HSE board meeting minutes 26 June 2026

Present

Mr Ciarán Devane (Chairperson), Dr Yvonne Traynor (Deputy Chairperson), Mr Brendan Whelan, Mr Aogán Ó Fearghail, Mr Tim Hynes, Ms Anne Carrigy, Mr Matt Walsh, Mr Michael Cawley, Mr Kenneth Mealy, Ms Lily Collison and Mr Patrick Bailey.

In Attendance for Board Meeting

Ms Anne O’Connor (CEO), Mr Damien McCallion (CTTO), Mr Pat Healy, (ND Services and Schemes), Dr Colm Henry (CCO), Mr Ben Cloney (Communications), Ms Anne Marie Hoey (CPO), Ms Emer Moran (Asst CFO), Ms Sara Long (REO Dublin and North East), Dr Andy Phillips (REO South East), Ms Martina Queally (REO Dublin and South East), Ms Sandra Broderick (REO Mid West), Mr Tony Canavan (REO West and North West), Ms Kate Killen White (REO Dublin and Midlands), Mr Brian Murphy (Head of Corporate Affairs), Mr Dara Purcell (Corporate Secretary), Ms Niamh Drew (Deputy Corporate Secretary), Ms Patricia Perry (Office of the Board).

Joined the Meeting

Dr Jennifer Carroll MacNeill (Minister for Health), Mr Patrick Lynch (ND Planning & Performance), Mr Brian O’Connell (ND Strategic Health Infrastructure and Capital Delivery), Mr Gareth Morton (ND Procurement),

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 held a discussion in advance of the meeting with the Minister for Health.

The Chair welcomed the Minister for Health, Dr Jennifer Carroll MacNeill TD, to the Board meeting. A discussion was held on Ministerial priorities, including system performance, accountability, and reform delivery. The discussion covered productivity, finance, legal services, agency conversion, staff bank model, POCC implementation, delayed discharges, urgent and emergency care (UEC). Following the discussion, a number of actions were agreed to advance these priorities, with a focus on performance improvement, governance, workforce sustainability and service capacity.

Minister for Health left the meeting.

The Board held a discussion in private session following the meeting with the Minister for Health.

4.1 Declarations of Interest

No conflicts of interest were declared.

4.2 Chairperson’s Remarks

The Chairperson provided an update to the Board on the Ministerial meetings which took place on 17 June 2026:

• DCDE Quarterly meeting with Chair, CEO, Board member and Minister for Children, Disability & Equality.
• Meeting with Minister for Health re UEC.
• DoH Quarterly meeting with Chair, CEO, Board members and Minster for Health.

4.3 Ministerial Correspondence

The following Ministerial correspondence were noted by the Board:

• Letter from Chair to Minister for Health dated 29 May 2026 re Urgent and Emergency Care
• Letter from Chair to Minister for Health dated 22 June 2026 re Cost Recovery
• Letter from Minister for Health dated 23 June 2026 re Cost Recovery

4.4 Minutes of Board meeting

The Board approved the minutes of the Board meeting of 27 May 2026, subject to an amendment.

5.1 Task and Finish Group HSE Financial Position 2026 and Funding Challenges

The minutes of HSE Board Task and Finish Group regarding the 2025 HSE Financial Position of 22 May 2026 were noted. The Chairperson of the Task and Finish Group (TFG) provided an overview to the Board on the matters considered at the TFG of 25 June 2026.

The Board discussed the need to prioritise non-clinical savings measures while recognising that any reductions affecting clinical services would require careful risk assessment, clear engagement with the Minister and the Department of Health, and a longer-term programme of standardisation and efficiency improvements across clinical operations.

5.2 Audit and Risk Committee

The minutes of the Audit and Risk Committee meeting of 15 May 2026 were noted. The Chairperson of the Audit and Risk Committee (ARC) provided an overview to the Board on the matters considered at the ARC meeting of 19 June 2026.

The Board held a discussion on the following areas:

• The Internal Audit Management System Procurement, welcoming the anticipated lower project cost compared to the initial budget and noted the importance of incorporating this learning into future project planning and budgeting.
• The significant level of procurement non-compliance, including 25% linked to a single supplier, with further investigation requested.

5.3 Performance Committee

The minutes of Committee meeting of 21 May 2026 were noted. The Committee Chairperson provided an overview to the Board on the matters considered at the Committee meeting that took place on 18 June 2026.

The Board held a discussion on the following areas:

• The status of Section 38 Service Arrangements.
• Funding for national programmes and clinical strategies to regional budgets and the consideration with regard to retaining strategic funding under central oversight in 2027.
• Focus on reducing waiting times and improving access to community-based therapy services by prioritising urgent referrals, closely monitoring KPI performance and addressing capacity gaps.

5.4 Strategy and Reform Committee

The minutes of Committee meeting of 23 March 2026 were noted. The Committee Chairperson provided an overview to the Board on the matters considered at the Committee meeting that took place on 19 June 2026.

The Board held a discussion on the following areas:

• One Health Record (OHR) programme which remains under close governance and oversight.

6.1 CEO briefing to the Board

The CEO briefed the Board on several matters in private session.

6.2 CEO Monthly Report

Members of the Senior Management 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.

The CEO briefed the Board on the continued focus on addressing the organisation’s financial challenges through corrective actions, strengthened controls, enforced compliance, and increased accountability to bring expenditure back within approved levels, and the Board discussed the introduction of strengthened national financial, recruitment and workforce controls, including enhanced oversight of pay, agency and overtime expenditure, and cost recovery.

The Board discussed the implementation of enhanced purchase order controls, noting that CEO approval will be required for non-clinical purchase orders above €10,000, with priority clinical orders continuing to be prioritised through IFMS. Members emphasised the importance of robust oversight, effective system controls and monitoring of expenditure to support financial recovery objectives.

The Board sought an update on the proposed Chief Performance and Planning Officer role and the CFO recruitment process, and the CEO provided a progress update on both matters.

The Board noted the progression of plans to transfer Civil Registration Services to the Department of Social Protection, including interim consolidation under a national leadership model within the HSE and the establishment of a joint HSE/DSP Steering Group to oversee transition planning and governance.

The Board noted ongoing industrial relations matters across the National Ambulance Service, Perfusionists, OWTA compliance, Clinical Measurement Physicians and Craft Workers, with engagement continuing through Labour Court, WRC and other established processes.

The CEO advised that the new monthly Performance Review process with Regional Executive Officers (REO) commenced in June, with a focus on delivering the performance improvement targets set out in the REO Performance Agreements.

The Board noted the conclusion of the fourth cycle of pilot regional engagements and the readiness of a revised UEC oversight process, including seven-day monitoring, enhanced national performance reporting, and structured reporting from sites under operational pressure, was also noted.

The CEO advised that the first draft NSP 2027 New Service Developments submission has been submitted to the Department of Health, with priorities focused on capacity expansion, National Children’s Hospital Phase II staffing, and Digital for Care initiatives.

The Board noted that national induction standards for NCHDs have been implemented and that National HR is working closely with the Regions to support the annual NCHD changeover. The Board received an update on preparations, noting that readiness and assurance processes are in place across all sites, with a particular focus on contracting, induction and day-one preparedness.

National Performance Report

The monthly National Performance Report (NPR) April 2026 data was presented to the Board.

The Performance Committee also reviewed this at its meeting on June 2026. The Board approved the April 2026 NPR for submission to the Minister for Health, and Department of Children, Disability and Equality (DCDE), and noted that once submitted, the NPR will be published on hse.ie.

7.1 The National Maternity Hospital (NMH) at St Vincent’s University Hospital (SVUH) Programme: Programme Briefing Post Pre-Construction Services Agreement.

The National Director for Strategic Health Infrastructure and Capital Delivery presented the Pre‑Construction Services Agreement (PCSA) Completion Report and Final Business Case Addendum for the National Maternity Hospital (NMH) at St Vincent’s University Hospital Programme, seeking the Board’s approval for submission to the Department of Health, alongside the Final Business Case submitted in July 2025, to support progression to Approval Gate 3 and the award of the main construction contract.

The Board discussed key project risks, noting that the PCSA process has significantly reduced delivery risk through enhanced design development and programme planning.

The Board acknowledged that the project is not risk free but agreed that proceeding represents the best opportunity to deliver the new National Maternity Hospital, subject to continued close monitoring and oversight of identified risks, and approved the project. Decision No.: 260626/34

7.2 Amendment of Bank Mandate

The Board considered and approved the proposal to update the HSE Bank Mandate to remove Monica Percy, Stephen Mulvany, and Bernard Gloster and add Brendan Byrne, Michael Lane and Anne O’Connor as Main Signatories on the HSE bank accounts. Decision No.: 260626/35

7.3 Contracts & Properties

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

1. 1. 1. Provision and Management of Laundry and Hire of Linen, Curtains, Workwear, Scrub Suits, and the Laundry of Patients’ Personal Clothing, Miscellaneous Items, and Dust Mat Hire Services to the HSE Mid-West Region Decision No.: 260626/36
      2. Outpatient Parenteral Antimicrobial Therapy (OPAT) Compounded Medication Decision No.: 260626/37
      3. National Contract for Monoclonal Antibody for Respiratory Syncytial Virus (RSV) Passive Immunisation for Infants Decision No.: 260626/38
      4. Contract award for the construction of an Enhanced Community Care building on Cavan General Hospital campus Decision No.: 260626/39

8.1 Ministerial Priorities

Finance – agency reduction, procurement reform

The CTTO provided an update on agency reduction and procurement reform, noting that while the HSE remains above the Department of Health agency expenditure ceiling by €46.9m (15.6%), performance is improving, with agency overspend reducing from 17.1% in April to 15.6% in May and agency expenditure falling by €2.9m (4.1%) from April and €5.9m (8.2%) from March. The Board discussed measures to accelerate agency cost reduction, including conversion of agency posts to permanent roles, elimination of off-framework and administrative agency usage, development of a national staff bank, and reducing absenteeism. Members highlighted the importance of securing VAT efficiencies through the staff bank model, with concerns raised that outsourcing could result in an avoidable 23% VAT cost. The CTTO confirmed that no decision has yet been made on the operating model and that options are being assessed to meet the Minister’s September deadline. Board members also discussed the lead time required for savings to materialise, the need for robust workforce planning and safe staffing levels, and the importance of developing a clear business case for a national staff bank, including costs, benefits, governance, vetting requirements and expected financial savings. Overall, the Board noted early positive signs but emphasised the need for sustained focus on agency, overtime, absenteeism and pay controls to deliver the required financial improvements.

POCC implementation

The Board received an update on the implementation of the Public Only Consultant Contract (POCC). Progress was noted in the completion of consultant work schedules and the transition to POCC, with regions directed to review schedules that do not provide for evening and Saturday working. Members discussed ongoing audits to verify compliance with contractual requirements relating to private practice on public hospital sites and emphasised the need for appropriate action where breaches are identified. Concerns were expressed regarding the pace of implementation of weekend and extended-hours services, particularly where supporting workforce and infrastructure capacity remain limited. The Board noted the importance of shared accountability across management and clinical leadership and agreed that greater focus is required on demonstrating measurable patient benefits and service improvements arising from POCC implementation, including enhanced access, weekend discharges, emergency care and diagnostic services.

UEC Reform

The Board noted the briefing, including the conclusion of the fourth cycle of the pilot weekly regional engagement programme and the development of a draft UEC oversight process, which is now ready for implementation. The revised arrangements include seven-day monitoring, a daily national performance report and structured reporting for sites experiencing operational pressure (Red and Amber status).

The Board acknowledged that national performance remains stable and within target parameters, while noting ongoing pressures arising from delayed transfers of care, bed capacity constraints and reliance on surge measures.

During the discussion, members emphasised the importance of the revised oversight arrangements in supporting early identification of emerging pressures and timely intervention. The Board highlighted delayed transfers of care and discharge performance as key contributors to capacity and patient flow challenges and stressed the need for continued oversight of hospitals reporting Red status.

The Board further noted that key risks remain delayed transfers of care, insufficient discharge activity, sustained admission pressures and constrained capacity. While overall performance remains stable, the Board emphasised the need for targeted actions to improve patient flow, maximise capacity, accelerate discharges and support de-escalation across challenged sites, and welcomed the enhanced reporting arrangements as a means of strengthening operational oversight.

There was no further business. The meeting concluded at 3.10pm.