the regulations on the new Area Integrated Partnership Boards (AIPBs)?
Regulations on the new AIPBs are provisionally expected in autumn 2022.
Question 15 - Will the Local Commissioning Groups (LCGs) change or continue in the same format?
LCG functions will remain as they currently are.
Question 16 - Who is support Local Commissioning Groups (LCGs) post April 2022?
On the closure of the Health and Social Care Board, existing staff, although now part of the Strategic Planning and Performance Group, continue to support LCGs post closure.
Question 17: Why are Local Commissioning Groups continuing post HSCB Closure?
Health Committee were particularly keen to ensure that the potential loss of local input from Local Commissioning Groups, from a legislative perspective, was addressed whilst the new Integrated Care System (ICS) continued to be developed. Given that it was highly unlikely that the secondary legislation pertaining to the ICS will be laid by the 31 March 2022, Minister Swann agreed that LCGs continue until such time as the new regulations are laid.
Where can I get more information?
Details of the Bill’s legislative process can be found on the Northern Ireland Assembly’s website
Further queries and questions can be directed to the mailbox below: