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Transforming Your Care: Heralded healthcare shake-up is stuck in first gear, says top doctor

By Victoria O'Hara

Major plans to transform the Northern Ireland healthcare system have cost the taxpayer more than £300,000 but remain stuck in "first gear", a leading doctor has said.

Four years after the Transforming Your Care (TYC) review was published, the health service continues "firefighting", with community-led care - its main aim - grossly underfunded. The claim comes as figures reveal the cost of the original review in 2011 headed by the former chief of the Health and Social Care Board, John Compton.

Although a nursing union has said some innovative work outlined in the TYC "roadmap for change" has been carried out, there has been heavy criticism over the slow pace to implement it fully.

A breakdown of figures made public through a Freedom of Information request revealed the internal staff costs to the Health and Social Care Board was £170,000. More than £90,000 was paid to the private sector for consultancy and project managers. Deloitte was paid £89,019 for the work of the two project managers. McCann PR was paid £8,400. The total payments made to all five expert panel members and chair was £46,753.81. An Omnibus Survey conducted by Ipsos Mori cost £7,800, and £3,000 was spent on venues to host meetings.

Among the main recommendations in the report was that more care is delivered in the home; changing care packages for people in nursing homes; increased role of the GP; and increased role of pharmacy in medicines management and prevention.

Dr John O'Kelly, chair of the Royal College of General Practitioners in Northern Ireland, said that while the health service faced unprecedented pressures, measures that "fly in the face" of TYC, such as a reduction in respite and domiciliary care and minor injuries units, were being proposed by struggling health trusts to balance slashed budgets.

Dr O'Kelly said: "The people involved in the review are highly respected but it certainly seems that their work has been frustrated by the lack of progress.

"We all realised that three years into the process not everything would be implemented, but we are stuck, we are still in first gear."

The SDLP's Fearghal McKinney said it was expected public money be invested in any proposed major policy change - but if it failed to be transformed into action, then it questioned its value.

"We are not getting the results. We had the plan, we had a review team. It should have been able to work, but this shows that this plan has not been implemented." The comments come as A&E waiting times in Northern Ireland deteriorated in the past month.

At the start of January all healthcare trusts here were forced to cancel planned elective surgeries after struggling to cope with the number of patients.

Dr O'Kelly said the RCGP was still supportive of TYC but it was crucial change was introduced and funded properly. "I think where we are now is that we are still firefighting," he said. "We are trying to keep going under quite a stressful environment and I think the financial difficulties within the health service are well-known, and I think one of the things that have suffered is TYC. The plans were to cut back on community services which to me flies in the face of the ideology of TYC."

A spokeswoman from the Health and Social Care Board said: "Integrated Care Partnerships (ICPs) are a key element of Transforming Your Care and a new way of working for the health service in Northern Ireland to transform how care is delivered.

"Seventeen Integrated Care Partnerships have been established and are implementing service improvements in the clinical priority areas. Actual and forecast expenditure in this key TYC initiative to the end of 14/15 year is £6.2m.

"Actual and forecast expenditure on TYC implementation to the end of the 14/15 year is £25.5m, with further investment anticipated in 2015/16 to fulfil approved commitments made this year."

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