HSE board meeting minutes 29 January 2025

Present

Mr Ciarán Devane (Chairperson), Mr Brendan Whelan, Mr Aogán Ó Fearghail, Tim Hynes, Ms Anne Carrigy (joined approx. 09:40am), Ms Michelle O’Sullivan (left approx. 1:05pm), Mr Matt Walsh, Ms Lily Collison, Mr Michael Cawley and Mr Kenneth Mealy

Apologies

Dr Yvonne Traynor

In Attendance for Board Meeting

Mr Bernard Gloster (CEO), Mr Brian Murphy (Head of Corporate Affairs), Niamh Doody (CEO Office), Mr Dara Purcell (Corporate Secretary), Ms Niamh Drew (Deputy Corporate Secretary), Ms Rebecca Kennedy (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), Mr Tony Canavan (REO West & North West), Ms Sandra Broderick (REO West & South West), Ms Sara Long (REO Dublin & North East), 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); Mr Brian O’Connell (ND Strategic Health Infrastructure and Capital Delivery); Mr Patrick Lynch (ND Planning & Performance); Mr Joe Ryan (ND Public Involvement, Culture and Risk Management), Ms Sara Maxwell (CEO Office), Mr Kilian McGrane (Director National Women and Infants Health Programme), Prof Pat Nash (Regional Clinical Director, West and North West), Ms Caitríona Meehan (AND Communications), Ms Sheila McGuinness (Director of Access).

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

A Board member advised of their role in a Section 38 agency, but that there was no conflict of interest. No other 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 CEDIY re NSP 2025 dated 17 December 2024
• Letter from Minister for Health re NSP 2025 dated 03 January 2025
• Letters to Minister for Health and Minister for CEDIY re amended NSP 2025 dated 07 January 2025
• Letters to Minister for Health and Minister for CEDIY re Capital Plans dated 09 January 2025
• Letter from Minister for Health re 2024 final approved level of net expenditure dated 20 January 2025
• Letter from Minister for Health re direction regarding children waiting for spinal care dated 21 January 2025

2.4 Minutes of Board meeting

The Board approved the minutes of the Board meeting of 13 December 2024.

3.1 Performance Committee

The minutes of the Committee meetings of 22 November 2024 and 10 December 2024 were noted.

The Committee Chairperson provided an update to the Board on the matters considered at the Committee meeting that took place on 09 January 2025. The Committee discussed the nature of the reporting it will use to fulfil its role and in its reporting to the Board. It was highlighted that the reporting structure should reduce undue burden on the Executive team.

3.2 Strategy and Reform Committee

The minutes of the Committee meeting of 11 December 2024 were noted.

The Committee Chairperson provided an update to the Board on the matters considered at the Committee meeting that took place on 14 January 2025. The Chair highlighted the discussion on risk management and the CTTO’s update on progress in the Transformation Programme. The Committee was also updated on the Patient App and encouraged by the progress presented. The Committee discussed its workplan and agreed that after the March meeting, it would meet quarterly.

4.1 CEO briefing to Board

The CEO provided an update to the Board on the National Children’s Hospital commissioning and a company providing sensors and associated product to the HSE, which the Board discussed at length. It was agreed that the CEO would engage with the Audit and Risk Committee on the basis of his recommended approach, and would provide the Board with a further update at the February 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. The CEO highlighted the work carried out by staff during the HSE’s emergency response to two significant adverse weather events, requiring not only critical service continuity but also in many cases preservation of life. Focused discussions were held on the following areas of the CEO Report:

The CEO reported that Covid-19 did not feature in any significantly increased challenging way during the recent respiratory illness season, with flu and RSV dominating the concern but the uptake of Covid-19 booster does remain a challenge.

In relation to Scheduled Care, the CEO advised that 2024 started the year with 671,373 patients awaiting care, across 3 waiting lists. Total referrals increased by 95,307 (+5.5%) compared to 2023, of this Outpatient (OPD) referrals increased by 74,393 (+6.3%). During the year, the number of patients removed from the waiting list also increased by 73,910 (+4.3%) of this 56,660 (+4.7) related to OPD.

Concerning Unscheduled Care, the CEO advised that Emergency Departments have seen significant pressures by factors including demographic pressures, an earlier onset of flu and adverse weather events. January 2024 saw an unprecedented increase in demand with +16.8% increase in attendances compared to January 2023. The CEO confirmed interventions were made in various ways in respect of capacity and additional measures were also put in place to improve primary care access on evenings and weekends.

The Board noted that NSP as approved by the Board was approved by both Ministers of the outgoing Government. There were some amendments within the range of delegated approval by the Board to the Chair and CEO. The NSP is published, and the Capital Plan will remain for final clarification and publication with the new Ministers.

In relation to Disability Services, the CEO advised that he has been engaged as part of Government formation talks and pending Departmental approval, the CEO intends to bring forward proposals for internal HSE changes in approaches to assessment of need, staffing to include training and career path, tweaking of the delivery model such as to give parents greater agency and confidence in the services.

The CEO briefed the Board on funding and resource challenges concerning Section 38 Hospitals. The efforts by the Minister, Department, HSE Board and the Section 38 Agencies themselves to manage were highlighted and the CEO confirmed that many of the previous weaknesses of systems and controls have been identified and a multi-annual funding approach will be developed. The Board considered that an exercise explaining the basis for respective financial allocations to one Section 38 hospital and one comparable HSE hospital take place and be brought to the Audit and Risk Committee for consideration.

The Board requested that consideration be given to the proposal to adopt activity based budgeting in arriving at the allocations to all hospitals.

Board Strategic Scorecard

The Board noted that all scorecards maintained their rating, except one scorecard, #12 Recruitment and Retention which reported a downgrade in its rating from 4 to a 3. The Board approved the Board Strategic Scorecard for December 2024, reflecting October 2024 data, for submission to the Minister for Health, and Department of Children, Disability and Equality.

M O’Sullivan left the meeting

Director of Access joined the meeting

5.1 Waiting List Action Plan 2025

The National Director Access and Integration introduced the Director of Access to the meeting.

Documentation was circulated in advance of the meeting which outlined the Waiting List Action Plan (WLAP) 2025 which aims to deliver capacity, enhance the reform and support the enabling of scheduled care services to improve access to care for patients. The WLAP 2025 places significant focus on the patients waiting the longest for care and in reducing waiting times for all and includes a set of targeted actions under three pillars: Delivering Capacity; Reforming Scheduled Care; and Enabling Scheduled Care Reform.

The Board was advised that the WLAP 2025 sets out key reform priorities such as optimization of the patient pathway and sustainable care groups. In order to support the achievement of targets set out in WLAP 2025, there will need to be implementation and development of a number of key enabling technologies such as the Integrated Patient Management System (IPMS), the Scheduled Care Dashboard and robotic process automation. It was highlighted that progressing the HSE eHealth agenda continues to be integral to supporting the achievement of improved access to care.

The Board discussed the four overarching targets associated with WLAP 2025 and noted that achieving these targets will be based on increased HSE activity and maximising NTPF commissioning. There will also be ongoing monitoring and oversight of the activity targets set out in National Service Plan (NSP) 2025 at a national and regional level. The Board queried the targets alignment with international standards and the Director of Access confirmed that these are concurrent with best practice and in line with Sláintecare.

The Board queried care pathways and whether there is redesign underway. The Director of Access confirmed this is the case and in 2025, the focus will be on the development of integrated care pathways between hospital and community services, such as Dublin North, Dublin North Central and Tallaght Chronic Disease Hubs, in line with the reorganisation of the HSE into Regional Health Authorities (RHA).

The Director of Access confirmed that WLAP 2025 has been developed and agreed between the HSE CEO and the Department of Health with the support of the National Treatment Purchase Fund (NTPF) and the publication of the WLAP 2025 by the Department of Health is awaited. The Board thanked the ND Access and Integration and the Director of Access for the work completed on the WLAP.

SLT left the meeting

There was no further business. The meeting concluded at 2.05pm.