Transforming Your Care

Older people campaigning

In June 2011, the Minister for Health, Social Services and Personal Safety (DHSSPS), announced that a review of the provision of health and social care would be undertaken.

The Minister when announcing the review said, 'It is clear that the full range of health and social care services is unsustainable in its current form...'

He appointed John Compton, Chief Executive of the Health and Social Care Board (HSCB) to complete the task.  A number of other independent experts were appointed to assist him in this task. The report, ‘Transforming Your Care: A Review of Health and Social Care in Northern Ireland,’ was published on Tuesday 13 December 2011.

What the Report Says?

The Report, 213 pages with 99 recommendations outlines:

  1. The principles for change, which should underpin the shape of the future model of health and social care
  2. The proposed future model for integrated health and social care and
  3. Ten major areas of impact

A) Principles

  • Individuals should be at the centre
  • Outcomes and evidence to shape services
  • Right care in the right place and at the right time
  • Population based planning
  • Focus on prevention and inequalities
  • Integrated care
  • Promote independence and personalisation
  • Safeguarding the most vulnerable
  • Sustainability of service
  • Value for money
  • Technology
  • Incentivise innovation at local level.

 B) Future Model for Integrated Health and Social Care

  • Individuals will have the opportunity to make decisions that help maintain good health and wellbeing
  • Services will be provided locally
  • Services will regard home as the hub of care
  • Professionals will be required to work together
  • Patients will be discharged to local services after specialist hospital services
  • Some specialist services will be provided in RoI and in other parts of the UK.

 C) Major Areas of Care

  • Population health and wellbeing
  • Older people
  • People with long term conditions
  • People with a physical disability
  • Maternity and child health
  • Family and child care
  • People using mental health services
  • People with a learning disability
  • Acute Care
  • Palliative and end of life care.

Structural Changes

The Report envisages a number of structural changes to enable their model of integrated health and social care to be implemented. There will be a major shift to care delivered within people’s homes and a greater access to care in the local community. There will be a shift away from residential care and those who need 24 hour care will be cared for within nursing homes.

Acute hospital services will be re-profiled to mean between five and seven major acute hospitals or networks. There will be an enhanced role for the Ambulance Service and technology will be used as a key enabler.

The report envisages an enhanced role for the independent sector in terms of nursing accommodation and a major reduction in statutory residential accommodation.


To allow the implementation of the new model, funding allocated to health and social care  will be re-allocated as follows:

2011 / 2012 (£3,904m) 2014 / 2015 (£4,105m)
Hospital 41.8% 39.8% (- 5%)
Personal & Social Services 21.8% 22.3% (+ 2%)
Family Health 21% 21.5% (+ 3%)
Community 11.5% 12.5% (+9%)
Management & Other 4% 4%
Transitional Costs
Year 1 £25m
Year 2 £25m
Year 3 £20m

Older People

The section on older people refers to the high level of dependence on institutional and hospital care, and inconsistencies in the quality and range of services available. The Report also details that services are not meeting expectations and highlights that the service focus is on acute events and crises points, with no emphasis on proactive or preventative that can support and maintain the health and wellbeing of older people.

Next Steps

The Report details a roadmap for the successful delivery for the steps needed to move from the current model of care to the new model of care. A Strategic Implementation Plan will describe the planned approach for the delivery of the TYC recommendations and each Local Commissioning Group and Trust will develop a comprehensive understanding of the impact of TYC at Trust level by developing Population Plans. An Implementation and Engagement Plan will set out how the changes will affect users, families and staff.

The Minister and the DHSSPS will lead the programme of change. The Programme Board will be chaired by the HSCB and consist of representatives from the HSCB and the Trusts. The Programme Board will be responsible for steering the implementation through the commissioning process. A number of other bodies will be established to ensure implementation of TYC such as the Expert Panel.

Detail on the Strategic Implementation Plan and the Population Plans for each Health and Social Care Trust is included on the next two pages.

Next page: Strategic Implementation Plan

Contribute to the TYC Consultation by 15 January 2013

Age NI Advice Line:
0808 808 7575

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