Government approves Regional Health Areas proposal for the geographic alignment and integration of care across Ireland
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From: Department of Health
- Published on: 5 April 2022
- Last updated on: 15 April 2025
The Minister for Health Stephen Donnelly has today announced government approval for the next steps for the implementation of Regional Health Areas (RHA)s.
RHAs will plan, fund, manage and deliver integrated care for people in their region as geographically aligned, regional sub-divisions of the HSE. They will provide for the integration of hospital and community healthcare services, creating better access to services closer to home.
The establishment of RHAs is fundamental to delivering Sláintecare reform and is in line with the Oireachtas Committee on the Future of Healthcare Sláintecare Report that regional bodies should be accountable for the planning and delivery of integrated health and social care services.
Minister Donnelly said:
“Regional Health Areas will ensure the alignment of hospital and community healthcare services at a regional level, based on defined populations and their local needs which delivers on the Sláintecare vision of an integrated health and social care service. Today’s government decision marries the benefits of a centralised delivery structure with more agile, innovative, and locally-informed decision-making.
“The implementation of Regional Health Areas and the introduction of population-based service planning are changes which will bring many benefits for both patients and staff. Our health and social care workers have been heroic in their pandemic response, putting their own lives on the line to care for patients’ needs time and time again. They now need us to support and resource empowering reforms such as RHAs across the system to make their working lives easier and to maximise their efforts in the care of their patients.”
The Minister continued:
“This will allow for the alignment of services where patients and staff feel safe, supported, and well-informed at all points in their care journey. Our Regional Health Areas will facilitate a community-first delivery model where care is provided as close to a patient’s home as possible. Today heralds an important step to creating a more devolved, integrated, and truly accountable health service, one that is person-centred, logically aligned, and better equips our health and social care professionals to plan and deliver services around the needs of our people today, tomorrow, and into the future.”
Mr Leo Kearns, Chair of the Regional Health Areas Advisory Group said:
“As well as enabling the integration of community and acute care, RHAs aim to empower local decision-making and support population-based service planning. Following today’s government decision, RHAs will enable a devolved service delivery framework with a view to strengthening clear corporate and clinical governance. This will ultimately strengthen our health and social care service, leading to improved patient experience as well as access to healthcare closer to home. RHAs will have a “one budget, one system” approach, with improved accountability and governance, more equitable resource allocation, and strengthened clinical governance.”
Today’s government decision will facilitate the introduction of one population-based budget per region and a clearly identifiable head of health and social care per region, operating as part of a strengthened national health and social care service. These new reporting arrangements will replace existing structures and reporting arrangements. Government also today agreed that existing Hospital Groups and Community Healthcare Organisations will eventually be stood down to facilitate RHA implementation, as recommended by the Oireachtas Committee on the Future of Healthcare Sláintecare Report.
Nominated leads have been already appointed from the HSE and the Department of Health to a joint RHA Implementation Team. This team has responsibility for drafting a detailed RHA implementation plan, and also includes representation from the Department of Children, Equality, Disability, Integration and Youth, in light of the transfer of policy responsibility for disability services.
The RHA implementation plan will include comprehensive and meaningful reform, communication, stakeholder engagement, and a focus on timely delivery that minimises disruption to services and direct costs.
Notes
Regional Health Areas are in line with recommendations made in the Oireachtas Committee on the Future of Healthcare Sláintecare Report (2017), that regional bodies should be responsible for the planning and delivery of integrated health and social care services.
Integrated care is where services, funding and governance are co-ordinated around the needs of the patient, encompassing both acute and community care.
RHAs will ensure the geographical alignment of hospital and community healthcare services at a regional level, based on defined populations and their local needs. This is key to delivering on the Sláintecare vision of an integrated health and social care service.
As well as enabling the integration of community and acute care, RHAs aim to empower local decision-making and support population-based service planning. This will ultimately strengthen our health service and lead to improved patient experience as well as access to healthcare closer to home.
Sláintecare
Sláintecare is the programme with cross-party support that is focused on reforming Ireland’s health services, ensuring people can get the right care, in the right place, at the right time. Sláintecare is the roadmap for building a world-class health and social care service for the Irish people. It aims to deliver universal healthcare and to greatly improve patient experiences through integrating care and forging stronger connections in and across community and acute care. Sláintecare reforms are patient-centred, placing their needs at the heart of the system. Regional Health Areas are an integral part of Sláintecare whereby services will be geographically aligned, making care available closer to home and resulting in more patients being treated in their own communities where possible. Sláintecare aims to give patients equal access to services based on their need, and not their ability to pay.
Regional Health Areas: A Case for Change
There are currently nine Community Health Organisations and six Hospital Groups plus Children’s Health Ireland. These do not align geographically, nor do they overlap in terms of management, clinical oversight, or budgets for defined populations. This significantly hinders the delivery of integrated care. Regional Health Areas involve the full alignment and better integration of health and social care delivery structures within each specific region. RHAs recognise the value of geographical alignment for population-based resource allocation and governance to enable integrated care. This is a key component of how the HSE will organise and deliver integrated health and social care services into the future.
The objectives of regionalisation are aligned with Sláintecare’s overall aims and objectives and are intended to:
1. Increase the integration of community and acute services
2. Introduce a population-based approach to service planning
3. Improve clinical governance
4. Improve corporate governance and accountability
Learn more about the Sláintecare’s Regional Health Areas.
Geographies of the Regional Health Areas
The geographies of the six Regional Health Areas are based on population data including how people currently access health services and how disruption to patients could be minimised, as well as a public consultation. A government decision approved the RHA geographies in July 2019.
