A meeting of the HSE Performance and Delivery Committee was held on Friday 23 October 2020 at 8am via video conference.
From: HSE Board
Published: October 2020
Updated: October 2024
Tim Hynes (Chair), Sarah McLoughlin, Brendan Lenihan, Fergus Finlay, Louis Flynn, Sarah Barry, Regina Moran.
Stephen Mulvany (CFO), Dean Sullivan (CSO), Anne O’Connor (COO), Connor Cleary (EY, Item 2), Orla Treacy (Item 3), Risteárd Ó Laoide (Director, National Cancer Control Programme, Item 4), Patrick Lynch (ND QAV, Item 5), Dara Purcell (Secretary), Rebecca Kennedy.
The Chairperson, Tim Hynes welcomed members to the meeting. No conflicts of interest were declared.
At the start of the meeting the Committee met in the absence of management.
The Committee approved the minutes of the meeting of 18 September 2020.
EMT members joined the meeting at 8:15.
The CSO presented a paper as requested by the Committee which provided details on the National Service Plan (NSP) 2021, namely: an overview of budget announcements related to the HSE, an outline of the National Service Planning process, the proposed structure of the NSP 2021, and the timeline and Next Steps. The CSO confirmed that the draft National Service Plan 2021 is in development and is aligned with the draft Corporate Plan 2021-2024, 2020 Planning for Health Services Delivery in the COVID-19 Pandemic – Winter 2020 to End 2021 (referenced as the Pandemic Plan), and Winter Planning within the COVID-19 Pandemic October 2020 – April 2021 (the 2021 Winter Plan).
He noted that the implications of Budget 2021 are being assessed by National Finance, and the Letter of Determination (LoD) and the Annual Statement of Priorities are awaited from the Department of Health in order to complete planning processes and bring a draft NSP to the Board for final adoption prior to submission to the Minister.
The CSO advised that this is a more complex process for 2021 recognising the implications of COVID19 and the linkages with Corporate and Pandemic/ Winter Planning and additional special meetings of the EMT, P&D Committee and Board will be required to ensure full review of the draft NSP 2021 prior to submission to the Board. He noted that the early approval of the NSP 2021 is critical to facilitate the production of operational plans for the delivery system
The approach and timeline for the production of the NSP 2021 was noted by the Committee and it was agreed that additional meetings of the Committee will be required to provide the relevant oversight. Dates for these meetings will be confirmed following receipt of the LoD.
C Cleary left the meeting
O Treacy Joined the meeting
The COO provided a high-level overview of the monthly August 2020 report. She informed the Committee the Performance Profile is published on a quarterly basis and provides an update on key performance areas for Community Healthcare, Acute Hospitals and National Services in addition to Quality & Patient Safety, Finance and Human Resources. It was noted that some areas of reporting remain impacted by the COVID-19 pandemic but there has been a significant improvement particularly in community services data which was most severly impacted during the early response to the COVID19 pandemic.
The Committee discussed the reporting from a number of areas including, vaccination, disability services and mental health. Clarity was sought in relation to achievement of performance targets relating to Child and Adolescent Community Mental Health Teams and to General Adult Mental Health, as the % of adults seen within 12 weeks and the Admission of Children to CAMHs are metrics noted as meeting their targets. The COO confirmed these KPIs relate to specialist services.
Access to primary care services is more challenged. It was agreed that a representative from Mental Health Services would engage directly with F Finlay as requested In relation to Disability Services, the Committee queried adult day services and the unmet targets for the %/No of Children’s Disability Networks established. The COO advised that new funding will be provided in 2021 for day services recovery. The COO shared the Committee’s concerns regarding Children’s Disability Networks and advised that Children’s Disability Networks were not due to be established until the second half of the year, so no targets were profiled from January to June 2020. Re-deployment of staff relating to COVID-19 response and the appointment of network managers has also contributed to the delay, but the establishment of these networks is very much a priority.
Concern was raised in relation to the availability of the flu vaccine this year and reports that there may be a shortage of doses. The COO advised that demand is currently exceeding supply but prioritised groups will be covered. The HSE could only secure a certain number of doses as there is a global limit on what has been produced. The Committee requested that an update be included in the meeting minutes which is set out hereunder: -
‘The HSE has procured approximately 1.4 million doses of Quadrivalent Influenza Vaccine (QIV) for adults, which is over 20% more QIV than was used last season, as increased uptake was expected in the targeted groups, as identified by The National Immunisation Advisory Committee (NIAC) and the Department of Health.
The HSE has also purchased 600,000 doses of Live Attenuated Influenza Vaccine (LAIV) for children aged 2-12 years old, this vaccine is available now free of charge.’
The Committee discussed COVID-19 surge capacity including availability of private hospitals. The COO updated the committee with regard to HSE surge capacity and on the private hospitals discussions which are ongoing between DPER/DoH/HSE. An update regarding arrangements with private hospitals will be provided to the Committee.
The impact of COVID-19 on the performance and delivery of corporate and services plans was discussed at Board meetings from April 2020. In tandem with the work on the Service Continuity Framework in June 2020 the COO advised the Board ‘that an important piece of the ongoing work is to capture the present activity levels of the services’ which would determine the pace at which the 4 Framework can be implemented. The Board meeting on 25th September noted that the COO would bring forward to the Performance and Delivery Committee revised performance measures for the second half of 2020. The COO provided a report on proposed Revised Estimates of Activity / Targets 2020 which was circulated to the Committee prior to the meeting. The COO advised that this report relates to the National Performance Activity Suite from National Service Plan 2020. The COVID-19 pandemic has had considerable impact on the levels of service planned at the time of completion of National Service Plan (NSP) 2020. In this context and cognisant of the implementation of the approved Service Continuity Framework and the on-going work with regard to appropriate measurement of performance, a review of achievable activity/targets 2020 was presented for consideration by the Committee. The Committee questioned the appropriateness of revising these measures and did not approve the change. It was instead requested that the work undertaken be incorporated into next year’s measures.
The COO spoke to the Committee on the COVID-19 Daily Data Report which was circulated prior to the meeting. The Report represented the data in the COVID-19 Dashboard, COVID-19 Situational Report and the COVID-19 Intraday Operations Report. The Committee reviewed the report and requested that going forward, the Daily Situational Report should specify the number of COVID-19 cases and number of deaths occurring in HSE-run nursing homes. It was also requested that further data be provided on the quality of testing.
3.4 National Scorecard Dashboard
The Committee had requested the development of a new National Scorecard for the Health Service Executive that will assist the Committee and Board in their oversight and governance role. The COO presented the draft scorecard which was prepared based on: Feedback from Board and Committee members; Engagement with all Board Committees; International Research; A Safe Return to Health Services – focus areas across all phases; Outcome focussed KPIs available in the current suite; and The National Performance Indicator Suite and available data-sets. An outline of the National Scorecard Dashboard 2021 Automation Project was also presented. Following the discussion, the Committee agreed that the draft National Scorecard should now go to the Board for its consideration.
The Committee had requested the development of a new National Scorecard for the Health Service Executive that will assist the Committee and Board in their oversight and governance role. The COO presented the draft scorecard which was prepared based on: Feedback from Board and Committee members; Engagement with all Board Committees; International Research; A Safe Return to Health Services – focus areas across all phases; Outcome focussed KPIs available in the current suite; and The National Performance Indicator Suite and available data-sets. An outline of the National Scorecard Dashboard 2021 Automation Project was also presented.
Following the discussion, the Committee agreed that the draft National Scorecard should now go to the Board for its consideration.
R Ó Laoide joined the meeting.
During the monthly monitoring of the Performance Report at its September meeting, the Committee recognised a need to closely examine the performance of Cancer Services and the impact of the COVID-19 pandemic on them. The CCO requested that Prof R Ó Laoide, Director, National Cancer Control Programme present to the Committee on this matter. R Ó Laoide presented a briefing paper to the Committee on the impact of the COVID-19 pandemic on the diagnosis of cancer. He noted that the pandemic’s impact on cancer morbidity and mortality due to delayed diagnosis in Ireland to date is not yet quantifiable and answered a number of questions on subjects such as the timeliness of the data presented and whether the psychological impact of a cancer diagnosis is being measured. It was noted that the roll out of the proposed Individual Health Identifier would be incredibly useful in cancer treatment with the Chair agreeing that this should be pushed for at Board level.
The Committee acknowledged the work undertaken to keep cancer services running during the COVID-19 response and thanked R Ó Laoide for his time.
R Ó Laoide left the meeting
ND QAV joined the meeting
ND QAV updated the Committee on developments relating to the CRR. He confirmed that the revised risk assessments report will be completed in the coming week and will be then sent to EMT then the ARC before final presentation to the Board. He also advised that external support was secured and John Moody has been engaged to undertake this work. Meetings with the EMT and Committee Chairs will be arranged in the coming weeks.
The COO gave an update on this risk as requested by the Committee at its September meeting. She advised that this risk has yet to be reviewed by EMT as part of the risk assessment reporting described by the ND QAV.
The Committee queried whether difficulties in achieving the levels of recruitment required to implement the additional controls required for mitigation of this risk would be significant as there is concern that nursing homes would likely be impacted disproportionately if so. The COO advised that the implementation of the recommendations of the COVID-19 Nursing Homes Expert Panel Report should help ensure that nursing homes are not negatively impacted in this regard.
The Committee agreed that it will continue to hold other special meetings outside of its usual monthly meeting to provide the required oversight on corporate planning processes.
Date of Next Meetings: 20 November 2020 (TBC).
The meeting concluded at 12:30pm.
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