HSE Performance and Delivery Committee Meeting Minutes 21 February 2020

Members Present

Sarah McLoughlin, Brendan Lenihan, Fergus Finlay, Regina Moran.

In attendance: Stephen Mulvany, Dara Purcell, Hannah Barnes, Sarah Barry (observing).

Apologies

Tim Hynes (Chair), Louis Flynn, Dean Sullivan, Anne O’Connor.

Joined the Meeting

HSE: Stephanie O’Keeffe (Item 2 and 3), Brian Murphy (Item 2), David Walsh (Item 2, 3, 4, 5,6), Orla Treacy (Item 4), Paul Connors (Item 7), Fran Thompson (Item 8) Yvonne Goff (Item 8), Michael Redmond (Item 8), Helen Coughlan (Item 8).

EY: Dara Glynn, Gary Comiskey (Item 2).

The Acting Chair welcomed members to the meeting and introduced Dr Sarah Barry who had been invited to observe February’s Committee meeting.

Prior to the arrival of EMT, the Committee discussed and agreed the agenda and approach to the meeting.

The committee approved the minutes of the Performance and Delivery meeting held on 24th January 2020.

The committee raised a query relating to discussions on the Mental Health report, committee members agreed that this would be discussed during the Corporate Plan briefing. Committee members reiterated the importance of being hands on during the Corporate Plan development phase.

No conflict of interest was declared.

S. O’Keeffe, B. Murphy, G. Comiskey, D. Glynn joined the meeting to provide a progress update on the Corporate Plan.

S. O’Keeffe spoke to the committee on the various projects involved with the consultation process of the Corporate Plan. Insight was provided on both formal and informal feedback received by the project team from the first Corporate Plan Town Hall session held in Cork City and progress on the reach of the methods of communication were also provided. Committee members in attendance at the Town Hall planning session commended the project team on the session’s success. The committee reflected on benefits of receiving this feedback and encouraged the team to continue to work on this communications piece.

Taking into consideration some of the specific priority and goal orientated feedback received, a detailed conversation took place surrounding the wording and meaning of the three priorities. The committee worked with the project team to reshape the wording of the draft priorities and the ‘sizing’ of goals specifically as it relates to gaps and areas for improvement in the analysis. This will assist in narrowing the focus and identifying goals and associated actions that require further development (i.e. addition of performance measures, targets, timelines, critical success factors and risks) to provide a clearer message for the Corporate Plan.

The committee considered the next steps, timelines, broader external considerations, and opportunities and agreed a special meeting to review further progress on the Corporate Plan should be held for all board members to attend. Although the committee was pleased by the progress and work undertaken in drafting the Corporate Plan to date, it was felt that further costings and scoping work should be prioritised for the next meeting.

A further update was provided to the committee on the drafting of the Annual Report. It was noted that the 2019 edition of the Annual Report will look demonstrably different due to the focus on risk management and the committee were assured that their previous concerns were being addressed.

A discussion around the overall positive message that has been presented in past versions of the Annual Report took place as committee members felt that some achievements that have not been fully met may need to be reflected in the report to ensure that full transparency is achieved.

The committee discussed December’s performance profile with executive members present and sought clarification on resolutions put in place to ensure certain targets are met within the next reporting timeframe. Committee members raised concern over the varied results seen between CHOs and sought clarification as to why performance in one area can differ so significantly. One specific area which was highlighted by D. Walsh was waiting lists within the therapy’s services.

Discourse surrounding this issue involved better models of service delivery by turning service reviews into specific actions, implementation of the revised protocol of need, and whether or not there is a large impact on services due to “no shows” for appointments. Concern was also raised at the failure to meet target levels for the role out of home care packages. This was attributed mainly due to a change in tender. Committee members also noted the positive low rates of emergency readmissions which reflects the quality of care being provided to patients.

The committee proceeded to discuss the NSP 2019 Qtr. 4 Priorities and Action Report. This report enables high level reporting on a quarterly basis against implementation of the priorities and actions in the National Service Plan against a RAG score and documents progress on Key Performance and Actions as of Quarter 4 2019. The Committee considered the level of delivery against the targets in NSP 2019. B Lenihan circulated an analysis of the overall performance percent based on the RAG ratings in the report, highlighting to the committee that reanalysis of the data according to strict target achievement resulted in a different and more red RAG profile.

The committee were advised that the Performance and Accountability Framework (PAF) for 2020 would be altered to account for the new governance structure in place within the organisation. The PAF sets out the systems, procedures and practices for performance management and accountability within the HSE and in particular, how, the Hospital Groups, Community Healthcare Organisations (CHOs), the National Ambulance Service (NAS), the Primary Care Reimbursement Service (PCRS), the Heads of other national services and individual managers, are held to account for their performance. The PAF outlines the accountability structure and responsibilities for performance management within this structure.

The Committee welcomed the development of the Performance and Accountability Framework as an important element of accountability. It noted that the HSE management has considered the draft PAF 2020 at its meeting on the 11th February 2020 and that the 2020 PAF will be provided to the DoH and published when it is finalised.

Before finalising the Framework, the Committee requested management to consider if the definition of Accountability could be clearer; if the escalation of Fraud to Audit and Risk should be included and if a process for escalation to Committee/Board was required.

Following his presentation at its January meeting, the committee requested that F. Thompson provide additional information relating to: Capital Plan approvals workflow; Priorities; Multi-Year view of the ICT Capital Plan; View of what difference will the investment in the ICT Strategy make; and a list of reserve projects.

F. Thompson and M. Redmond made this presentation and provided the committee with additional information to answer these queries and questions. They explained the three investment horizons that define the short, medium, and long-term goals to digitise the health system as they are portrayed within the ICT Capital Plan 2020. The committee were informed that the ICT team utilised the HIMSS adoption model scale which focuses on the functionality that users have access to and utilise. The committee questioned the approach to cyber security throughout the plan but were assured that cyber security is part of all aspects of the plan rather than being called out as a specific area. F. Thompson reassured the committee that the ICT Capital Plan 2020 was aligned with the National Cyber Framework. The Committee requested a further briefing on the Cyber Strategy which would provide insight on the actions within the strategy.

No matters were raised under this item.

Date of Next Meeting: TBC

The meeting concluded at 13:25 following a short discussion on the meeting by members after those in attendance had departed.