Transforming health and social care – what is stopping you?

Last week, colleagues and I attended the Northern Ireland Confederation’s annual conference (NICON) conference just outside Belfast. The opening plenary posed a direct question to delegates: “what is stopping you?”

In conversations throughout the event, there was one consistent theme: the pressure to deliver more and faster doesn’t leave much space for frontline staff to identify better ways of working. Public sector transformation doesn’t lose momentum because leaders lack ambition or plans – it slows because frontline practitioners aren’t afforded the time to reflect, challenge existing practice, and implement different ways of working. 

The health and care system in Northern Ireland has an ambitious transformation plan, Reset, and a lot of energy is going into its delivery. The theme of NICON 2026,  ‘Reset for all, action by all’, emphasised the scale of this endeavour. The plan is grounded in Northern Ireland’s integrated delivery structure in which, unlike in England, regionally based organisations deliver secondary, community and social care on a population-wide basis. 

So, if the health and care system has an ambition, the right structures, energised leaders, and the commitment to transformation… what is stopping systems from going further and faster in the delivery of the Reset plan?  

It’s a question IMPOWER is hearing across the sectors we work with. Partly driven by a revitalised UK government looking to answer big questions, partly driven by conditions on the ground – demand for services continues to increase and resources are ever scarcer. Northern Ireland is in a position to lead the way, going further and faster, creating learning for other parts of the public sector across the UK. But what is stopping Northern Ireland going even faster, is learning how to slow down.  

Since summer 2026, IMPOWER has been working with the Northern Ireland Department of Health and five Health and Social Care Trusts to test new ways of delivering adult social care transformation. What we have seen is that the real innovation often comes from the frontline of public service delivery, but the practitioners who operate there often have the least time to pause, think and innovate.

Our work often involves finding ways to create time for reflection, peer learning, challenge, and support. An hour spent deliberately slowing down can create new insights which helps transformation to speed up. So, what is stopping complex transformation? Maybe it’s the pressure to do too much, too quickly. Maybe slowing down is to key going faster. If you would like to find out more about our work in Northern Ireland, or insights from our work in adult social and health, please get in touch.