HSE board meeting minutes 31 March 2023

A meeting of the Board of the Health Service Executive was held on Friday 31 March 2023 at 9:00am via video conference.

Present:

Mr Ciarán Devane (Chairperson), Prof Deirdre Madden, Ms Anne Carrigy, Mr Brendan Whelan, Mr Aogán Ó Fearghaíl, Mr Fergus Finlay, Dr Sarah McLoughlin, Prof Fergus O’Kelly, Mr Tim Hynes, Dr Yvonne Traynor and Ms Michelle O’Sullivan

In Attendance for Board Meeting:

Mr Bernard Gloster (CEO), Mr Stephen Mulvany (CFO), Mr Damien McCallion (COO), Mr Dean Sullivan (CSO), Ms Mairead Dolan (Interim CFO), Ms Anne Marie Hoey (ND HR), Mr Joseph Duggan (ND IA), Mr Fran Thompson (CIO), Mr John Ward (CTTO), Ms Eileen Whelan (National Lead Test & Trace and Vaccination Programme), Mr Mark Brennock (ND Communications), Prof Risteard O’Laoire (Director NCCP), Mr Brian Murphy (Head of Corporate Affairs), Mr Dara Purcell (Corporate Secretary), Ms Niamh Drew (Office of the Board).

Joined the meeting:

Mr Mark Kane (AND Capital & Estates)(Item 5.2), Mr Patrick Lynch (ND Governance & Risk)(Item 5.3 & 5.4), Dr Philip Crowley (ND Strategy & Research)(Item 3.2), Ms Yvonne O’Neill (ND CO) & Mr Bernard O’Regan (Head of Op Com Services)(Item 5.1).

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 Board members to the meeting and held a private session to consider the agenda and papers for the meeting.

1.1 Declarations of Interest

No conflicts of interest were declared.

1.2 Chairperson’s Remarks

The Chairperson provided an update to the Board during their private session.

The Board formally noted the resignation of Mr Brendan Lenihan and took the opportunity to acknowledge the work carried out by Mr Lenihan during his time as a Board member and Chair of the Audit and Risk Committee.

1.3 Correspondence

The Board noted correspondence received relating to:

Ministerial Correspondence

• Minister for Health to Chair re HSE Financial Reports dated 28 February 2023
• National Service Plan 2023 - Chair to Minister for Health of 04/03/23
  Minister for Health to Chair of 16/03/23, Chair to Minister for Health of 24/03/23 and Minister for Health to Chair of 25/03/23

Correspondence

• Cork County Council re Owenacurra dated 27 February 2023
• Chair to Chairperson Voluntary Healthcare Forum dated 29 March 2023

1.4 Minutes of Board meeting

The Board approved the minutes of 03 March 2023 National Service Plan 2023 meeting. Feedback was provided regarding the minutes from the 20 February 2023 Board meeting with Minister for Health and 24 February 2023 Monthly Board Meeting, and once amendments were included, the Board agreed to approve both sets of minutes.

Board members held a private session with Mr Bernard Gloster, CEO.

The Chair welcomed the CEO to the meeting. The CEO commenced by thanking the Board for the very kind welcome and the amount of personal time Board members have given to him in advance of his arrival.

The CEO proceeded to report on recent activity and significant items of note since his commencement on 06 March 2023.

He briefed the Board on changes in the management structure which will apply from early April until further and more permanent structural changes can be decided and implemented. The three components to the interim arrangements are;

• Changed EMT focus and frequency.
• Introduction of an interim SLT (Senior Leadership Team).
• Regional Pods (whereby HG/CHO/Enabling and National Services would all collaborate in a Pod relevant to the Region in which they are located).

The CEO recapped on three priority challenges – Access and Performance, Public Confidence and Timely Implementation. He described the lens through which he would want the organisation to focus on all change and that is through Care, Culture and Governance. Two immediate issues that he has taken direct focus on are RHA implementation and the Waiting List Action Plan.

The CEO noted that he has commenced and intends to attend part of the Board Committees as they arise in the calendar, and this will contribute to his assessment of how the Executive can best engage for the busy agenda in the months and years ahead.

The CEO discussed with the Board a number of changes to the reporting processes and engagement between the Executive and the Board (including at Committee level). Following a discussion on the format of the CEO monthly report to the Board, the CEO agreed he will present the report in a revised format for the April meeting and then take Board members feedback.

He briefed the Board on engagements with the Department of Health and noted the opportunities for the HSE to further build relationships with the Department.

The Board welcomed the engagement with the CEO noting his proposals and suggestions which were supported. Board members took the opportunity to raise queries and questions with the CEO on a range of areas and matters. The Board agreed and supported his proposals as the correct direction of travel for the organisation.

EMT members joined the meeting

3.1 CEO Report

The CEO thanked EMT members for their welcome to him since his commencement as CEO, and acknowledged Stephen Mulvany for his period of time as Interim CEO.

The Board reviewed and discussed the key aspects of the CEO monthly report and supporting papers, including the Board Strategic Scorecard Report, which had been circulated prior to the meeting.

Reconfiguration of Services at Our Lady’s Hospital Navan (OLHN)

The CEO informed the Board that the OLHN Reconfiguration National Working Group has met on a number of occasions to review the impact of the changes made and to plan out the final reconfiguration step, which will also allow for the evaluation of the governance arrangements and processes for repatriation of patients across sites. The Working Group had met on 30 March 2023, and a final report on the impact of the change is being prepared for the end of March, and will be circulated through the Safety & Quality Committee, with a target date of 2 weeks.

The Board discussed their concerns with the pace of implementation of the agreed reconfiguration plans, and noted that their primary concerns remain patient safety and the commitment to the full reconfiguration of services in OLHN to a Model 2 hospital. It remains the Boards position that the overall risk to patient safety in OLHN remains high.

The CEO advised the Board that once the final report is received from the Working Group, he will then engage with the Minister for Health further.

Cervical Check

The CEO provided the Board with an update in relation to an issue which arose in relation to the Coombe Hospital Laboratory services, which have now paused HPV and cytology sample processing for Cervical Check while it completes its final accreditation documentation, as required by the Irish National Accreditation Board (INAB). With sample processing at the Coombe Hospital currently paused, all Cervical Check samples are being tested in Quest Diagnostics Inc. in the US. The Board noted that women will continue to get their results within the usual timeframe, and a resolution to submit the outstanding documentation to INAB will be in the coming weeks.

Transgender Model of Care

The Board welcomed and discussed the Transgender Model of Care report previously circulated, and were advised that the review of the implications of the Interim Cass report for the provision of Gender Identity Services for Ireland had been completed by the National Clinical Director for Quality and Patient Safety on behalf of the Chief Clinical Officer. The report outlines how it applies to clinical pathways from Ireland and pays particular focus on HSE pathways of referral and any improvements that should be considered to strengthen and standardise, ensuring safety and best practice, and outlined the recommendations made by the review.

The Safety and Quality Chair noted that this item had been raised and discussed at the Safety and Quality Committee also and gave an overview of the Committees discussion.

The Board highlighted the growing importance of this service, and the need for Clinician leadership and stressed the need for a Model of Care that is being developed to reflect the evolving scientific and clinical evidence base, which informs the work on understanding and meeting the health and social care needs of children and young people who express gender incongruence or dysphoria.

The Board noted and welcomed the inclusion of the service user’s voice, and requested that it is vital that this is maintained when the Model of Care is fully developed.

Test & Trace Transition Plans

The National Director, Test, Trace & Vaccination advised the Board that work is progressing to implement the final changes of the clinically led model in conjunction with Public Health by reviewing communications, contact tracing, ICT, 3rd Party contractors, laboratories and logistics arrangements, and outlined the key transition activities included in the CEO report. A further update will be available at the next Board meeting.

The Board discussed the update presented in the CEO report concerning Winter Viruses and noted that it was focussed on the acute side, with no reflection on long covid and the impact on staff, and requested that information be made available to the Board on these areas, and the importance of taking the learnings from the Covid pandemic and using them to understand and support emergency planning going forward in developing a Pandemic Handbook for the future.

National Service Plan 2023

Further to the Minister for Health’s letter of 16 March 2023 confirming the approval of the HSE National Service Plan 2023 (NSP 2023) subject to amendments, the final versions of the amended NSP 2023, the amended 2023 Capital Plan for Buildings and Equipment and the ICT Capital Plan (unchanged version) were circulated to the Board. The Board adopted the amended NSP 2023, the amended 2023 Capital Plan for Buildings and Equipment and the ICT Capital Plan 2023 and these were submitted to the Minister for Health on 24 March 2023, and confirmation of the Minister’s approval was received by the Chair on 25 March 2023. Decision No.: 310323/25.

The Board acknowledged the work that had been completed by the CEO/EMT and Finance Division to finalise the plan.

Finances YTD

The Board discussed the initial draft revenue financial position at the end of February 2023. The overall core deficit indicates an increased deficit in acute operations of €146m, offset by surplus in community €26.5m, other operations €29.9m and demand led of €1.8m. The CEO advised that Board that the financial information is currently under review and is being brought to the Board on that basis, and that projections for the rest of 2023 will be better informed when the Q1 figures are finalised later in April, and will be brought to the Board at their meeting in May 2023. The Board noted that an updated Letter of Determination (LOD) is expected to be received from the Department of Health in the coming days, and will be circulated to Board members once received.

Turnover 2022

The Board considered the 2022 Turnover rate of 10.2%, which shows significant increases over recent years, and queried what is a healthy attrition rate of staff leaving the HSE compared to other organisations. The ND HR advised the Board that this increase coincides with the re-opening of travel for emigration together with the recommencement of delayed decisions to retire or leave, has resulted in an increase in the turnover rate by 2.5% to 10.2% over the previous year, and that Scorecard 12 Recruitment and Retention for 2023 sets out the development of quarterly Turnover reporting to include the reasons for staff turnover, with the projected completion timeframe for this new development set out as Q4 2023. The People & Culture Committee will continue to receive updated reports at their meetings going forward.

3.2 Board Strategic Scorecard 2023

The CEO presented the March Board Strategic Scorecard (BSS) 2023, including January and February data, as circulated prior to the meeting.

The Board noted that the overall average rating on the eligible 20 scorecards is 3.25, and 99 out of 99 out of 124 KPIs have monthly target profiles, with 75% of the 99 reported on in this period, due to the lack of available data until late March / early April.

A discussion took place concerning Scorecard 2 Unscheduled Care (USC), with the Board noting their concern with regard to the Rating Scale of 1. The CEO advised the Board that the immediate impact on USC is the delayed transfers, and that the CEO and COO have held discussions with regard to refocussing on this issue, but that it will hold a challenge for services throughout the year.

The Board noted the recruitment and retention challenges, including the availability of skilled resources, were identified as significantly impacting performance across eight scorecards including USC, Reform of Disability Services, Reform of Mental Health Scorecard and Prevention and Early Intervention.

The Board approved the BSS for March 2023, reflecting January and February data, for submission to the Minister for Health.

4.1 Audit and Risk Committee

The minutes of the Committee meeting of 10 February 2023 were noted and Board member and Audit & Risk Committee (ARC) member Michelle O’Sullivan, in the absence of the Committee Chair, provided a verbal report on the matters considered at the Committee meeting that took place on 24 March 2023.

Ms O’Sullivan advised the Board that the Committee reviewed and noted 3 briefing papers relating to Cost of Care of Publicly Managed Beds; Ethics Disclosures (management assurance re compliance with SIPO Returns and related matters) and the Memorandum of Understanding with the Charities Regulator, which had all been considered previously by the Committee.

The CEO, Stephen Mulvany, and Board members Tim Hynes & Dr Sarah McLoughlin joined the meeting for the discussion of potential advices by ARC to the Board re NSP funding including budgeting and performance reporting 2023 on the NSP 2023, and the advices from the Committee are included in the ARC section of the Board papers, previously circulated.

The Committee reviewed and approved the final draft of the Protected Disclosures Annual Report 2022, which is a statutory report that has to be published by 31 March each year.

The Board were advised that the Committee reviewed and recommended to the Board the Quarter 4 Corporate Risk Register; the final draft of the HSE Enterprise Risk Management Policy and Procedures 2023; 3 papers concerning banking arrangements and the 1 st draft of the Annual Financial Statements which are all included under the Reserved Functions for the Boards approval.

The Committee received a number of updates in relation to Health Budget Oversight Group, Report on 2022 Review of Effectiveness of System of Internal Control within the HSE, Controls Assurance Review Process, Corporate Procurement Plan June 22 – oversight of progress against deliverables and Progress of self- assessment of non- compliant procurement 2022, which will continue to be on the Committee’s agenda.

An update was received by the Committee from the ND IA, and presented to the Committee was an ICT Audit briefing from Mazars which provided an annual update on ICT Audit activity and an update on the present regulatory environment pertaining to IT Audit and IT Audit trends and risks.

The Committee noted the revised version of the Programme Assurance Plan of the New Children’s Hospital - Governance Paper in relation to the positioning of the Board and ARC in the Plan, and also discussed Owenacurra, particularly in relation to the management controls of taking capacity out of the system and agreed that a further discussion would be required on this, which would include the COO.

The Committee noted a paper presented by the CSO, and considered the position in relation to the need to increase inpatient accommodation across the acute hospital sector nationally over the remainder of 2023 and 2024.

The Committee considered the existing thresholds for property transactions requiring EMT/ARC/Board approval, and recommended an amendment to these thresholds and also considered the detail of 7 proposed Property Transactions, which they agreed to recommend to the Board which will be discussed later in the Board meeting under Reserved Functions.

4.2 People & Culture Committee

The minutes of the Committee meeting of 13 January 2023 and HR Dashboard were noted and the Committee Chairperson provided a verbal report on the matters considered at the Committee meeting that took place on 10 March 2023.

The People & Culture Committee Chairperson advised the Board that the CEO was in attendance for some parts of the Committee meeting. The Committee received an update on the progress of the Regional Health Areas, and that RHA high-level functional design is now substantially complete, and further work will take place over the coming weeks across Operations, Strategy and Clinical to agree detailed functions and required structures, and the recruitment of the 6 RHA CEOs will be progressed through the Public Appointments Service when sanctioned. The Committee discussed the importance of the branding of the RHAs.

The Committee Chairperson advised the Board that the new public-only Hospital Consultant Contract is in place since the 8 March 2023, and the Committee were provided with an overview of the overall contract and informed that the Local implementation groups have been set up in each CHO and Hospital Group. Also following on from a Committee request at the January meeting the Committee were provided with data on staff compliance with mandatory training, and welcomed high levels of improvements in some areas, but held discussions regarding the low levels of compliance within the areas of cyber security training. The Committee will be further briefed at their next meeting.

The Committee were updated on the status of the continued roll out of NiSRP with successful go live in the South for 18,000 staff, and noted that a Business Case is now in development which will establish the delivery to all Section 38 Agencies. The Committee also reviewed and discussed the data in relation to their request for a Pay & Conditions comparative benchmarking exercise across other jurisdictions.

The Committee were provided an update on the HSE Corporate Risks Q4 2022 report in relation to the three corporate risks assigned to the Committee. The Committee welcomed a presentation from HR officials of CHO Midlands Louth Meath, and Dublin South, Kildare & West Wicklow and the Director of HR Saolta University Health Care Group with regard to some of the supports available to staff which enhance staff morale and service delivery.

4.3 Planning and Performance Committee

The minutes of the Committee meeting of 17 February 2023 were noted and Committee Chairman provided a verbal report on the matters considered at the Committee meeting that took place on 22 March 2023.

He advised that the topics discussed were similar to that of the February meeting and comprised of the ‘Roadmap for Service Improvement of Children’s Disability Services 2023 – 2025’ and the Disability Services Board Paper, which is the subject of today’s ‘Board Strategic Focus’. He advised the Board that the Committee had extensive input into the Roadmap and ongoing communications with the COO and officials, and that they would continue to discuss this very important subject of Progressing Disability Services until it is resolved.

The CEO advised that the Board that he is meeting with the Minister of State for Disability at the Department of Children, Equality, Disability, Integration and Youth (DCEDIY) in the coming weeks, and the policy direction of the Disability Roadmap would be made clear after this meeting.

4.4 Safety & Quality Committee

The minutes of the Committee meeting of 10th February 2023 and the January Quality Profile were noted and the Safety and Quality Committee Chairperson provided a verbal report on the matters considered at the Committee meeting that took place on 24th March 2023.

The Chair advised that the “Patient Safety Strategy (PSS) 2019 – 2024 Progress update on delivery of the strategy commitments” was presented by the NQPS Leadership team and an update on the Patient Safety Bill was also provided. The Committee considered if the six key commitments of the Patient Safety Strategy should form the basis of the Committees work plan themes for the remainder of the year.

The Chair advised that the Clinical Lead provided a Programme overview of the NCP ‘People with Disability’ (NCPPD) Programme and the HSE Lead for Open Disclosure presented a summary of the key developments from the HSE Open Disclosure Programme 2022, as outlined in detail in the Annual Report for 2022.

The Chair advised that the Quality Profile from the January data cycle was considered and that a discussion was held about the length of timeframes that are set in metrics. The ND Quality and Patient Safety advised that targets are based on best practice and consider service limitations.

The National Clinical Director, Integrated Care, Clinical Design & Innovation provided an update on the National Clinical Programme from the perspective of Priorities, Risks/Challenges and Modernised Care Pathways and an overview of scheduled Care Modernised Care Pathways was provided. The Chair reported that it was advised that an Integrated IT system was due to go to tender at the end of 2023/start of 2024.

The Chair reported that the Chief Clinical Officer report included an update on winter viruses and advised that Covid 19 activity remains stable and low. Updates were also provided on NSS and CervicalCheck, Our Lady’s Hospital Navan, Cariban and the administration of intravenous Antibiotics in Residential Care.

The Chair briefed the Board on an NiRP report which was commissioned in August 2020 relating to an elderly resident of a HSE nursing home. NiRP made six recommendations and the ND Community Operations provided the Committee with an update on them. The Committee agreed to a detailed presentation on Adult Safeguarding April.

4.5 Technology and Transformation Committee

The Committee Chair advised that there was no March meeting of the Technology & Transformation Committee.

The Chair advised that the Committee is due to hold a workshop on 13 April to discuss the development of the Transformation Roadmap and extended an invitation to members of the Board to attend the workshop. The scope of the workshop is to review the key existing transformation programmes in the context of how they contribute to the strategic priorities of the HSE, the risks associated with their implementation, and the dependencies that they have on other initiatives and enablers. In preparation for this workshop, PwC are engaging with a Reference Group of senior stakeholders, as well as the owners of the transformation programmes concerned.

The CTTO advised the Board that the CIO & IT Leaders Awards 2023 were held on Thursday 30th March, and the HSE won an award under Crisis Leadership for the HSE Ukraine Data and Informatics project.

5.1 Proposed Changes to Board Approval Thresholds for Property Transactions

The CSO presented to the Board for consideration and approval the proposed changes to Board approval of thresholds for property transactions which had been discussed and recommended by the ARC at their meeting on 24 March 2023. He outlined that the paper sets out the recommended changes in relation to certain property transactions and delegation of authority in this regard by the Board.

The Board reviewed the papers and noted that the proposed changes to Board approval arrangements will help streamline Board processes and support more responsive and efficient implementation of transactions.

The CSO outlined to the Board the proposed changes:

1. The increase to the Category (CAT) 3 threshold for property transactions from €2m to €10m.
2. Removing the requirement for Board approval of a subset of CAT 3A transactions, specifically those which relate to property disposals (freehold and leasehold) at nominal value to charities, approved housing bodies or local authorities, subject to the requirement that such transactions relate to the objectives of the HSE and the delivery of Health and Social Care.

The Board noted ARC’s request that as part of these changes, that the HSE Capital & Estates will issue a summary report on transactions approved between €2 - €10m and low value/nominal CAT 3A transactions to EMT and ARC on a quarterly basis, which was agreed by the CSO.

The Board considered and reviewed the proposed changes and agreed to approve the Proposed Changes to Board Approval Thresholds for Property Transactions, with a caveat of the Board reviewing again after a year. The CEO advised the Board that he is reviewing the process of ARC reviewing projects before coming to the Board. Decision No.: 310323/11.

5.2 Properties

The Board approved the following property transactions which were recommended by the Audit & Risk Committee:

1. Proposed lease of Primary Care Centres at Glanmire PCC, Glanmire, Cork Decision No.: 310323/12
2. Development of a Cancer Centre at Galway University Hospital and Annex Decision No.: 310323/13
3. Development of new Emergency Department at Beaumont Hospital and Annex Decision No.: 310323/14
4. Infrastructure to support the development of a Major Trauma Centre (MTC) at The Mater Misericordiae University Hospital; Strategic Assessment Report Decision No.: 310323/15
5. Development of New Acute Ward Block, Tallaght University Hospital; Strategic Assessment Report Decision No.: 310323/16
6. Development of 95 Bed Acute Ward Block at Beaumont Hospital, Strategic Assessment Report. Decision No.: 310323/17
7. Lease Acquisition Building, Galway. Decision No.: 310323/18

5.3 HSE Corporate Risk Register Q4 2022 - End of Year Report

The CRO presented the HSE Corporate Risk Register (CRR) Q4 2022 End of Year Report to the Board noting that under the Code of Practice for the Governance of State Bodies it is the responsibility of the Board to ‘review management reporting on risk management and note/approve actions as appropriate’. He outlined that the Board, had previously agreed to approve the Quarter 4 CRR instead of the Quarter 3 CRR, to align risk reporting in the HSE’s Annual Report with the end of year CRR. The Board noted that the CRR Q4 2022 End of Year Report was being brought before them by the CRO for their consideration of the HSE’s principal strategic risks.

The CRO and Ms Michelle O’Sullivan confirmed that the CRR Q4 2022 End of Year Report had been presented and discussed at their meeting on 24 March 2023 with a recommendation to the Board for approval.

Board members reviewed and considered the paper and agreed to approve the HSE Corporate Risk Register Q4 2022 - End of Year Report. Decision No.: 310323/19

5.4 HSE Enterprise Risk Management Policy and Procedures 2023

The CRO presented to the Board the final draft of the HSE Enterprise Risk Management Policy and Procedures 2023, for consideration and approval. He advised that the revised Policy and Procedures have been contributed to by many teams across the health service and is based on international risk management standards, and provides a step by step guide to how we should identify and manage risk, in a way that is intended to be both useful and practical.

He advised the Board that the ARC had reviewed the final draft at its meeting on 24 March 2023 and considered parts in relation to External Risk Engagement and asked that the wording be strengthened here, which has been done, and the draft presented to the Board reflects this.

The Board noted that once the Policy is published, the next steps will include the launch of the Policy in April 2023, a series of briefing sessions facilitated by the ERM Programme Team in Dublin, Galway, Cork and Donegal, and several online webinars. A key objective of the Enterprise Risk Management Programme in 2023 is to develop and deliver training to support the implementation of the Enterprise Risk Management Policy and Procedures, and to build the HSE’s capacity and capability to effectively manage risk. This training programme which is currently being developed will demonstrate the key steps in the Risk Management process.

The Board considered and approved the HSE Enterprise Risk Management Policy and Procedures 2023. Decision No.: 310323/20

5.5 Adoption of Draft AFS 2022 in line with Health Act 2004

The CFO recommended the draft Annual Financial Statements (AFS) 2022 to the Board for adoption. The Documents presented were the:

• draft Financial Statements 2022 and notes to the Accounts including draft accounting policies (AFS)
• draft Chairman’s Statement on Internal Control (SIC)
• DPER Disclosures and Compliance Statement required by the DPER Code.

The CFO advised the Board that the ARC had reviewed the draft AFS 2022 at its meeting on 24 March 2023 and considered parts of the AFS’s in relation to the wording regarding the Going Concern, which has been included in today’s briefing paper stating that the NSP calls out a significant financial challenge in relation to funding arrangements in 2023, and the Employment Note for management to address the high earners and the administrative staff pay costs v agency administrative pay costs. The CFO and ARC member Michelle O’Sullivan on behalf of the ARC recommended the draft AFS to the Board for adoption.

In accordance with the requirements of Section 36 of the Health Act 2004, the Board adopted the draft AFS and draft Statement of Internal Controls for submission to the Minister and the C&AG for audit and the Chairperson and CEO were nominated to sign the accounts. Decision No.: 310323/21

5.6 Banking Arrangements

The CFO presented to the Board the following banking papers which were recommended by the Audit & Risk Committee for approval, to which the Board considered and approved.

1. Update to existing Bank Mandate with Danske Bank - Bernard Gloster, CEO to be added as Main Signatory to the Mandate. Decision No.: 310323/23
2. New bank account re HSE In-House Cash (IHC) bank strategy - New bank accounts to be opened with Danske Bank in accordance with the Mandate. Decision No.: 310323/24
3. Patient Private Property - Transfer of the PPP Central Unit Ulster Bank Account to Danske
   - Transfer of c57 local Ulster Bank PPP accounts to either BOI or AIB as appropriate locally
   - Approval of 4 main signatories, 2 of which are sufficient to sign new bank opening forms
   - Approval for one main signatory to approve changes to local changes to signatories subject to recommendation from Manager of PPP Central Unit.

Decision No.: 310323/22

The CEO acknowledged the enormous commitment that Mairead Dolan gave to the position of Interim CFO for the past 6 months, to which she thanked the CEO, Board and EMT colleagues for the opportunity.

M Dolan, Interim CFO left the meeting.

6.1 Disability Services including Roadmap for Service Improvement 2023 - 2025 for Disability Services for Children and Young People

The Board Strategic Focus paper on Disability Services and the ‘Roadmap for Service Improvement 2023 – 2025’ were brought to the Board for consideration.

The Head of Operations for Disability advised that the HSE strategic objective for specialist disability services was set out in the Corporate Plan 2021 – 2024. He outlined the priorities for HSE Disability Services and provided a current status update. He outlined the range of services to persons with disabilities and their families that the HSE Service Plan 2023 provides for, with an assigned budget of approximately €2.6 billion, while outlining the key issues arising. Also set out was the Key Performance Indicators (KPIs)/targets and the key metrics in the context of the Roadmap for Children’s Services. He advised of the implications for other strategic priorities / service plan and also outlined the approach to Stakeholder Management.

The CEO advised the Board that he is progressing disability services and a meeting is being arranged with the Minister of DCEDIY in the coming weeks. The Board agreed to hold further discussions in relation to the Roadmap for Service Improvement 2023 – 2025 for Disability Services for Children and Young People until after this meeting, and the Roadmap would then be brought back to the Board. The Board noted the workforce recruitment difficulties faced in the area of Disabilities.

The Chair of the Safety & Quality Committee advised that the theme of the April Safety & Quality meeting would be ‘Disability Services’ and extended an invitation to members of the Board to attend. She advised the Board that HIQA had also been invited to attend to discuss the “HIQA – Disability Overview Report 2021”.

The Board held a discussion on the establishment of a Sustainability Programme of Work regarding St. John of Gods and the development of a model of care. The complexity of the project was acknowledged and it was advised that it is progressing well. It was advised that there are four other groups dedicated to trying to maintain suitability structures through provisions of service arrangements and it was advised that it may be necessary to intervene and put in dedicated HSE people as a support. The crossdepartmental nature of this work was highlighted noted.

A discussion was had about a forum based on the Catherine Day Report and the financial implications in this area. The need for champions and leaders to drive this focus was acknowledged.

The meeting concluded at 3.30pm