HSE board meeting minutes 27 June 2025

Present:

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

In Attendance for Board Meeting:

Mr Bernard Gloster (CEO), Mr Pat Healy (ND Services & Schemes), Ms Sandra Broderick (REO Mid West), Ms Kate Killen White (REO Dublin & Midlands), Ms Martina Queally (REO Dublin & South East), Dr Andy Phillips (REO South East), Mr Joseph Duggan (Chief Internal Auditor), Ms Grace Rothwell (ND Access & Integration), Mr Patrick Lynch (ND Planning & Performance), Mr Fran Thompson (Chief Information Officer), Ms Anne Marie Hoey (Chief People Officer), Mr John Fitzmaurice (IHA Manager for Sligo, Leitrim, West Cavan & South Donegal), Ms Niamh Doody (CEO Office), Mr Brian Murphy (CEO Office), Mr Dara Purcell (Corporate Secretary), Ms Niamh Drew (Deputy Corporate Secretary), Ms Patricia Perry (Office of the Board).

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.

2.3 Ministerial Correspondence

The Board noted the following correspondence.

- Letter from Minister for Health re HSE Corporate Plan 2025-2027 dated 25 June 2025

2.3 Minutes of Board meeting

The Board approved the minutes of the Board meeting of 22 May 2025.

3.1 Audit and Risk Committee

The minutes of the Committee meeting of 09 May and Special meeting on 29 May 2025 were noted. The Committee Chairperson provided an overview to the Board on the matters considered at the Committee meetings that took place on 13 and 16 June 2025.

The Board held a discussion on the following areas:

• National Maternity Hospital Final Business Case and the lessons learned from other major health infrastructure programmes including National Children’s Hospital.
• Concern that savings plans have not yet been finalised and are not at the level of detail required. It was agreed that a discussion would be held later in the meeting with SLT members.

3.2 Performance Committee

The minutes of the Committee meeting of 15 May 2025 were noted. The Committee Chairperson provided an overview to the Board on the matters considered at the Committee meeting that took place on 12 June 2025.

The Board held a discussion on the following areas:

• National Performance Report (NPR) noting that work remains outstanding on HR and Disability KPIs.
• R001 Delivery of Care increase in score to reflect greater exposure and action plan to address.
• Challenges facing mental health services and the need to prioritise mental health service funding.

3.3 Strategy and Reform Committee

The minutes of the Committee meeting of 12 March 2025 and Joint meeting of Strategy & Reform Committee and Audit & Risk Committee of 23 April 2025 were noted. The Committee Chairperson provided an overview to the Board on the matters considered at the Committee meeting that took place on 17 June 2025.

The Board held a discussion on the following areas:

• Feedback by the Committee in relation to the Draft People Strategy 2025 - 2027 which has been incorporated into draft.
• Noting that the People Strategy is an internal document and does not reflect wider policy objectives.
• The Board noted the Draft People Strategy 2025 – 2027.

4.1 CEO briefing to Board

The CEO briefed the Board on matters relating to Insourcing and NTPF related matters; and an update on CHI developments.

4.2 CEO Monthly Report

The CEO reported to the Board on a number of the key significant areas as set out in the CEO Monthly Report.

The CEO reported to the Board on Urgent Care, and advised that the national oversight calls have been stood down for July which allows Regions to manage and provide oversight, with national calls being resumed for the August holiday weekend. The CEO advised that he will make an assessment of the level of national intervention required in the pending autumn/winter period. The Board noted the updated position relating to the UEC performance post June bank holiday analysis.

The CEO advised that Scheduled care continues to receive focus with ongoing engagement with the Department of Health. The Board noted the predicted growth demand is more accurate this year however it remains in a position at the end of April where ‘Ons’ exceed ‘offs’ and these impact aspects of performance, the reduction in long waiters continues as do the weighted average wait time.

The CEO reported to the Board that he had concluded his engagements with families and front-line practitioners relevant to children’s disability services, and provided two feedback webinars to parents and staff. The CEO appeared before the Oireachtas Committee on Disability Matters, and provided the Board with his feedback and decisions in a number of matters, including Single Front Door, which will see a central referral and one referral pathway for children’s services which currently operates across three (Primary Care, Disability and CAMHS). The Board noted that models of this are already in place in a handful of areas and that the CEO has mandated Access and Integration to advance this by October 2025.

The CEO advised the Board that agreement in principle has been reached with the Department of Health on the year end position, and engagements with both finance and budget holding senior staff have been held.

The Board held a discussion with the CEO and SLT in relation to financial planning, management, and control. Significant concern was expressed by the Board and the CEO noting that there was just over 6 months left to year end to implement any additional savings measures required, and highlighted the lack of progress in finalising matters relating to reducing forecasted expenditure growth at regional and central level, and the increased savings necessary to reduce I/E based deficit to €224m which is the maximum estimated to be affordable in cash terms.

The Board noted that SLT members are working on their 2025 Savings Plans and documents have previously been shared with the Audit and Risk Committee. The Board noted concern that the Savings Plans have not yet been finalised, are not at the level of detail required, and do not add up to a total possible savings plan which gives the Board confidence as to the required financial outturn. It was agreed that the Chair would write to the CEO requesting visibility of a more detailed tracking of the actions in these 2025 Savings Plans.

The CEO reported to the Board that agreement has been reached with the health service trade unions on arrangements to facilitate the introduction of an extended working day/week (on a 5/7 basis) in the HSE and HSE funded agencies. The Board welcomed that this initiative will facilitate a smoother patient flow and greater levels of discharge in all parts of the healthcare system over a full 7 day week.

The CEO provided a briefing to the Board in relation to employees off duty with pay and advised that significant progress continues to be made but more is needed, both in terms of awareness and correct application of critical HR policies.

In relation to the National Children’s Hospital (NCH), a further meeting of the National Oversight Group with the Department, HSE, CHI and Paediatric Hospital Development Board is due in early July, and the Performance Committee’s visit to the NCH, which will include updates from the key clinical and operational management responsible for the commissioning, is currently being scheduled.

The ND Access and Integration advised the Board of the publication of the Mental Health Commission 2024 Annual Report and outlined the headlines from the report which are overseen regionally by the relevant IHA Manager, reporting in turn to the relevant REOs.

National Performance Report

The monthly National Performance Report (NPR) April 2025 data was presented to the Board. The Performance Committee also reviewed this at its meeting on 12 June 2025. The Board noted the commentary of the Chief Clinical Officer in respect of Q1 2025, which will be submitted to the Board on a quarterly basis, as agreed with the Performance Committee.

The Board approved the April 2025 NPR for submission to the Minister for Health, and Department of Children, Disability and Equality, and noted that once submitted, the NPR will be published on hse.ie.

5.1 Contracts & Properties

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

1. NMH at SVUH Programme - Business Case and Contract Award Decision No.: 270625/26 a. Final Business Case Approval and request the approval of the Contract Award for onward submission to Department of Health and ultimately for Government Decision for the relocation of the National Maternity Hospital to St Vincent’s University Hospital, Elm Park. b. Contract Award for the Pre Services Contract Agreement with the selected contractors while awaiting Government Decision on the contract award and Final Business Case Approval.
2. National Maternity Hospital (NMH) at St Vincent’s University Hospital (SVUH) Programme – Digital Tooling Contract Award Decision No.: 270625/27
3. Proposed lease of additional space at Navan Primary Care Centre, Balmoral Industrial Estate, Balmoral, Kells Rd, Navan, Co. Meath Decision No.: 270625/28
4. Contract Award for HSE’s Climate Action Pilot Pathfinder Project at Clonakilty CNU, Clonakilty, Co Cork Decision No.: 270625/29
5. Award of contract for the Supply & Delivery of 6 in 1 Vaccines Decision No.: 270625/30
6. Award of contract for the Supply & Delivery of a Monoclonal Antibody for Respiratory Syncytial Virus (RSV) Passive Immunisation for Pathfinder Programme 2 Decision No.: 270625/31

6.1 Resource Allocation & Budgeting Strategic report

The CFO presented to the Board a paper for their consideration in relation to the development options for Activity Based Funding (ABF) in Ireland, the advantages and disadvantages of each and asked for the Board to provide any advice / direction to the executive.

The CFO outlined that the 2017 Sláintecare Report sets integrated care as a key objective, sees population-based resource allocation (PBRA) as a means to determine a fair share of the available resource for a geographic population and supports Activity Based Funding as one element of the overall payment models that should be used to distribute funding to the providers of those integrated services.

The Board noted that there are many well recognised risks and benefits associated with implementation of ABF as a method of healthcare funding, which fall under the headings of financial risk, unintended consequences and unrealistic expectations.

An outline of Barriers and Enablers to ABF in Ireland was considered and the Board noted that the implementation of ABF in Ireland has been somewhat limited to date and discussed how it can be addressed for future enablement.

As outlined, the Barriers to ABF include cultural, data, policy and dedicated resources; and Enablers for the further development of ABF in Ireland were categorised as those already in place; those currently in development; and those which will require future decisions. An enabler in progress was highlighted that consists of deep dive exercises currently being undertaken by six hospitals, one per region, with an aim to develop an understanding of their latest ABF benchmarking performance and operation, which are expected to be completed and reported on by October 2025. The Board requested that the report be brought back at a future meeting.

Possible development options for ABF in Ireland were set out, which related to the implementation of ABF in terms of how it would affect the hospital funding process. It was noted that the options were not mutually exclusive and elements of each could potentially be combined, and that it would be prudent to seek international advice on the potential benefits and drawbacks of the approaches before committing to a particular course of action. Advantages and disadvantages of options were considered relating to: Retaining the Current ABF Model; Augment the Current ABF Model; and Move to a Prospective Funding Model.

The Board noted that regardless of the overall form of any future funding model, many of the enablers identified should be seriously considered for implementation or more widespread adoption to maximise the potential for ABF as both a funding and management tool in the Irish healthcare system.

It was agreed that the CFO will provide an annual update to the Board on progress being made, which will be provided as part of the annual process to adopt the service plan, starting with NSP2026 which is expected to be adopted in November this year and will leverage the significant progress being made on the roll out of IFMS.

An update was provided to the Board in relation to the location for a planned surgical hub in the North West.

There was no further business. The meeting concluded at 15.25pm