The Northern Ireland heath and social care system has been put under the microscope in a report produced by leading medical bodies.
A new report has said that the Assembly shutdown is a potential threat to long-term, strategic investment in Northern Ireland’s health and social care sector.
The joint report, by The Royal College of Physicians of Edinburgh (“the College”) and The Good Governance Institute, also warns that effective management of health and social care services is lacking and that spending is unsustainable at current levels.
It says that more focus must be placed on innovation and fundamental changes to the health and care system, including savings and investment priorities focusing on workforce development, preventative care, and addressing waste in the system.
While the report welcomes the long standing commitment to the integration of health and care services in Northern Ireland, it highlights concerns that hospital-based care still forms too large a part of service provision, and that community expectations are often tied to the idea of traditional ‘brick and mortar’ hospital buildings.
Strengthening networks in emergency care, chronic disease and long-term conditions should be prioritised to help reduce demand on acute hospital services while improving care coordination, and supporting research and innovation.
Commenting on the report, Dr Albert McNeill (cardiologist at the Western Health and Social Care Trust and Fellow of The Royal College of Physicians of Edinburgh) said: “There is a great sense of frustration among healthcare professionals at the lack of reform and resulting inefficiencies and governance issues within healthcare provision in the province – there has been no effective progress to implement the recommendations of the Bengoa and Donaldson Reports.
“In the past we have had some successful reform. For example, we’ve seen service innovation for heart attack patients through the regional primary percutaneous coronary intervention service. This service has enabled the delivery of an equitable, evidence based and guideline driven service. Unfortunately the absence of political structures and leadership is stifling much needed reform, as was possible even to a limited extent in the past.”
Prof Michael Deighan (Lead for the Quality Governance Collaborative, based at The Royal College of Physicians of Edinburgh) said:
“Northern Ireland is well placed to be an innovator and a leader in European healthcare. Health and social care professionals in the province must have the full backing of politicians from all parties to realise this potential, but it’s important to develop system-wide solutions rather than waiting for greater political stability to deliver progress – we do not know when the Assembly’s devolved functions may be restored.
“But it is of course incumbent on NHS senior management to ensure that effective and measurable governance structures are in place to deliver quality services and quality care. Health and social care trusts and leadership teams must reflect on whether they are asking themselves the right questions in order to bring about the required improvements, and whether they are collaborating effectively with the partners involved in quality service delivery.”
Mark Butler (Director of Development, The Good Governance Institute) said: “Authentic citizen engagement, and the good governance it depends on, should be driving forward population health and health and care services much more than they currently do in Northern Ireland. The critical word here is authentic. Real engagement has consequences. It requires clinical and system leaders to give up some of their power and control in the interests of gaining greater ownership for innovative service change
“Overcoming issues of public trust in leaders, and leaders’ trust of the public is going to be a critical governance dynamic here. There is much for leaders in statutory and voluntary organisations to reflect on in this report.”
The full report is attached and can also be found on the RCPE website.
