Features: New structures for Northern Ireland
27 July 2009
GMCtoday highlights changes to health and social care structures in Northern Ireland.
Review of Public Administration
Healthcare structures in Northern Ireland are changing as part of a wider 'Review of Public Administration' that has been going on for a number of years. With an overall plan to reduce the total number of public bodies from over 150 to just 75, healthcare has been at the forefront of the change agenda.
Although the changes are still working their way through the system with recruitment for senior and middle management posts ongoing at present, 19 health and social services trusts have now been merged into just six health and social care trusts.
From 1 April 2009, under The Health and Social Care Reform Act 2009 all of Northern Ireland’s 1,600 GPs and more than 300 GP practitioners come under the single Regional Health and Social Care Board which replaces the four previous health and social services boards.
Dr John Jenkins, Senior Consultant Paediatrician at Antrim Hospital and GMC Council member, told GMCtoday: ‘The recent and major changes in the structures and arrangements for commissioning and provision of care in Northern Ireland bring a reduction from four commissioning boards to one, and from 19 provider trusts to six.
'These and many other changes will undoubtedly prove challenging for all concerned, but the constructive contacts which have already developed provide a firm foundation for the effective collaboration which is essential to enable individuals and organisations to achieve their aims, and ultimately to improve the safety and quality of care.’
Changes to the RQIA
One of the key changes sees the Regulation and Quality Improvement Authority (RQIA) assuming the responsibilities of the former Mental Health Commission, bringing all health systems regulation under one roof. An independent body, RQIA will be responsible for monitoring and inspecting the availability and quality of the integrated health and social care services in Northern Ireland, and encouraging improvements in the quality of those services.
RQIA's main functions are to inspect the quality of services provided by health and social care (HSC) bodies in NI through reviews of clinical and social care governance arrangements within these bodies and to regulate a wide range of services delivered by HSC bodies and by the independent sector. With the transfer of duties of the Mental Health Commission to RQIA, it will in future also undertake a new range of responsibilities for people with a mental illness and those with a learning disability.
Dr Jenkins adds: ‘RQIA recognises the importance of working with the professional regulators for medicine. Following a recent meeting between the GMC, UK systems regulators and the NHS Revalidation Support Team, it was agreed that RQIA will carry out a clinical governance review in 2010 to pilot assessment processes of organisational readiness for the introduction of revalidation.’
There are also important links between RQIA’s work and the standards of medical education and training, and a Memorandum of Understanding with the Postgraduate Medical Education and Training Board was signed in January 2009. PMETB has already participated in two clinical reviews since then – in maternity and blood transfusion services.
‘Effective communication between professional and systems regulators,' Dr Jenkins concludes, ‘is crucial in order to develop, implement and monitor standards of patient care, as these depend to a great extent on not only the knowledge, skills and behaviours of professionals, but also on the contexts in which they work and the effectiveness of the systems for delivery of care.’