Co-operation and Working Together (CAWT), Cross Border Health and Social Care

Countries: Ireland, United Kingdom
Border(s): Ireland-United Kingdom,
- Social inclusion
- Public Services
- Healthcare

CAWT, the cross border health and social care partnership was established 1992 and comprises the border counties of the Health Service Executive in the Republic of Ireland and the Southern and Western Health and Social Services Boards and Trusts in Northern Ireland. CAWT’s mission is to improve the health and social well being of the populations covered by the CAWT region, by working across boundaries and jurisdictions in a way which effectively engages the people, service planners and providers.


  • Health Service Executive Dublin North East, Republic of Ireland
  • Health Service Executive West, Republic of Ireland
  • Southern Health and Social Services Board, Northern Ireland
  • Western Health and Social Services Board, Northern Ireland
  • Southern Health and Social Care Trust, Northern Ireland
  • Western Health and Social Care Trust, Northern Ireland
  • Department of Health, Social Services and Personal Safety in Northern Ireland
  • Department of Health and Children in the Republic of Ireland

Project goals

CAWT Strategic Objectives 2007 - 2013

  • To improve the health and well-being of the population of the island of Ireland with a particular emphasis on the border
  • To continue to have a focus in assisting border areas in addressing their distance from the centre of Government including addressing obstacles to cross border mobility;
  • To acknowledge that the next stage in the development of CAWT requires a change in the strategic emphasis in both geographic and service remit which includes a more integrated approach to health provision on the island of Ireland;
  • To play a facilitating role in the provision of population based island health care and in particular contribute to the debate to achieve enhanced service provision and patient satisfaction;
  • To exploit the opportunities of joint working or sharing of resources particularly through the following:
    - Engagement with the wider European community
    - Engagement with other public sector, community or voluntary initiatives
    - Better engagement with the providers of care.
  • To identify opportunities for co-operation in the planning and provision of services, particularly the sharing of best practice;
  • To promote and facilitate better engagement with users and patients;
  • To seek to influence Government policy in respect of planning and provision of health and social care on a cross border basis and in particular promote cross border mobility issues.

Project activities

CAWT provides a forum for Health Service managers to come together on a range of common issues relevant to their service areas via cross border sub groups. In addition to their main roles and responsibilities within their respective organisations, each member commits time and expertise to cross border activity. These sub groups plan practical activities including research, needs assessment and pilot initiatives to improve cross border services. CAWT’s sub groups have initiated and developed over forty cross border projects to date, many of which have been successful in attracting European funding via the European Union INTERREG IIIA and PEACE II programmes.
CAWT has actively facilitated the transfer of experiences and sharing of ideas with other European cross border regions and countries. For example, CAWT has promoted and participated in the ’Manahealth’ and Europhamili’ programmes, a European management training course for health service professionals managed by the Institute of Public Health, Rennes, France in addition to supporting and participating in HOPE (Standing Committee of the Hospitals of the European Union) and contributing to various European research studies including the Europe for Patient project. CAWT has also supported the Eurogio project managed by the Institute of Public Health NRW.