Northern Ireland

Policy and Legislation in Northern Ireland

Northern Ireland has a devolved government.  This means there is the transfer of certain powers from a central government (Westminster) to a regional government, (Northern Ireland Assembly)  the central government still retaining power over certain areas. 

Northern Ireland Assembly: A guide to the Assembly and Parliament Buildings (Chapter 4 describes the work of the Assembly including the legislative process).

Please note there are now 90 Members of the Legislative Assembly MLAs - previously 108.

The Programme for Government

The Programme for Government is the highest level strategic document of the Executive – setting out the priorities that it will pursue during Assembly mandates, and the most significant actions it will take to address them.

 The next Programme for Government will be from 2016 – 2021. This is the overall plan for government here. In the next PfG  there are three structural issues that they want to shift:

  1. To be citizen-facing – to address directly the aspirations of people and to engage their action
  2. To be outcome-focused – to stop only measuring activity and to start measuring the impact wanting to be achieved
  3. To deliver joined-up government – to act in meaningful partnership across organisations and sectors

Find out more on the Northern Ireland Government website

The Head of the Civil Service is the Senior Responsible Owner for the Programme for Government. The present Programme for Government is still in process due to the political situation in Northern Ireland, though the Draft Programme for Government Framework 2016-2021 is available.

Health and Social Care Policy and Strategy

A Healthier Future: A twenty year vision for health and well-being in Northern Ireland 2005-2025

A 20-year regional strategy for health and well-being, A Healthier Future presented a vision for health and personal social service development in Northern Ireland from 2005-2025. It covered issues such as:

  • promoting health and wellbeing
  • protecting and caring for the most vulnerable
  • delivering services effectively and efficiently with the available resources
  • closer working between  all the people and organisations who influence health and well being

Its intentions were to give the direction of travel for health and social services and it placed a strong emphasis on:

  • promoting public health
  • engagement with people and communities to improve health and well-being
  • the development of responsive and integrated services which will aim to treat people in communities rather than in hospital
  • new, more effective and efficient ways of working through multi-disciplinary teams
  • measures to improve the quality of services
  • flexible plans, appropriate organisational structures and effective, efficient processes to support implementation of the strategy

Department of Health (2004) ‘A Healthier Future:  A twenty year vision for health and well-being in Northern Ireland 2005-2025 Department of Health, Belfast

Caring for People Beyond Tomorrow - a 20-year strategic framework (2005-2025)

In 2005, the former Department of Health, Social Services and Public Safety published Caring for People Beyond Tomorrow - a 20-year strategic framework for primary health and social care for individuals, families and communities in Northern Ireland.

Key aspects of the Strategic Framework were:

  • A service focused on providing comprehensive person-centred care
  • A first point of contact that is readily accessible and responsive to meet people's needs day or night
  • A co-ordinated, integrated service employing a team approach with multi-agency linkages
  • An emphasis on engagement with people and communities about their care and the way services are designed and delivered
  • A focus on prevention, health education and effective self-care

Outcomes envisaged included:

  • Making primary care services more responsive by encompassing a wider range of services in the community
  • Making primary care services more accessible, by way of time to see practitioners, greater number of locations, enabling people to see appropriate practitioners and greater provision of information
  • Developing more effective partnerships and team working across organisational and professional boundaries, as a means of increasing the effectiveness of the services.
  • More proactive engagement with service users about service planning, design and delivery
  • Improved premises and infrastructure, harnessing new technologies and clinical advancements

 

Making Life Better A Whole System Framework for Public Health 2013-2023

Making Life Better 2012–2023 is the ten year public health strategic framework which seeks to create the conditions for individuals and communities to take control of their own lives and move towards a vision of Northern Ireland where all people are enabled and supported in achieving their full health and wellbeing potential and to reduce inequalities in health.

The framework provides direction for policies and actions to improve the health and wellbeing of people in Northern Ireland. The Public Health Agency is the lead agency for implementation of the Making Life Better framework.

Making Life Better has 6 themes:

  1. Giving Every Child the Best Start
  2. Equipped Throughout Life
  3. Empowering Healthy Living
  4. Creating the Conditions
  5. Empowering Communities
  6. Developing Collaboration

Department of Health, Social Services and Public Safety - Making Life Better – A Whole System Framework for Public Health 2013-2023 (June 2014).

Transforming your Care: A Review of Health and Social Care in Northern Ireland (2011)

Transforming Your Care was designed as an overarching road map for change in the provision of health and social care services in Northern Ireland.  A model for the delivery of integrated health and social care services focused on prevention initiatives and earlier interventions, and on promoting health and well-being. It also highlighted that more services should be provided in the community, closer to people’s homes where possible and that there should be more personalised care

 This review proposed a new model of care for Northern Ireland underpinned by 12 major principles:

  1. Individual at centre
  2. Evidenced based services
  3. Right care right place right time
  4. Population- based planning of services
  5. Prevention focus and tackling inequalities
  6. Integrated care
  7. Promoting independence and personalisation of care
  8. Safeguarding most vulnerable
  9. Ensuring sustainability of service  provision
  10. Realising value for money
  11. Maximising use of technology
  12. Incentivising innovation at a local level

 

The Right Time, The Right Place (Donaldson 2014)

Sir Liam Donaldson was commissioned by the Health Minister in 2014 to advise on the improvement of governance arrangements across the HSC. The report set out ten recommendations which refer to a wide range of areas across the health service. Sir Liam Donaldson endorsed the policy behind TYC but recommends the appointment of an impartial panel of experts to deliver the right configuration of HSC services. 

Systems, Not Structures - Changing Health and Social Care - Full Report Date published: 25 October 2016 (Bengoa Report)

An international expert panel to develop a clinically informed model for the future configuration of health and social care was appointed in January 2016 and comprising of local and international members. Their report 'Systems, Not Structures said  that there needs to be re organisation of how things are done and this must be in partnership with the people who use the service and those who work in it. 

https://www.health-ni.gov.uk/sites/default/files/publications/health/expert-panel-full-report.pdf

 

Health and Wellbeing 2026 Delivering together (October 2016)

Health and Wellbeing 2026: Delivering Together is the outworking of the Expert Panel’s recommendations.

The then Minister of Health said in this report that aligned with the aspirations the Executive set out in the draft Programme for Government her overarching ambition was for every one of us to lead long, healthy and active lives. Aims outlined were for a future in which:

  • people are supported to keep well in the first place with the information, education and support to make informed choices and take control of their own health and wellbeing
  • when they need care, people have access to safe, high quality care and are treated with dignity, respect and compassion
  • staff are empowered and supported to do what they do best
  • our services are efficient and sustainable for the future

The aims are to be underpinned by a new model of person-centred care focussed on prevention, early intervention, supporting independence and wellbeing.

The change needed

  • Build capacity in communities and in prevention to reduce inequalities and ensure the next generation is healthy and well
  • Provide more support in primary care to enable more preventive and proactive care, and earlier detection and treatment of physical and mental health problems
  • Reform our community and hospital services so that they are organised to provide care when and where it is needed
  • Organise ourselves to deliver by ensuring that the administrative and management structures make it easier for staff to look after the public, patients and clients

Actions are under three main headings:

  • Stabilisation
  • Reconfiguration and service change
  • Transformation

Annual Commissioning Plan Direction

An annual Commissioning Plan Direction sets out Ministerial priorities, key outcomes and objectives and related performance indicators.

The Health and Social Care Board (HSCB), in conjunction with the Public Health Agency (PHA) then produces a Commissioning Plan. The 2016/17 Commissioning Plan is available online.

Quality 2020 (Nov 2011)

Quality 2020 was launched in November 2011 to create a strategic framework and plan of action that will protect and improve quality in Health and Social Care (HSC), over a 10 year period.

Reform of Adult Care and Support

The Department of Health is currently taking forward a process to reform adult care and support. The reform process is being taken forward in 3 stages: The first was a consultation on the discussion document Who Cares? The Future of Adult Care and Support in Northern Ireland, which has been completed.

As part of the next stage two leading experts in social care were appointed to work with the  Department of Health (Expert Advisory Panel on Adult Care and Support)  to develop proposals for change to the adult care and support system. These experts are working alongside the Department of Health to produce a paper for public consultation in April 2017, which will set out options to put the care and support system on a sustainable footing. Legislation may be required thereafter

The College has responded to the consultation and been involved in the Expert Panel Workshops.

Improving Health and Well-being through Positive Partnerships. A Strategy for the Allied Health Professions in Northern Ireland (2012-2017)

This strategy is based around 4 Strategic Themes

  • Promoting person-centred practice and care;
  • Delivering safe and effective practice and care;
  • Maximising resources for success; and
  • Supporting and developing the AHP workforce

Department of Health and Social Services and Public Safety, (2012-2017) Improving Health and Well-being through Positive Partnerships.

Personal and Public Involvement

Personal and Public Involvement (PPI)

Personal and Public Involvement (PPI)  is a legislative requirement for Health and Social Care organisations as laid down in the Health and Social Services (Reform) Northern Ireland Act 2009. The PHA has responsibility for leading implementation of policy on PPI across HSC.

Management of the Transforming your Care reform programme. Northern Ireland Audit Office Report (11 April 2017)

The report by the Comptroller and Auditor general on the ‘Management of the Transforming your Care reform programme' outlines progress made and identifies a series of factors that need to be addressed in order to increase the pace of transformation and the implementation of more effective models of care.

HSC Structure and Organisations

(Please note the department of Health, Social Services and Public Safety is now named the Department of Health)

Further Reading

Organisation for Economic Co-operation and Development (OECD)  Public Governance reviews (July 2016)  Northern Ireland (United Kingdom): Implementing Joined-up Governance for a Common Purpose AvailableAccessed on 12.04.17

Thompson Dr J. Northern Ireland Assembly Research and Information Service Briefing Paper (June 2016) Transforming Health and Social Care in Northern Ireland – Services and Governance Paper 40/16 Accessed on 12.04.17

Work and health/disability

Enabling Success: A Strategy to Tackle Economic Inactivity in Northern Ireland (2015)

Enabling Success is the new strategy for reducing economic inactivity in Northern Ireland.

The strategy specifically seeks to help the following target groups:

  • individuals with work-limiting health conditions or disabilities
  • lone parents
  • individuals with caring commitments

This strategy recognises that a better integration of health and work services is the key preventative measure to reduce economic inactivity.

‘Supporting Equality Through Inclusive Employment’ An Employment Strategy for People with Disabilities

The ‘Employment Strategy for People with Disabilities’ contains proposals that will help the Department working in partnership with others, to address the difficulties and inequalities that people with significant disabilities are attempting to overcome in employment.

Legislation

Special Educational Needs and Disability Act (Northern Ireland) 2016

Royal Assent was received March 2016.  This represented the first building block in a process which aims to put in place a strengthened Special Educational Needs framework.  The framework has four elements: the Bill, new Regulations, a new Code of Practice and training for school staff and Boards of Governors.

The Mental Capacity Act (NI) 2016

The Mental Capacity Bill received Royal Assent on 9 May 2016. This is a ground-breaking piece of legislation that will fuse together mental capacity and mental health law for those aged 16 years old and over.  The Act introduces, for the first time anywhere, a single legislative framework governing situations where a decision needs to be made in relation to the care, treatment (for a physical or mental illness) or personal welfare of a person aged 16 or over, who lacks capacity to make the decision for themselves.

The DoH are now working towards implementation of the new legislation and the College is included as part of the Reference Group.   The College has been linking with the   Mental Capacity Implementation team as part of this.

It is important that it is noted this is legislation which will impact across other adult services not just mental health. 

The Children’s Services Co Operation Act( Northern Ireland) 2015

The Children’s Services Co-operation Act (Northern Ireland) 2015  aims to improve the well-being of children and young people and places obligations on Departments / Agencies to co-operate with each other in order to contribute to the improvement of outcomes for children and young people. The Act places a statutory obligation on Government to adopt a Children and Young People’s Strategy. The development of the next Northern Ireland Executive Strategy for Children and Young People is currently underway. This will be the overarching framework under which all services provided to children and young people in Northern Ireland and all issues impacting on their lives will sit.

‘The Welfare Reform (Northern Ireland) Order 2015’

Occupational therapists are listed as one of the professions in relation to the “work-focused health-related assessment”.

Personal Independence Payment (PIP)

PIP is a new benefit, replacing Disability Living Allowance (DLA) for people aged 16 to 64 years. PIP was introduced in Northern Ireland on the 20 June 2016. 

The Northern Ireland Law Centre has provided a timeline for welfare reform to help.