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Multi-million pound TYC health reform project 'limited'

John Compton, former chief executive of the Health and Social Board, headed up the Transforming Your Care project which has been criticised by auditors
Seanín Graham

AUDITORS have described the impact of a multi-million pound NHS reform project aimed at overhauling the troubled health service as being "more limited" than originally envisaged.

Transforming Your Care (TYC) - a programme billed as the biggest shake-up of services in over a decade - was set up in 2011 and was due to be rolled out over five years. Its goal was to focus more care in the community and reduce hospital stays.

Northern Ireland Audit Office investigators looked at TYC's management and found that while some progress had been made in community mental health services and rehabilitation of stroke victims, the stalled progress ultimately hampered outcomes.

They note that a key facet was to redirect £83m from the hospital sector into GP and community services but that the initiative was "particularly hampered by financial challenges" that led to health chiefs relying on 'in-year' monitoring rounds.

"To compound matters, many of the Department of Health's bids (for monitoring monies) were unsuccessful," the report states.

"By March 2016, the programme had only realised £28m of the £130m savings anticipated by the original business case."

The report adds: "TYC was to act as a beacon, setting out a shared view on how services would need to change...where home would become the 'hub' of health and social care services.

"...the impact of TYC overall has been more limited and the pace of change not as swift as originally envisaged. In January 2016, the Public Accounts Committee (PAC) said: 'TYC is heralded as the great transformational saviour for health and social care, but the pace of change has been at best mediocre'."

The project was conceived by John Compton, the former head of the Health and Social Care Board, who appointed a dedicated team of staff as well as two private consultancy firms - a move that sparked controversy after it emerged that KPMG and Ernst & Young had been paid £2m for their work.

From the outset, it was dogged by criticism over its output and failure to deliver on the ground.

Major concerns were also raised over why the Board employed costly external consultancy firms to examine public healthcare need when it had more than 550 staff members whose very remit was to assess need.

Fears that the project was doomed came in August 2015 when its high-profile director, Pamela McCreedy, left for a new NHS job - with no-one appointed to replace her.

Auditors conclude that many TYC projects have been "successfully implemented" but point to the "huge opportunity for further improvement" against a backdrop off financial challenges.

The audit report pre-dates the collapse of the Assembly and the current financial crisis gripping the health service in the absence of an agreed budget.

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