Governance structures within health and social care were described as ‘inadequate’ by the Comptroller and Auditor General who also called for ‘urgent action’ to be taken in a report published in September.
Now the Health Department, which admitted that ‘corporate and clinical governance has not been as clear or rigorous as it should have been’ and accepted that ‘improvements must be made’ has revealed how it intends to address the 22 recommendations outlined by C&AG Karen McConnell.
However, the department said that bringing about the changes would take time and so its action plan would ‘span years not months’.
A report published by the department said that since the C&AG’s review, which reflected the governance structures in place in May, that there had already been ‘firm and swift action’ to make improvements.
It said that these improvements included the States moving towards a new target operating model which ‘provides clarity’ as to which departments are responsible for different aspects of health and care services.
Due to this, the Health and Social Services Department has been renamed as Health and Community Services ‘placing a stronger emphasis on an integrated approach to health and care’.
Meanwhile, the report says the senior leadership team had been strengthened through the appointment of a Director General at the department – who replaces the chief officer role and is supported by three group directors. Meanwhile, a senior doctor is now part of the management executive, and so part of decisions at strategic levels.
In the short-term, the report states that to rectify the ‘unnecessarily complex governance arrangements in place’ the department intends to establish a streamlined Health and Community Services Board, which will be responsible for the department’s performance and will provide ‘strategic direction’ as well as formulating strategy.
Consultation on the board, which will be made up of the Health Minister, Assistant Ministers and the executive management, is due to begin this month with the aim for it to come into force early next year.
A good governance handbook for staff ‘which will seek to be a catalyst for change to a more accountable culture across health’ will also be published with the aim it will be rolled out in the New Year.
Other priorities for the department include:
ensuring a more efficient, effective use of limited resources while maintaining a strong focus on quality and safety
creating a more agile organisation by ensuring staff can perform effectively in clearly defined roles
building a strong and healthy culture that encourages challenge and embraces learning
Anthony McKeever, interim Director General for Health and Community Services, said: ‘The criticisms contained in the C&AG report do not relate to the dedicated staff working around the hospital or in community settings.
‘The structures and processes that were found to be inadequate related mainly to “back office” functions and relationships between departments. In future, we aim to ensure these organisational structures and processes reflect the high standards clinical professionals expect of themselves.’