Despite ongoing engagement between Fórsa and the HSE on the transition to the six health regions, established as part of Sláintecare, no agreement has been reached on senior clinical reporting relationships as part of the Integrated Service Delivery (ISD) model. 

The establishment of the health regions is to be accompanied by a new ISD model, which is supposed to outline how the health regions and the integrated healthcare areas (IHAs) will operate.  

This new organisational approach was designed to devolve HSE decision-making and allow for regional planning, funding, and delivery of integrated healthcare services, however the union has consistently raised concerns about the lack of engagement and consultation with unions and staff.  

In a letter to the HSE issued last week, national secretaries Ashley Connolly and Linda Kelly sought urgent engagement and again outlined the union’s key concerns, in relation to resourcing, reporting relationships, pharmacy roles in non-acute settings, and the multiplicity of governance arrangements for discipline managers in current proposals. 

The letter also conveyed the union’s position that the ongoing dispute in relation to community health network (CHN) model must be resolved before a model of integrated service delivery can be agreed. 

Head of the health and welfare division Ashley Connolly said: “These issues are of fundamental importance to our members, the very people who keep the health service running day after day. We all want Sláintecare to be a success but that won’t happen if workers’ concerns are put to one side.” 

Linda Kelly said: “Organisational reform can’t be imposed top-down, that never works. Rather the spirit of consultation and engagement that helped develop Sláintecare must be maintained now as we seek to agree functioning models for better service delivery, that will ultimately benefit everyone, from patients to workers across the health service.” 

In an update to members, Ashley and Linda re-stated the importance of strict adherence to the union instruction in place, which advises members not to co-operate with any changes to reporting relationships as part of the ISD transition. If you have any questions in relation to the instruction, you should contact your local branch committee.  

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