With the devolution of political power and the shift towards financial federalism, health care planning, the organisation of health care supply and the development of quality strategies are to a large extent the responsibility of the regions through regional health departments. Beyond its legislative role, the regional level has also executive functions carried out through the regional Department of Health. Based on the Patto per la Salute, the Piano Sanitario Nazionale and on regional health needs, regional governments develop their own regional health plans which are also three-year plans.