1999–2003
People First: Community Care in Northern Ireland 1990
Strengthened the role of Health and Social Care Boards from providers to purchasers, and set out the principles of social care in the context of Northern Ireland’s integrated structure.
Well into 2000 – a positive agenda for health 1997
Set the new goals for the overall health of the nation, including integrated action through proposed partnerships for health promotion centred around local community needs.
Investing for Health 2002
Required all boards to enter into a partnership with a coalition of statutory, voluntary and community organisations for local delivery, with a requirement to draft Health and Wellbeing plans with objectives set over 7-10 years.
2004 – 2009
Review of Public Administration 2005
Proposed alternative options to reduce the number of boards into one single regional strategic Health and Social Care Board, with delivery across 5 to 7 acute trusts, and 15 Local Health and Social Care Groups to replace GP fundholding.
Independent Review of Health and Social Care 2005
Made recommendations around low productivity of the health and social care system, lack of leadership, the need to ringfence social care from acute care, and advocated for a stronger commissioner-provider system.
Health and Social Care Reform Act 2009
Placed a statutory duty on the Department to promote integrated health and social care, and enacted the development of a single regional Health and Social Care Board which would focus on commissioning, financial and performance management of 5 integrated Health and Social Care Trusts. These would hold the responsibility for primary, secondary, and community health care instead of the regional Health Authority. The Act also created a Public Health Agency to work with the Board and with responsibility for health protection and prevention.
2010–2014
Transforming your Care (the Compton Review) 2011
Put forward 12 principles for change and 16 core recommendations under a new model for integrated health and social care, with 10 major areas of care examined. The Health and Social Care Board was expected to lead the transformation programme. Changed role of general practice through working in 17 Integrated Care Partnerships focused on the elderly and long-term care conditions. Implementation developed through local population plans and local commissioning.
Quality 2020 A Ten-Year Strategy to Protect and Improve Quality in Health and Social Care in Northern Ireland 2011
Set out 5 strategic goals in line with Transforming Your Care to be achieved over the decade.
Integrated Care Partnerships 2013
Following the Strategic Implementation Plan’s publication in 2013 the 17 Integrated Care Partnerships were rolled out as networks of health and social care professionals including pharmacists, local government, providers across acute and community services, service users and carers. The ICPs were designed to align to geographical boundaries across the 5 Local Commissioning Groups and cover all general practices, located within the 5 Trusts but with no statutory basis.
The Right Time, the Right Place 2014 (Donaldson Review)
Reviewed quality and safeguarding in the health and social care system and recommended the creation of an independent expert panel to deliver the organisational transformation to embed the vision set out in Transforming Your Care.
2015–2020
Systems not Structures – Changing Health and Social Care 2016 (Bengoa Report)
Review undertaken by an Expert Panel presented to the Department of Health with recommendations to develop Accountable Care Systems which would integrate by agreement and break down professional barriers, without the need for structural reform. It recommended joint responsibility of providers in a given area with a joint budget linked to agreed outcomes, intended to empower existing networks of Integrated Care Partnerships and GP Federations. It also recommended specialist services to be organised around regional commissioning and provider model (rather than local), and primary-care based models similar to the Vanguards in England.
Health and Wellbeing 2026: Delivering Together 2016
Developed in response to some (but not all) recommendations laid out in the Bengoa Report, which acknowledged the limitations of the current structures for effective integration of health and social care delivery. Put forward a number of new models of care to work in a joined-up manner scaled up from existing good practice (e.g. Practice-Based Pharmacists, Acute Care at Home). It also planned to simplify administrative and management structures within the health and social care system.
Power to People: Proposals to Reboot Adult Care and Support in Northern Ireland 2017
Built on Transforming Your Care and Systems not Structures to reform adult social care delivery and join up care delivery better with health services, including plans for co-creation of intermediate care, self-directed support, and single point of contact multidisciplinary teams. Accountability at Department-level for joined up working within local systems.
Future Planning Model – Targeted Stakeholder Consultation 2021
Consulted on a Future Planning Model based on Integrated Care Systems with integration at multiple levels. The consultation proposed to abolish the Health and Social Care Board and replace it with a regional group providing oversight, as well as proposing the creation of 5 Area Integrated Partnership Boards coterminous with the Health and Social Care Trusts.