Role of the Health and Social Care Board
The new Board together with its Local Commissioning Groups (LCGs) will be accountable to the Minister for translating his vision for health and social care into a range of services that deliver high quality and safe outcomes for users, good value for the taxpayer and compliance with statutory obligations. A key role of the new Board with the Public Health Agency (PHA) will be effective engagement with providers, Patient Client Council (PCC), local government, service users, local communities, other public sector bodies, the voluntary and community sectors.
The Board’s key functions will include:
• In line with Ministerial objectives, ensuring effective commissioning to secure the provision of health and social services and other related interventions that address the needs of people from pre-conception to death. Commissioning plans will be developed in close partnership with the PHA and through a ‘commissioning cycle’ that moves through from assessing needs, strategic planning, priority setting, securing resources to address needs, agreeing with providers the delivery of appropriate services, monitoring that delivery, assuring that the safety and quality of services commissioned are improving, that recommendations from Regional Quality Improvement Agency (RQIA) and other reviews have been implemented and that as a minimum, services meet DHSSPS and other recognised standards; evaluating impact and feeding back that assessment into the new baseline position in terms of how needs have changed;
• The efficient, effective and appropriate use of delegated funding of some £4bn per annum to meet agreed objectives in line with Ministerial objectives and Department policy in order to maximise access to quality and safe services and reduce unnecessary bureaucracy. This should include a clear governance framework to ensure sufficient and appropriate controls are in place;
• Implementing a comprehensive framework for performance management and service improvement that will monitor HSC performance against relevant objectives, targets and standards and provide appropriate assurance to the Department and the Minister about their achievement. Poor performance will be addressed promptly and effectively through intervention and, where necessary, the application of sanctions. An integral part of these arrangements will be the identification and promulgation of best practice to promote consistent service improvement across the HSC;
• Establishing arrangements at a regional and local level that ensures close strategic and operational partnership with key stakeholders both within the HSC and wider public sector in meeting the objectives of the Board and proactively engages and informs local communities and the voluntary and community sectors on the work of the Board;
• Establishing a close working relationship at a regional and local level with the PHA minimising unnecessary duplication and ensuring a seamless approach to the improvement of the health and social wellbeing of all the people of NI reflected in the development of an integrated annual commissioning plan for approval by the Minister;
• Facilitating and supporting Local Commissioning Groups in their role of achieving effective locality based commissioning, managing their performance, and holding them to account so that they can exercise their devolved authority within an effective framework of regional priorities and standards;
• Within the parameters of the Department’s overarching Framework Document, working with other key stakeholders such as the Department, PHA, Trusts and Regulation & Quality Improvement Authority (RQIA) to ensure clarity of responsibility and appropriate provision for the safety of services, the management of critical incidents and service failings and the protection of the public.
• Ensuring that regional priorities – for example programmes for improving cancer services – are integrated into local plans while promoting real delegation to a local level within that framework; and
• Overseeing the agreed publication of performance information.
Local Commissioning Groups
Within the devolved authority of the HSCB, Local Commissioning Groups will be aligned to the boundaries of the existing HSC Trusts though this will remain subject to review pending the outcome of local government reform. They will:
• Improve the health and social well-being of people in the area for which they are responsible;
• Plan and commission health and social care to meet the needs of people in that area;
• Secure the delivery to people in that area of health and social care that is safe, efficient, co-ordinated and cost-effective;
• Improve the availability and quality of health and social care in that area;
• Establish arrangements that ensure close strategic and operational partnership with key stakeholders both within the HSC and wider public sector in meeting the objectives of the LCG and proactively engages and inform local communities and the voluntary and community sectors of their work;
• Contribute to the development of standards, guidance and strategic targets;
• Contribute to the development of regional commissioning plans and local targets;
• Assess local needs and capacity and identify local priorities within the overall strategic outcomes to be achieved;
• Negotiate service and budget arrangements with providers, applying principles of “choice” and “money following service” to determine which providers can provide services most effectively and economically, while ensuring that regional and local targets set by the Minister, Department, the HSCB and PHA are met;
• Put in place strong governance arrangements covering contractual responsibilities, incentives, quality and patient satisfaction to ensure that targets and expectations are met; and
• Contribute to the central data collection and performance information processes.