HSE Performance Committee Meeting Minutes 19 September 2025

Committee Members Present

Brendan Whelan (Chair), Tim Hynes, Matt Walsh, Lily Collison, Kenneth Mealy and Pat Kirwan.

HSE Executive Attendance

Tony Canavan (REO West and North West), Patrick Lynch (ND Planning and Performance), Anne Marie Hoey (CPO), Dr Philippa Ryan Withero (AND HR), Joe Ryan (ND Public Involvement, Culture and Risk Management), Neal Mullen (CISO), Dr Colm Henry (CCO), Deirdre McNamara (Director of Strategic Programme CCO Office), Ronan Buckley (Business Manger CCO), Miin Alikhan (AND Planning), Niamh Drew (Deputy Corporate Secretary), Patricia Perry (Office of the Board).

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 Committee held a private session to review the agenda, the relevant papers and approach to conducting the meeting.

1. Declarations of Interest

No conflicts of interest were declared.

2. Minutes

The Committee approved the minutes of 15 July 2025.

3. Action Log

The Committee noted the action log which was circulated in advance of the meeting.

HSE Executive members joined the meeting

1. Recruitment, Retention, Turnover and Absences

This item was deferred to the October meeting due to the late submission of papers.

2. Performance Achievement

The Committee noted the paper provided by the CPO in advance of the meeting which provided an outline of the Performance Achievement process implemented in the HSE since December 2018, which is a tool to support staff develop in their role, and provides staff with an opportunity to meet with their manager to discuss learning and development needs required for their role.

The Committee noted the low response rate in Q1 and Q2 2025, with 4.2% of staff members engaged in initial Performance Achievement meetings, and 47% of respondents from a recent staff survey reporting having regular performance and achievement reviews with their line manager. The Committee discussed the importance of embedding a performance management culture in the HSE.

The Committee held a discussion with the CPO in relation to the Performance Accountability Framework, noting that scheduled performance meetings are to be extended to AND and downwards.

3. POCC – Consultants Rostering

The Committee noted the paper provided by the CPO in advance of the meeting and were provided with an update on the implementation of consultant rostering principles within the Public Only Consultant Contract (POCC) 2023. The Committee noted that as of September 2025, 3,159 POCC 2023 holders had been post-matched on the Doctors Integrated Management E-System (DIME), which represented 64.5% of all consultants on the system.

The Committee discussed the issues and challenges faced regarding consultant rostering and the progress that needs to be made in this area to address them.

The Committee raised the issue of the absence of governance structures in respect of healthcare worker safety and health at Regional Level. The executive confirmed that this was still to be addressed but was under consideration and the CPO agreed to revert to the Committee on the matter.

HSE Executive members joined the meeting

1. Q2 2025 CRR Report

The CRO presented the Q2 2025 Corporate Risk Register (CRR) and accompanying Committee extract and metric report to the Committee. The Q2 2025 CRR was reviewed and approved at the Senior Leadership Team (SLT) meeting on the 05 August 2025 and subsequently brought to the Audit and Risk Committee.

The Committee discussed its allocated principal risks (R001 Urgent and Emergency Care Services (previously Delivery of Care), R002 Standards of Safety and Care, R004 Health Care Acquired Infections and Anti-Microbial Resistance, and R007 Cyber Security), and highlighted W005 Health and wellbeing of the Workforce. The CRO outlined the change to W001 Delivery of Care to an Open risk R011 Scheduled Care Services.

The Committee noted the Q2 2025 CRR and associated documentation.

2. Focus on R007 Cyber Security

Mr Neal Mullen Chief Information Security Officer (CISO) joined the meeting

At the request of the Committee at the June meeting the CISO provided an update in relation to R007 Cyber Security. The Committee welcomed the comprehensive update, noting the cyber security initiatives progressing in 2025, progress made and the independent assurance of achieving the 2025 objective. The Committee discussed operational resilience and it was agreed that a report would be brought back to a future meeting.

1. National Performance Report (NPR) June/July 2025 Data

The NPR (June/July 2025 Data) and accompanying briefing paper, which had been circulated in advance of the meeting, were noted. The June/July 2025 NPR presents the HSE’s performance through the four lenses of the Balanced Scorecard (Quality, Access, People, Money), against a subset of the KPIs contained in the National Service Plan (NSP) 2025.

The Committee noted the additional commentary relating to Urgent and Emergency Care; Scheduled Care; Cancer Services; Community Services; Quality and Safety; Human Resources; and Finance, which were highlighted by the ND Planning and Performance, and noted the quarterly status update on the 46 priority actions from the HSE Corporate Plan 2025-2027 and NSP 2025.

The Committee discussed the two-page summary heatmap of all KPIs in the NPR.

The Committee were advised of correspondence from the Minister for Health regarding acute hospital performance in the HSE North West region and SVUH and asked that a copy be circulated to the Committee.

CCO, Deirdre McNamara, and Ronan Buckley joined the meeting

1. Clinical Commentary on the National Performance Report

The Committee noted the papers provided by the CCO in advance of the meeting which provided commentary on the key clinical elements of the NPR relating to Public Health; National Screening Service; Antimicrobial Resistance and Infection Control; Urgent Colonoscopy; National Cancer Control Programme; and Mental Health.

2. Chief Clinical Officer report on Clinical Areas of Focus

The Committee noted the CCO report on Clinical Areas of Focus report provided by the CCO which had been circulated in advance of the meeting. The papers provided the Committee with updates on topical areas of focus under the CCO’s remit, which included Exceptional Management Interventions; Key clinical actions addressing opportunities for improvement; and Examples of good/exemplary clinical practice/services.

The Committee discussed Maternity Services in PUH; Children’s Health Ireland; Breast Cancer Services; Gender Identity Services; Implementation of Recommendations Arising from Clarke Report; Histopathology Lookback Review at Our Lady of Lourdes Hospital, Drogheda.

In relation to opportunities for improvement, the CCO outlined the process to update the Clinical Governance Framework; the National Clinical Programme Review; Heart Strategy; and the Immunisation Programme.

2.2 Quarterly Quality & Patient Safety Report

The CCO provided the Committee with the Quarterly Quality and Patient Safety report, which outlined a high-level overview of patient safety incidents reported via the National Incident Management System (NIMS) for Q2 2025. The Committee noted the strategic insights from national incident reporting data, highlighted risks, trends, and areas which require leadership focus to strengthen patient safety across the HSE.

The Committee noted the Patient Safety Protocol Report for July and August 2025.

2.3 Serious Incident Reporting KPI’s on the National Performance Report

The CCO provided a briefing in reply to a request from the Committee for explanation on issues with reaching key performance indicator (KPI) target of reviews completed within 125 days of category 1 incidents from the date the service was notified of the incident, which was noted by the Committee.

3. Maternity Services

The Committee noted the National Women and Infants Programme (NWIHP) Annual Report 2024, which has been approved by the Senior Leadership Team and will be submitted to the Minister for Health and published on the Department of Health’s website.

4. Scoliosis Services

The Committee discussed the current status of the spinal service at Children’s Health Ireland (CHI), noting the considerable work that has gone into improving the CHI spinal service, and was provided with an update in relation to waiting lists, noting that whilst waiting times have improved year on year, there are still long waiting times. Noting that as of July 2025, there was a 17% increase in the number of patients added to the Spinal Service Waiting List compared with the same period last year.

1. CHI Commissioning

The Committee noted the paper previously circulated by the ND Planning and Performance (ND P&P) on the status of the New Children’s Hospital Ireland (NCHI) and CHI Integration, Commissioning and Operational Readiness Programme. The briefing updated the Committee specifically on the Construction Programme; the opening of the hospital; Clinical Integration; Workforce; and Assurance Programme.

The ND P&P updated the Committee on the status of the NCHI, advising that the Contractor submitted an updated programme with the reported Substantial Completion Date moved from 30 September 2025 to 24 November 2025. The Committee noted that the National Paediatric Development Board’s (NPHDB) expert programme advisers, Kroll, provided an updated assessment based on the current rate of site progress, which indicates a March/April 2026 date for Substantial Completion.

The ND P&P advised the Committee that he is awaiting an assurance report specifically addressing clinical integration, which is a critical aspect of CHI’s role in delivering clinical services and commissioning the NCHI facility, which is being reviewed by KPMG and Professor Melvin Samson and will update the Committee at a future meeting.

1. Approach re NSP 2026

The ND P&P provided an update to the Committee in relation to the National Service Plan (NSP) 2026, and the Committee noted the background, that status of the NSP development, the changes to NSP 2026, reporting on performance against the NSP and the indicative timelines.

No matters arose under this item.

The meeting ended at 15:10.

Terms of Reference: Performance Committee