Skip to main content
Board meeting minutes

HSE board meeting minutes 23 October 2024

A meeting of the Board of the Health Service Executive was held on Wednesday 23 October 2024 at 9:00am, Boardroom, Dr Steevens’ Hospital.

Meeting details

Present

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

Apologies

Mr Aogán Ó Fearghaíl and Mr Kenneth Mealy

In Attendance for Board Meeting

Mr Bernard Gloster (CEO), Mr Brian Murphy (Head of Corporate Affairs), 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 Tony Canavan ( REO West & North West), Ms Sandra Broderick (REO Mid-West), Ms Sara Long (REO Dublin & North East), Ms Kate Killen White (REO Dublin & Midlands), Ms Martina Queally (REO Dublin & South East), Dr Andy Philips (REO South East), Mr Patrick Lynch (ND Planning & Performance), Ms Miin Alikhan (AND Planning)

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

1. Board Members Private Discussion

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

2. Governance and Administration

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 a meeting was scheduled for Thursday 24 October with the Chairpersons of the Section 38 Acute Hospitals to discuss productivity across the hospital system and the work of the Joint HSE/Department of Health (DoH) Productivity and Savings Taskforce.

The Chair noted that the Letters of Determination were due, and also noted that a meeting is to be held with a Board member and the Nursing & Midwifery Director of the HSE and the Chief Nursing Officer in the DoH in November to discuss the topic of nurses working to their scope of practice. The Board noted the response to the Minister for Health in relation to the Medicines Reimbursement Process and Medicines Tracker, and the National Disability Authority (NDA) correspondence received by the CEO, noting that the Chair and a Board member will meet the NDA.

The Chair of the Audit & Risk Committee advised that the Review on the Implementation of Scoliosis and Spina Bifida Action Plans 2022 & 2023 were circulated to members of the Committee and the CEO intends to publish the review following engagement with key stakeholders.

2.3 Ministerial Correspondence

The Board noted correspondence sent and received relating to

  • Letter to Minister for Health re Health Performance Visualisation Platform (HPVP) system dated 27 September 2024
  • Letter from Minister for Health re Ombudsman for Children Report dated 16 October 2024

2.4 Minutes of Board meeting

The Board approved the minutes of the Board meeting of 27 September 2024.

2.5 Schedule of Board meetings for 2025

The Board approved the schedule of Board meetings for 2025.

3. Committees of the Board Briefings

3.1 Audit and Risk Committee

The minutes of the Committee meeting of 06 September 2024 were noted.

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

  • The need to get monthly costs, particularly non-pay costs, down to a level of spend by December 2024 that is consistent with the average monthly cost that the 2024 spend limit supports.
  • The Half Year Protected Disclosure Report for the period 01 January 2024 to 30 June 2024, noting that 50% of the disclosures reported relate to Health & Safety issues and requested that this data be provided to the appropriate Board Committee and the Chief People Officer for information and action where appropriate.
  • The planning approach for the Internal Audit Plan 2025.
  • The report on the provision of major Healthcare Infrastructure programmes.
  • The Committees continued concern relating to the governance arrangements and operational preparedness for the commissioning of the National Childrens Hospital (NCH).

The Board discussed the NCH Governance arrangements which were approved by Government in November 2021 and implemented in April 2022. The programme roles and responsibilities for each of the key stakeholders; National Paediatric Hospital Development Board (NPHDB), Children’s Health Ireland (CHI), HSE and the DoH were outlined.

Under the governance arrangements, the Board noted that the CEO nominated the National Director Planning & Performance as the HSE Lead Director with specific delegated authority for developing and implementing a Programme Assurance Plan, to provide an assurance and challenge function. Also noted under the arrangements, the Secretary General of the DoH Chairs the National Oversight Group, which oversees and monitors the progress of the programme to ensure that it is delivered against the agreed parameters in relation to cost, time, scope, and funding.

3.2 Establishment of new Committees of the Board

The Board approved the establishment of the Performance Committee; the Transformation Committee; Task and Finish Groups (as required); the appointment of Committee Chairs, as well as details of membership, including executive representation.

  • Approval of the Appointment of Performance Committee Chair – Brendan Whelan Decision No.: 231024/41
  • Approval of Performance Committee Terms of Reference Decision No.: 231024/42
  • Approval of the Appointment of Transformation Committee Chair – Tim Hynes Decision No.: 231024/43
  • Approval of Transformation Committee Terms of Reference Decision No.: 231024/44
  • Approval of the Appointment of ARC Committee Chair – Yvonne Traynor Decision No.: 231024/45

A discussion was held regarding the establishment of a number of Board Task and Finish Groups.

Work remains ongoing with regards to the development of the Terms of Reference and workplans and further briefings will be provided at the next Board meeting.

4. Chief Executive Officer

CEO and Head of Corporate Affairs 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, the three Board members identified, Anne Carrigy, Matt Walsh and Michelle O’Sullivan, to be in reserve for potential future functions in regard to University Hospital Limerick (UHL), left the meeting and recused themselves for the duration of the CEO briefing to the Board on the Report from Justice Frank Clarke. On the conclusion of the CEO’s UHL briefing, the three Board Members 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:

Discussions were held in relation to urgent care with October 2024 seeing a return to higher demand in unscheduled care, with attendances for the year to date 8.4% higher than the same period last year. Demand has grown in all sites (-1) with growth rates in one hospital as high as 14%. Acuity rates remain steady with admittance rates at 25.7%, a slight drop from 25.9% last year. This reflects an additional 76 patients needing inpatient care per day. Trolley numbers remain below 2023 levels at 11.3%. However concern remains as the numbers are growing ahead of the expected onset of seasonal viral and respiratory illness. Specific focus and oversight plans are in place to allow for every possibility of achieving the same improvements this winter as last, when set against previous years.

The Board discussed trolley numbers in some of the most challenging sites and the difference in figures, and queried the reasons, noting what has worked well in certain hospitals and the lessons learned should be implemented in other hospitals going forward.

In relation to Disability Services, the Board welcomed the engagement with the CEO and a member of the Board, and were advised that discussions took place with the Secretary General of Department of Children, Equality, Disability, Integration and Youth (DCEDIY) on the need for the approach and models to be fundamentally reconsidered.

The Board discussed the Financial Position and the settlement in June, which included a number of savings and efficiency targets with an acceptance that an addition to the €1.5bn would be required on a temporary basis in 2024. The temporary addition to the €1.5bn was envisaged to be €0.2bn, bringing the revised supplementary to €1.702bn, and the Board noted the cash position of €1.749bn which has been granted in the supplementary.

The Board noted that the employment controls continue to work effectively in respect of full-time employment, and that a body of work is to be completed in Agency staffing. Agency conversion to full-time positions of 500+ positions has been approved to services, with each position realising a 20% cost saving. The CEO advised that the Pay and Numbers Strategy (PNS) continues to be the subject of industrial relations challenges with planned lunchtime protests and ballots for industrial action. The CEO advised that he was satisfied that the current approach and controls are appropriate with REOs having the discretion to fill posts prioritised by them while remaining within their position and spend limits.

The Board requested that in 2025, an employment dashboard by region, heatmap and update on POCC operating within their scope be included in the CEO report.

The Board noted that the Productivity and Savings Taskforce met on the 08 October 2024, and that there is a critical focus on developing the approach to and use of Activity Based Funding (ABF). The CEO advised that he anticipates having an updated position on the organisation’s readiness for and limitations in this particular space. He advised that productivity continues to be a focus in the approach to and understanding of best use of resources across the system.

In relation to organisational change, the CEO advised the Board that the Integrated Health Area (IHA) managers took up their posts on 01 October 2024, and responsibility and accountability has transferred from the Community Healthcare Organisations (CHOs) and Hospital Group (HG) Senior Management Teams to the new Health Region Executive Management Team (EMT) and IHA Managers. The detailed design phase of the future state Integrated Service Delivery (ISD) model is underway, featuring engagements with REOs/IHA Managers and other key stakeholders, including patients and service users, internal clinical and operational representatives, and voluntary providers to progress ISD design. The Board noted that there is an ongoing programme of extensive consultation / partnership working with staff representative groups, and Fórsa engagement continues to be facilitated by Workplace Relations Commission.

The CEO informed the Board of a new online system for Adult Safeguarding which went live for the Safeguarding and Protection Teams in the six health regions for the case management of safeguarding, enabling greater visibility and learning across the system. It will assist approximately 130 staff managing approximately 18,000 concerns annually.

Board Strategic Scorecard

The CEO confirmed that two scorecards, #9 Enhancing Bed Capacity and #15 Capital Infrastructure, reported a downgrade in their rating from 4 to a 3. One scorecard, #8 Prevention and Early Intervention, reported an upgrade in its rating from 3 to a 4, and all other scorecards maintained their rating. The Board approved the Board Strategic Scorecard for October 2024, reflecting August 2024 data, for submission to the Minister for Health and DCEDIY.

5. Reserved Functions of the Board

5.1 Contracts and Properties

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

  1. Contract Approval Request for the bespoke open tender competition for the Supply and Delivery of Ambient Goods to the HSE Nationwide Decision No.: 231024/46
  2. Proposed Acquisition of 1 Adamstown Boulevard, Adamstown, Lucan, County Dublin for a Primary Care Centre Decision No.: 231024/47
  3. Contract Award for Coronary Care Unit (CCU) and Extension at Mater Misericordiae University Hospital (MMUH) Decision No.: 231024/48

6. Board Strategic Focus

Ms Miin Alikhan, AND Planning joined the meeting

6.1 National Service Plan 2025 (Pre-Letter of Determination draft)

The National Director Planning and Performance provided an update to the Board in relation to the approach to the Letters of Determination (LoD) and the National Service Plan (NSP) 2025. The Board were advised that the final LoDs have not been received from the DoH or DCEDIY, but that they are expected. It was noted that tri-lateral engagement between the HSE and both Government Departments has continued to ensure close alignment throughout the development of the NSP.

The Board noted that the final content of the NSP must reflect the direction from both Ministers set out in the LoDs once they are received, and welcomed the work ongoing to ensure that the HSE are in a position to comply with the 21 day legislative timeframe for the approval and submission of the NSP to both Ministers.

The Board noted the four iterations of the Plan’s development which will be brought to the Performance Committee for consideration, and the final draft which will be the version submitted to the Board for approval.

The Board reviewed and discussed the Pre-LoD draft of the NSP presented, noting that it had been prepared to provide an early view of how it is proposed the Plan will be structured and the type of content to be included in the Plan. The approach to the development of the NSP 2025; the Key Performance Indicators (KPIs) and activity targets; Capital Plans and Pay and Numbers Strategy; and the Key indicative timelines was discussed.

The Board requested that the Disability Services aspect of the plan be further enhanced; concept relating to measurable outcomes in diagnostic services to be delivered be broadened; and suggested that that Right Cost be included in the themes. It was agreed that the Board comments would be considered in the next draft.

The Board noted the timelines for completing the NSP within 21 days of receiving the final LoD, and the key milestones and dates for delivery of the plan, including the full Capital Plan (built infrastructure) and ICT Capital Plan, which are currently in development and will, following consideration by the relevant Committees and Board approval, accompany the NSP’s submission to the Ministers.

The CEO advised the Board that the 2025 service planning process is being undertaken in parallel with the development of the HSE’s new Corporate Plan 2025 – 2027, and the NSP 2025 will reflect the first year of delivery of the three-year Corporate Plan (the Plan).

6.2 Corporate Plan 2025 – 2027 (draft 2)

The National Director Planning and Performance advised the Board that since the Board’s September meeting, the development of the HSE’s new Plan has continued, and tabled the second draft of the Plan for consideration by the Board. The Plan presented included previous suggestions by Board members relating to the titles of themes being simplified, and further work had been undertaken to ensure the HSE’s transformation priorities were adequately reflected in the Plan. The Board noted that the version presented contained new sections, a foreword from the Board Chair, an introduction from the CEO and a Setting the Context section.

The Board held a discussion and welcomed the direction of travel in relation to the draft, noting that the Plan’s goal of universal healthcare to provide affordable and timely access to high-quality healthcare for all, and the five ambitious commitments across the next 3 years to work towards achieving this goal. The Board welcomed that the Plan reflected the contributions of over 55,000 services users and staff gathered through stakeholder engagement processes, a detailed analysis of 171 HSE plans and strategies in place, and a review of 13 international healthcare strategies, which were made since the previous Corporate Plan.

The Board provided feedback to the National Director of Planning and Performance requesting that a companion document be made available on the HSE website, which will link readers to all other relevant reports, concept relating to measurable outcomes in diagnostic services to be delivered be broadened; and a section on Board governance to be included in the Plan.

It was agreed Board members would provide further feedback to the National Director Planning & Performance and the penultimate version of the Plan will be brought back for consideration at the November Board meeting

SLT left the meeting

7. Any Other Business and Close

There was no further business. The meeting concluded at 2.55pm.


This is a beta version - your feedback will help us to improve it