Department of Health, Social Services and Public Safety
The Minister has overall responsibility for the Health Service and is accountable to the public through the Assembly for its performance. His department sets policy on health and social care, public health and the Northern Ireland Fire and Rescue Service (the public safety remit). The department includes the chief officers for medicine, nursing, dentistry, pharmacy and social services, who lead each of their professions in Northern Ireland.
The Ministry of Health and Local Government was formed in 1944, in preparation for the post-war welfare state. It was re-constituted as the Ministry of Health and Social Services in 1965 and was renamed as a department under direct rule. Its current name was adopted in 1999 when devolution was re-established.
Health and Social Care Board
Arranges (i.e. commissions) a range of health and social services for the whole population of Northern Ireland, which are then provided by the health and social care trusts and others in the voluntary, community and private sectors. It also oversees the spending of the Health Service budget: £4.5 billion in this financial year.
The board was established in April 2009 as part of the Review of Public Administration. It replaced the four health and social services boards which had existed since 1973.
Local commissioning groups
Committees of the Health and Social Care Board, which commission services in their areas. There is one LCG for each local health and social care trust area i.e. Belfast, Northern, South Eastern, Southern and Western.
LCGs are responsible for assessing health and social care needs, planning the care to meet those needs and making sure that the care is properly delivered. Members of LCGs are drawn from local government, the voluntary and community sectors, general practitioners, the Public Health Agency and the Health and Social Care Board.
Health and social care trusts
Five health and social care trusts run hospitals, health centres and other care facilities in their respective areas. The geographic areas of the trusts cover the following areas:
• Belfast: Belfast, Castlereagh and some regional services;
• Northern: Antrim, Ballymena, Ballymoney, Carrickfergus, Coleraine, Cookstown, Larne, Magherafelt, Moyle and Newtownabbey;
• South Eastern: Ards, Down, North Down and Lisburn;
• Southern: Armagh, Banbridge, Craigavon, Dungannon and South Tyrone, and Newry and Mourne;
• Western: Derry, Fermanagh, Limavady, Omagh and Strabane.
The five trusts were formed in April 2007 and replaced the previous 17 health and social services trusts. The Northern Ireland Ambulance Service is also a health and social care trust and has a regional remit.
Patient and Client Council
Represents the views of patients (who receive health care), clients (who receive social care) and their carers. The council encourages people using health and social care services to set out their views and make a complaints where the quality of the service is poor. The council was formed in April 2009 and replaced the health and social services councils, which had shadowed the old health and social services boards.
Public Health Agency
Tackles the underlying causes of poor health and aims to reduce health inequalities between deprived and non-deprived areas. The agency was established in 2009 and took on the remit of the previous Health Protection Agency, although the PHA has a stronger focus on improving public health and R&D.
Business Services Organisation
Provides administrative and other support services to the rest of the Health Service. The BSO replaced the Central Services Agency in April 2009 and carries out most of the same functions. These cover legal, procurement, logistics, finance, human resources, audit and IT services.
Regulation and Quality Improvement Authority
Regulates and inspects health and social care services and encourages improvements in service quality, including nursing, residential and children’s homes. Established in 2003.