Update on Reform


One year on after taking up post as Chief Executive of the Health and Social Care Board, Valerie Watts shares her thoughts on the challenges and opportunities that lie ahead in reforming our services.

Photograph of Valerie Watts, Chief Executive of the Health and Social Care Board.

Valerie Watts, Chief Executive of the Health and Social Care Board.

It’s been over a year now since I took up my post as Chief Executive of the Health and Social Care Board – the organisation which leads on planning and commissioning health and social care services in Northern Ireland.

I knew this would be a demanding role as we are living in challenging times with significant financial instability coupled with the surge in demand on our services owing to our growing and ageing population.

I am acutely aware of the increasing number of people who are experiencing lengthy waits for both assessment and treatment, and the impact this has on their lives.  As I have said before, this is unacceptable, and regrettably waiting times will continue to increase as the money isn’t available to undertake the volume of additional assessments and treatments required to meet the demand for elective services, either within Trusts or in the Independent Sector.

I am reassured however, that Trusts are taking all possible steps to ensure the most urgent patients are prioritised, and that they are continually working to maximise the number of treatments and assessments they are providing from within existing resources.

It’s hearing patient stories that really brings it home to me that we must continue to reform services. We have a finite pot of money, as well as a year on year increase in demand for services – a situation shared by many public services. I fully endorse the widely shared view that we need change and modernisation if we are to ensure we have safe and sustainable services into the future.

Reform isn’t just a myth – it is already happening on a daily basis right across our services.

In terms of the delivery of the models set out in Transforming Your Care, the Board is responsible for delivering 72 out of the 99 recommendations in the Report published in 2011. And since we completed our public consultation in 2013 on how we proposed to take those forward, over half have already been implemented and built into how we plan and deliver services. A lot of progress has been made over the last few years which don’t always hit the headlines!

A range of new service improvements and innovative projects are in progress, and many are highlighted through this eZine, social media, Trust websites and other publications all the time. I have been particularly struck by the progress being made with Integrated Care Partnerships who now have over 25 projects on the ground, including new models of care such as Acute Care at Home and Rapid Response Nursing delivering care closer to home rather than in hospitals.

We have started implementing the Self-Directed Support programme across Northern Ireland and to date, feedback has been great.

The Ambulance Service, working in partnership with Trusts and other providers, are rolling out new pathways, which means patients are able to safely remain at home or be taken somewhere else more appropriate to their needs, such as Minor Injuries Unit.

We can also look forward to seeing the new Community Care and Treatment Centres up and running in the new few years in Ballymena, Lisburn and Newry.

These are just a few examples of reform, and there are many more stories to tell.

One particular service that is really making a difference to people’s lives is Reablement – which enables people to gain or regain their confidence to become independent again, in their own home, after an injury or social crisis.  I’m delighted that over 5500 people started on the programme last year with most being discharged within 6 weeks. This means we can care for people in the comfort of their own home and in many cases enable them to live independently, delaying their need for residential or domiciliary care. This is real reform in action!

We have already invested over £25m in the delivery of Transforming Your Care projects, with a further £15m this year to allow these projects to continue, and a small number of new initiatives. But we need to do much more, in the context of a broad debate about the future of our health and social care system, if we are to address the service, financial and workforce challenges of the future.  The broader political situation has had an impact on the normal monitoring round process, which in turn has had a significant bearing on our ability to invest in services.

Looking ahead to next year, the financial environment is unlikely to get any easier therefore we all need to work together as a system and as a community to ensure that reform remains our priority with service users at the very heart of everything we plan and do.

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