4.1 Audit and Risk Committee
The minutes of the Committee meeting of 12 April 2024 were noted.
The Committee Chairperson provided a verbal report on the matters considered at the Committee meeting that took place on 10 May 2024 as follows.
The Committee were provided with an update in relation to the Health Regions Programme Implementation with specific reference to functions under the remit of the Committee and how they will be structured and populated. The Committee discussed the span of control for both the CEO and the REOs and the Integrated Healthcare Areas (IHA) management structures, and requested that once the structure is finally established, a comparison on the number of people in Senior Management positions (AND upwards) pre and post restructuring be supplied to the Committee.
The Committee were provided with an update from the Deputy Director, Comptroller & Auditor General (C&AG) on the progress to date of the audit for the year ended 31 December 2023 and were
advised that the final audit is ongoing and that there are a number of key account areas where information and explanations were awaited. It was noted at that meeting that the estimated completion date for all outstanding work for submission to the C&AG was 31 May 2024.
The Committee Chair advised the Board that a further update was provided by the Asst CFO since the Committee meeting of 10 May 2024 and that the C&AG’s deadline of 31 May 2024 will now not be met. He advised that the financial statements are ready and final changes to the Statement of Internal Control (SIC) arising from the C&AG are not anticipated to be material. The Committee will meet on 7 June 2024 to review matters and will then make recommendations for final approval by the Board at its meeting on 28 June 2024.
The Committee reviewed and noted documentation relating to the SIC; Operating and Finance Review (OFR); Letter of Representation 2023; and the Chair’s Comprehensive Report.
The Committee received updates in relation to the YTD Financial Position as at March 2024, Supplementary 2023 and noted the March Performance by Health Region.
The Committee had considered the detail of proposed contracts and properties, and recommended approval to the Board.
The Committee was presented with the Q1 2024 Corporate Risk Register Report (CRR), and noted that since January 2024, for a majority of risks, there had been no significant changes noted to risk ratings or key controls and key actions.
The Committee reviewed the HSE Corporate and Operational Strategic Legal Matters report for September 2023 to March 2024, and in the course of reviewing the report, further information on a Section 39 organisation was requested, which was brought to the Planning and Performance Committee meeting of 24 May 2024.
The Committee discussed the high level of legal challenges and consequent legal costs for the HSE with the Assessment of Need process in the disability sector, which requires urgent attention both for financial and service impact reasons.
The Committee received an update in relation to the Primary Care Centres – Operational Lease Model (OLM), and noted the Quarterly Report on delegated authority for property transactions approved between €2m & €10m and low value/nominal CAT 3a transactions for the period of 01 January – 31 March 2024.
The Committee received a report which showed the comparison of contract amounts for major capital projects approved by the Board with the final outturn for those projects, and asked that a similar analysis of projects that are still in progress be conducted, comparing the forecast outcome and the original approval.
The Committee were provided with the Internal Audit Q1 2024 Report (IA Reports and IA Recommendations Monitoring), including Post Audit Client Surveys and Quality Assurance and Improvement Programme. The Committee noted that the result of Q1 2024 audits reported showed a similar unsatisfactory/limited assurance profile to previous quarters.
The Committee were joined by the CPO for the discussion of an IA report with regard to Compliance with HSE/HR Employment Controls and Recruitment Restrictions, and were advised that management had accepted the two medium recommendations in respect to offers of contracts of employment, and that they were being implemented.
The Committee received an update in relation to an Internal Audit Industrial Relations matter.
4.2 People and Culture Committee
The minutes of the Committee meeting of 12 March 2024 and HR Dashboard (March data) were noted.
The Committee Chairperson presented to the Board the amended version of the Terms of Reference, which was approved by the Board. Decision No.: 290524/19
The Chairperson provided a verbal report on the matters considered at the Committee meeting that took place on 10 May 2024.
The Committee were presented with the Internal Communications report which included an update in relation to the current communications activities including the staff communications relating to the Health Regions, the launch of the HSE Menopause Policy with almost 8,000 staff visiting the policy content since the launch in April; the support with the development of communications materials and a communications plan for the HSE Disability Survey; and the HSE Policy for the Prevention and Management of Work-Related Stress.
The HR Bi-Monthly report was presented to the Committee, which included an update in relation to staffing the Health Regions and the HSE Centre, noting the next phase of the implementation plan is the advertisement of the IHA Manager posts.
The Committee discussed the Sick Leave with Pay (SLWP) – Long Covid scheme for HSE employees; the HSE involvement in the Displaced Talent for Europe – DT4E with the recruitment of personnel with skills in Cybersecurity/IT professionals and network field technicians/engineers.
The Committee were provided with an update on the progress of the Recruitment Resourcing and Retention Strategy.
The Committee noted the Internal Management Data Dashboard and requested some changes to the data provided, and the discussion relating to the 2024 Pay & Numbers Strategy was deferred until finalised.
The Committee were briefed on progress in relation to the Health Regions Programme; and with an update on the CRR review, and discussed the draft Q1 2024 CRR.
The Committee were provided with an update on the HSE Staff Disability Survey report findings, noting that 17% of the respondents to the survey have a disability. With continued commitment, developments in training, awareness-raising, policy and communication, the HSE will continue to increase the percentage of its workforce declaring a disability.
The Committee received a summary of the disability workforce for the HSE and Section 38 agencies as reported in the HSE census February 2024. This showed an increase in the last 4 years of 14.7%. The Committee were advised of the actions that are or will have a direct impact on the Disability service, relating to the recruitment and retention of nurses and health and social care professionals in the disability services, talent attraction, engagement and national campaigns.
4.3 Technology and Transformation Committee
The minutes of the Committee meeting of 20 March and 17 April 2024 were noted.
As the Committee Chairperson was absent from the Board meeting, the verbal report on the matters considered at the Committee meeting that took place on 15 May 2024 was deferred.
4.4 Safety and Quality Committee
The minutes of the Committee meeting of 18 April 2024 were noted.
The Committee Chairperson provided a verbal report on the matters considered at the Committee meeting that took place on 16 May 2024.
As it was her last meeting as Chair of the Committee, she expressed her gratitude to the members of the Committee, and to the members of the senior management team.
The Committee discussed the Implementation Plan of the McIlroy Report on Adult Safeguarding, and agreed that timelines need to be included in the plan where possible. The Committee discussed the perceived culture around safeguarding and emphasised the importance of strong professional leadership to improve this as necessary.
The Committee noted the Quality Profile from the March data cycle and discussed the governance of the Quality Profile as the Health Regions are established. It was agreed that the CEO would be invited to speak to the Committee on the proposed governance of the Quality Profile and to outline improvement plans for the indicators which are not showing appropriate improvement.
The Committee were presented with the Patient Safety Together (PST) Evaluation Plan which outlines the work of the PST programme during its first year. The governance of the PST programme was highlighted as key to enable proper growth of the programme and allow its implementation across the Health Regions in both hospital and community care settings, and the Committee expressed its full support for PSTs work to date.
The new CRR was presented to the Committee, and it was agreed that the revision had delivered a better document, which will be more useful going forward.
The monthly Chief Clinical Officer’s report was presented to the Committee, which included a briefing on the National Women and Infants Health Programme (NWIHP) Annual Report 2023; the Organ Donation Transplant Ireland (ODTI) 3-year strategic plan for 10-year service output for Organ Donation and Transplant services nationally; and the HSE Independent Review of Paediatric Orthopaedic Surgery Service at CHI.
The Committee also noted the update provided on the National Venous Thromboembolism (VTE) Clinical Programme; and the HPV Associated Cancers Report from the National Cancer Registry Ireland (NCRI).
The Committee were updated on the National Healthcare Communication Programme (NHCP) which was established in response to the National Care Experience Programme, and aims to improve communication in practice to a professional level of competence as communication leads to positive outcomes for patients, staff and the healthcare system, and that poor communication often leads to complaints and adverse outcomes. The CEO advised that there has been engagement with the NHCP through the ND Communications and the plans to include them in the new centre.
4.5 Planning and Performance Committee
The minutes of the Committee meeting of 19 April 2024 were noted.
The Committee Chairperson provided a verbal report on the matters considered at the Committee meeting that took place on 24 May 2024. As it was his last meeting as Chair of the Committee, he expressed his gratitude to the members of the Committee and to the members of the senior management team.
The Committee noted updates relating to Enhanced Community Care data re Chronic Disease Management and Integrated Care Programme for Older People (ICPOP) discharges; and Genetic and Genomic Medicine Strategy.
The Committee received an update on current HSE media coverage, particularly in relation to University Hospital Limerick and the upcoming Mr Justice Frank Clarke Report.
The Committee were presented with the monthly COO Performance Report and Performance Profile (March Data), and were advised that the interim performance oversight process with the Regions and National services took place in early May.
Key strategic and operational updates were provided to the Committee with a particular focus on Cancer Services. The functioning of Cancer Services under the Health Regions was discussed, including the potential benefits with regard to the creation of a cancer lead role in each region. The Committee noted the update on the National Radiology Review, with the commencement on the development of a 5 Year National Strategic Plan for Radiology Services in early 2024.
The Committee noted the Quarterly Progress Report in relation to Roadmap for Service Improvement 2023 - 2025 Disability Services for Children and Young People (the Roadmap), and discussed the challenges with the rollout/implementation of the Roadmap; the work of the Roadmap Working Groups; the challenges associated with filling the posts required for the implementation of the Roadmap and noted that recruitment and retention is the most significant area for improvement to ensure effective delivery of services across all Children Disability Network Teams.
The Committee noted the Report from the Oireachtas Joint Committee on Disability Matters: Towards harmonisation of national legislation with the United Nations Convention on the Rights of Persons with Disabilities.
The Committee Chair provided a brief on care provision for a certain service user in a Section 39 Organisation which had been highlighted at the Audit & Risk Committee (ARC) meeting, and confirmed that assurances have been provided that they are receiving appropriate care.