HSE board meeting minutes 13 December 2024

Present

Mr Ciarán Devane (Chairperson), Dr Yvonne Traynor, Mr Brendan Whelan, Mr Aogán Ó Fearghaíl, Tim Hynes, Ms Anne Carrigy, Ms Michelle O’Sullivan, Mr Matt Walsh, Ms Lily Collison, Mr Michael Cawley and Mr Kenneth Mealy

In Attendance for Board Meeting

Mr Bernard Gloster (CEO), Mr Brian Murphy (Head of Corporate Affairs), Ms Niamh Doody (CEO Office), Ms Sara Maxwell (CEO Office), Mr Dara Purcell (Corporate Secretary), Ms Niamh Drew (Deputy Corporate Secretary), Ms Patricia Perry (Office of the Board)

Joined the meeting

Mr Damien McCallion (CTTO), Mr Stephen Mulvany (CFO), Mr Pat Healy (ND Services & Schemes), Ms Anne Marie Hoey (CPO), Ms Grace Rothwell (ND Access & Integration), Mr David Walsh (ND Access & Integration), Dr Colm Henry (CCO), Mr Tony Canavan (REO West & North West), Ms Kate Killen White (REO Dublin & Midlands), Ms Martina Queally (REO Dublin & South East), Dr Andy Philips (REO South East), Ms Sandra Broderick (REO Mid West); Mr Joseph Duggan (Chief Internal Auditor); Mr Brian O’Connell (Interim ND Capital & Estates); Ms Sonya Cotter (A/ND Planning & Performance); Mr Mark Brennock (ND Communications), Ms Miin Alikhan (AND Planning)

Minutes reflect the order in which items were considered and are numbered in accordance with the original agenda.  All performance/activity data used in this document refers to the latest information available at the time.

The Chairperson welcomed members to the meeting and provided an update to the Board during their private session.

2.1 Declarations of Interest

No conflicts of interest were declared.

2.2 Chairperson’s Remarks

The Chairperson provided an update to the Board on a number of matters that would be discussed during the meeting. He advised that there was no Board Strategic Scorecard (BSS) tabled at the meeting, and as agreed the BSS will continue to be reported in Q1 2025 for the purpose of closing out reporting on 2024.  

He noted the response issued by the appropriate Regional Executive Officers (REOs) to correspondence received from the Chairs of the Dublin Academic Teaching Hospitals (DATHs) of 13 November 2024, and correspondence received from the Irish Voluntary Healthcare Association of 11 December 2024 was also noted.

An update was provided relating to the Ombudsman Report Scoliosis Treatment, and it was noted that the Chief Clinical Officer is engaging with the relevant clinical leads and REOs and expects to be in a position to report back to the CEO, who will subsequently update the Board.

The Chair provided a briefing in relation to the meeting with the National Disability Association held on 10 December 2024.

2.3 Minutes of Board meeting

The Board approved the minutes of the Board meeting of 26 and 29 November 2024.

3.1 Board Committee membership

The Board noted and agreed the Board Committee membership. Discussion was held with regard to clinical areas and the importance of not losing sight of patients. It was agreed that work would continue on the Committee workplans ensuring that these areas are covered. It was noted that the three Committee Chairs will continue to work closely together.

3.2 Audit and Risk Committee

The minutes of the Committee meeting of 01 and 22 November 2024 were noted.

The Committee Chairperson provided a verbal report on the matters considered at the Committee meeting that took place on 04 December 2024, and highlighted the following areas to the Board.

• Future Health Infrastructure Delivery Model draft report, noting that a further update was received by the Committee Chair. CEO to hold a meeting with Committee Chair in the New Year.
• The HSE Sustainable Energy Authority of Ireland [SEAI] Capital Funding Memorandum of understanding and Funding Agreement was noted.
• The establishment of the new governance arrangements for the National Maternity Hospital at St. Vincent’s University Hospital - Programme mobilisation and Terms of Reference was noted.
• The Capital Plan 2025 and responses to Committee queries received by ND Capital and Estates
• Financial Outlook at 29th November 2024, and the work of the finance team was acknowledgement.
• The signing of Service Arrangements with Voluntary agencies.
• Updates relating to Controls Assurance Review Process (CARP); the Enterprise Risk Management (ERM) Strategic Plan and 2024 Report; and the KPMG Compliance Report Implementation; HSE Internal Audit Plan 2025; Internal Audit Activity Report Q3 2024 (IA Reports and IA Recommendations Monitoring); and the Implementation of Global Internal Audit Standards 2024 & Compliance with the Code of Practice.

3.2 Performance Committee

The Committee Chairperson advised the Board that the Committee is still in forming stage, and that there are plans to meet with the CPO and CCO to ensure the Committee is working effectively in supporting these areas.

He provided a verbal report on the matters considered at the Committee meetings that took place on 22 November and 10 December 2024, and highlighted the following areas to the Board.

Special Meeting 22 November 2024

• The Committee reviewed and provided feedback to the ND Planning and Performance and AND Planning for incorporation into the final draft NSP 2025, which was recommended to the HSE Board and adopted at its meeting of 26 November 2024.

Meeting 10 December 2024

• Briefing on new National Performance Report (NPR) and associated performance management arrangements; and the NPR (October Data), Key Messages Briefing, and Supplementary NPR Report. The Committee requested that a full year performance review of 2024 be provided when possible in Q1 2025.
• The proposed alignment of HSE Principal Risks to Board Committees.

3.3 Strategy and Reform Committee

The Committee Chairperson provided verbal report on the matters considered at the Committee meeting that took place on 11 December 2024, and highlighted the following areas to the Board.

• Driving Change and Transforming Services document, which is tabled under the CEO Monthly Report.
• The National EHR Preliminary Business Case was discussed and the connection between the EHR and Single Health Identifier (SHI) and agreed that the SHI will be considered as a focus area in 2025.
• Corporate Plan 2025-2027 and the Committee agreed to recommend the draft Corporate Plan to the Board for its meeting on 13 December 2024 on the basis that the Disabilities and Workforce sections are strengthened in the next draft.
• The Committee agreed that the Committee workplan should incorporate the Corporate Plan’s 5 strategic priorities.

CEO joined the meeting

4.1 CEO briefing to Board

The Chairperson welcomed the CEO to the meeting.

As previously requested by the CEO to the Chair, Board member Michelle O’Sullivan left the meeting and recused herself for the duration of the CEO briefing to the Board on matters related to UHL and HR Process. On the conclusion of the CEO’s briefing, Ms O’Sullivan rejoined the meeting.

4.2 CEO Monthly Report

Members of the Senior Leadership Team joined the meeting

The CEO reported to the Board on a number of the key significant areas as set out in the CEO Monthly Report. Focus discussions were held on the following areas:

The CEO advised the Board of notice from Fórsa of a mandate for action up to and including industrial action, with similar expected from other Health Unions. He outlined his concern given the Work To Rule adopted prior to the Pay and Number Strategy (PNS) and the effect had on the management of the organisation. He advised that the terms of the Public Service Agreement (PSA) will need to be closely monitored, and adherence to the PNS is continuing.

The CEO reported that the Covid-19, flu and RSV epidemiology continues to be monitored, noting a sharp increase in the position with respect to flu/respiratory illness with an earlier impact on capacity demand anticipated than last year and an expectation of added pressures during the Christmas week based on current indicators. Both REO and direct CEO national oversight of and focus on every aspect of performance to mitigate this for the public and staff is in place. He advised that some advance communication to the public is planned on health in winter, self-care, options other than ED and for those needing to attend hospital to expect delays. The CEO agreed to keep the Board updated.

The Board discussed funding challenges and sustainability in relation to the Section 38 agencies, and noted that regional engagement to understand the challenges for 2025 is continuing with the CFO, REOs and Regional Finance Leads. A meeting with the Chairs and CEOs of each Section 38 acute hospital is planned for January 2025.

The Board discussed Section 38 agencies historical deficits and the opportunity to address these with the new Minister for Health and Minister for Children, Equality, Disability, Integration and Youth at the quarterly engagements with the Chair and CEO.

The Board discussed the commissioning of the National Children’s Hospital and requested that an update be included each month in the CEO briefing to the Board.

Driving Change and Transforming Services

The Board noted the Driving Change and Transforming Services document, and that the proposed approach to prioritisation and strategic oversight of these Transformation Priorities will provide improved assurance and visibility of change to the HSE and the Department of Health.

5.1 Special Legislative Accounts

The Board approved the following special legislative accounts which had been recommended by the Audit & Risk Committee for approval:

• Patient Private Property Accounts (PPP) as required by Health (repayment scheme) Act 2006
• Hepatitis C Insurance Scheme Accounts as regulated by the Hepatitis C Compensation Tribunal (amendment) Act, 2006.
• Long Stay Repayments Account as regulated by Section 18 of the Health Act 2006.
• Long Stay Donations fund as regulated by Section 11 of the Health Act 2006

Board Decision No.: 131224/55

Clarification was sought in relation to the Long Stay Repayments Account, and the CFO will provide further information.

5.2 Contracts and Properties

As recommended by the Audit & Risk Committee for approval, the Board considered and approved the following proposed contracts and properties:

Clarification was sought in relation to items 5.2.i, ii and iv, and the ND Capital & Estates, CFO and National Director Services and Schemes will provide further information.

A/ND Planning and Performance and Planning joined the meeting

6.1 Draft Corporate Plan 2025

The CEO advised the Board that since the Board’s October meeting, the development of the HSE’s Corporate Plan has continued, and tabled the third draft of the Plan, which takes account of previous Board direction, for consideration by the Board.

The A/ND Planning & Performance advised the Board that one of the priorities in developing the Plan, was a requirement to measure both its delivery and impact. In developing measures, work was undertaken with 40+ subject matter experts, which included clinical programme leads and advisors, teams leading on enhanced community care, acute services, disability services, public health, health intelligence, National Productivity Unit, scheduled care, social inclusion, the National Ambulance Service and the DoH’s Performance Management and Research and Analysis Units.

Proposals were outlined to ensure the HSE’s priorities for 2025 which is to develop and implement a more structured approach to the identification, development and implementation of Key Performance Indicators, ensuring there is a clear hierarchy of measurement which allows for the appropriate balance of priority input, process, output, outcome or impact measures.

The Board held a discussion and welcomed the direction of travel, and provided feedback to the A/ND Planning and Performance with regard to strengthening the Disabilities and Workforce sections, and that the Plan remains more strategic rather than operational.

The CEO outlined the timelines for finalising the Corporate Plan, pending any required calibration in line with a new Programme for Government as result of the General Election held on 29 November 2024. It was agreed Board members inputs would be welcomed and the Plan’s current draft content would be socialised with the Secretary Generals of both Departments.

SLT left the meeting

There was no further business.

The meeting concluded at 12.40