To ask the First Minister and deputy First Minister, given that reducing health waiting lists was a priority in the Programme for Government 2024-2027, to outline the steps the Delivery Unit has taken to drive progress in this area.

Mrs Little-Pengelly

Supported by a £61 million investment from the transformation fund, the delivery unit has been overseeing the implementation of a transformation project to expand multidisciplinary teams in GP practices. That is a core element of the wider health reforms aimed at strengthening early intervention and prevention, shifting care closer to home and supporting the development of a neighbourhood model of care to take the pressure off our overstretched hospitals. The unit has also had a key role in identifying new transformation opportunities across the public sector with the potential to improve population health and well-being. In addition, it has identified a range of best practice measures to address hospital waiting lists and has explored the implementation of those initiatives with health officials and delivery partners. They include the enhanced triaging of waiting lists; the potential for AI and digital solutions to improve efficiency; and the role of behavioural science in supporting much-needed reform.

Mrs Little-Pengelly

There is a lot of misunderstanding about what the delivery unit is. It is a unit in the Executive Office made up of civil servants. It is a small unit, and it is designed to be small and agile. When we were setting up the unit, we took advice from the experts in delivery units. We spoke to officials in Whitehall about what was happening there, and we spoke to the Welsh First Minister about her delivery unit. We have taken that advice, which is that the units are to be small, agile and answerable directly to the Ministers, who, in this case, are the First Minister and I. The units are also to identify key pieces of work that, they feel, can make the most difference. I often liken the unit to a small tugboat. The unit is small, but sometimes it can genuinely make a significant difference in turning round big, tricky issues, just as the little tugboat can turn a bigger boat around in the harbour. That is what it is designed to do, and it works. It is an official-level group that works with officials on a number of projects. The health waiting list initiative is led by Health — that is understandable and absolutely right — but our officials are there to work with Health officials to identify research and ideas and feed that back to us, and we respond on that to the Executive. That is the structure.

Mr McGuigan

Deputy First Minister, you have mentioned a number of measures and the work by your officials in the Executive Office and the delivery unit. Subsequent to that, what specific actions has the delivery unit taken to reduce waiting lists?

Mrs Little-Pengelly

Again, the delivery unit is designed to work closely with the officials who are taking the lead in the relevant Department. They support them with data analytics, for example, the examination of that data and looking at ideas from elsewhere. We have good people working in our system, but, often, we find that the best people working in the system tend to be the busiest. They have a task, and they are trying to drive that forward. Delivery units are often used because they give a bit of space to look elsewhere and to see some of the ideas that have been implemented in other jurisdictions, which we can magpie and take for possible piloting or implementation in Northern Ireland. We need game changers. The public are, of course, frustrated when they cannot get through to their GP; when they have been sitting on a waiting list for many years; or when they see some of those big issues in our public services. We cannot keep doing what we are doing. We need to do things differently, and we need the good ideas to enable us to do that. That is exactly what the delivery unit is designed to do.

Mr Kingston

Will the deputy First Minister say a bit more about what the delivery unit is, for the benefit of Members but particularly for the benefit of some from the SDLP who, going by some of their recent Assembly questions, do not seem to have a clear understanding of what it is?

Mrs Little-Pengelly

The delivery unit is a new concept for the Northern Ireland Executive and Departments, but it is not a new concept. It is a concept that has been rolled out successfully in many other jurisdictions. Before we set it up, we had conversations at a high level to make sure that whatever structure we put in place was based on the delivery units that have been most effective. It is a challenge for all of us: it is a challenge for every Committee and every Member. If you see a good idea, experience a policy or change or see something being implemented elsewhere that seems to be producing good results, we want to hear about it.

You can feed that in, and we will get our delivery unit to look at that. We need those good ideas and game changers. We must improve public services, which must mean doing things differently and getting better outcomes for the people whom we serve.

Mr O'Toole

Deputy First Minister, we are keen to hear, as Mr Kingston said, about what the delivery unit is actually doing. The unit was heavily trailed in the Programme for Government, so it is legitimate to ask about it. So far today, we have heard that it is both a tugboat and a magpie. I am all for mixing metaphors when it is appropriate, but I want to know exactly what the delivery unit has delivered — no pun intended. You said that you and the First Minister would bring recommendations from the delivery unit to the Executive. How many have you brought, and what have they been?

Mrs Little-Pengelly

As I outlined, the delivery unit works with officials in other Departments. At the moment, it is focused on the nine key priorities in the Programme for Government. However, it is about learning from best practice regarding delivery units. I believe that the Member was involved in London when the delivery unit there was quite successfully rolled out. We have taken the learning from that. It is absolutely key that a delivery unit is not given too many things to look at. It should not be given a top-heavy structure. It is designed to work within the system and for the system, with direct accountability to the First Minister and me. That is the way in which we have set up the delivery unit. It is not about the delivery unit's coming up with an idea, implementing it over the head of another Minister and gaining glory; it is about working collaboratively. One of the big challenges that we have in government is achieving genuine cross-departmental, cross-agency collaborative working. It has been a frustration for much too long. The unit will work across government, and, at the moment, it is focusing on two things: first, supporting the Health Department when it comes to health waiting lists, which is a multifaceted issue, particularly regarding the transformation project; and, secondly, overseeing the transformation and the range of transformation projects.