HSE Planning and Performance Committee meeting minutes 17 November 2023

Committee Members Present

Fergus Finlay (Chair), Brendan Whelan, Joan Johnston, and Sarah Barry.

Apologies

Anne Carrigy, Sarah McLoughlin.

HSE Executive Attendance

Damien McCallion (COO), Tony Canavan (CEO Saolta Hospital Group – left approx. 1:15), Joe Ryan (ND Operational Performance and Integration), Orla Treacy (Operational Performance and Integration), David Walsh (ND Community Operations), Robert Kidd (AND Acute Operations), Niamh Drew (Deputy Corporate Secretary), Rebecca Kennedy (Office of the Board).

Joined the Meeting

Mark Brennock (ND Communications - Item 2.5), Robert Morton (Director National Ambulance Service – Item 4).

Joint Meeting with ARC

Sharon Keogh (ARC Member), John Moody (ARC Member), Pat Kirwan (ARC Member), Stephen Mulvany (CFO), Patrick Lynch (CRO), Stephanie O’Keeffe (ND Operations Planning), Philip Crowley (ND Strategy and Research) Miin Alikhan (AND Nat Strategic Planning & Reporting), Trevor O’Callaghan (CEO Dublin Midlands Hospital Group), 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, noting that the focus of the meeting would be to receive updates on key items and to suggest relevant actions as they became apparent.

2.1 Declarations of Interest

No conflicts of interest were declared.

2.2 Minutes of Committee Meetings

The Committee approved the minutes of 20 October 2023.

2.3 Workplan 2024

The Committee discussed the Workplan for 2024 and agreed focus areas for each month January to June. It was agreed that the Committee’s input would be included in an updated draft of the workplan which would be considered at the December meeting.

2.4 HSE in the News

ND Communications joined the meeting

The ND Communications provided the Committee with an update on current HSE media coverage, particularly in relation to coverage since Budget 2024 and how it has differed to previous years. It was agreed that the COO would discuss with ND Communications how to most effectively get positive developments to the attention of the public and staff in services.

ND Communications left the meeting.

The COO Performance Report, HSE Hi-level KPI Report (previously OSR), Performance Profile (September Data), National Performance Oversight Group (NPOG) Meeting Notes, which had been circulated prior to the meeting, were noted.

The COO updated the Committee on the key strategic and operational updates outlined in the above documents, focusing in particular on Scheduled Care, Urgent and Emergency Care, Urgent Colonoscopy, Cancer Services, Therapy Waiting Lists, CAMHs, Disability Services, National Screening Services, Human Resources; Pay and Numbers Profile, and Escalation under Performance and Accountability Framework (PAF) 2023.

In relation to Scheduled Care, the COO advised that improvements are being seen across the country in both activity and waiting list times and highlighted that reduction in waiting list times is a key priority for the Minister. The Committee discussed the sustainability of the push in this area and the projected impact of the upcoming surgical hubs. Regarding Emergency care, the COO highlighted four targets in particular: ED wait time for patients over 75, Delayed Transfers of Care, Average Length of Stay, and Trolley Numbers.

Regarding Cancer Services, the COO advised regarding escalations and improvement plan timelines. The Committee discussed issues surrounding replacement of essential equipment in St Luke’s Radiation Oncology Network which is resulting in reduced capacity. It was agreed that a report would be provided to the Committee at its December meeting on the process and timelines for replacing this equipment.

In relation to CAMHs, the COO highlighted in particular targets for urgent referrals responded to within 3 days, bed days used, and use of adult units and it was agreed that the final CAMHs audit would be submitted to the Committee when completed. The Committee also agreed to invite the new CAMHs National and Clinical leads to present to the Committee in early 2024.

The Committee discussed Older Persons Services, in particular the Commission on Care which is a Government initiative and will begin work in 2024. The ND Community Operations confirmed that engagement is ongoing with advocacy groups and an update will be brought to the Committee when work in this area is more developed.

In relation to Disability Services, the Committee discussed the launch of the Roadmap for Service Improvement 2023-2026, Disability Services for Children and Young People. The Committee highlighted that the level of service user consultation was not strong enough during the development of the Roadmap and that has been reflected in the public reception. The Committee also sought clarity on how the Roadmap’s implementation would be monitored. It was agreed that an update on implementation would be brought to the Committee quarterly in 2024 and a further update would be brought to the Committee on progress made in improvement of data capture in disability services overall.

4.1 National Ambulance Service (NAS)

Director NAS joined the meeting

The Director of NAS presented to the Committee a Focus Area Report on the NAS, outlining the NAS Strategy to 2031 and the key strategic risks facing NAS at present. He advised that the NAS continues to experience a significant mismatch between demand for services and available capacity with a significant degree of approved but unfunded service delivery operating in 2023. Current service delivery continues to focus on NSP KPI performance, however, the pace in the growth of demand significantly exceeds available capacity. This degree of organisational stress continues to impact on staff wellbeing, morale, attraction and retention.

The Committee discussed the issues in relation to recruitment as approx. 1080 additional NAS staff are currently required. Director NAS advised that while a lot of effort has been put into recruitment, there is a need for pay modernisation in the service.

The Committee noted the Focus Area Report on NAS and thanked Director NAS for the presentation.

Director NAS left the meeting

5.1 National Service Plan (NSP) 2024

ARC Members and additional HSE Executives joined the meeting

B Whelan took over as Chair

The ND Operations Planning and CFO updated the Committee on the NSP 2024 process. The Committees noted that all material included in the papers circulated in advance of the meeting was presented as draft, subject to deliberation and is not a final position of the HSE. They were written in the context of the Committees noting the positions and information likely to inform consideration of final Letters of Determination which are not yet received. The CFO recommended Board Committee members understand that all of the material is subject to further amendment and detail as engagements regarding supplementary and revised estimates are ongoing.

The Committees were advised that a particular focus is the ongoing work and deliberations relating to 2024 service priorities and the workforce and financial positions. An update was provided on the current status of formal correspondence from the Department of Health (DoH) and Department of Children, Equality, Disability, Integration and Youth (DCEDIY).

The ND Operations Planning provided a summary of work completed to date on a pre-LoD version of the National Service Plan and briefly summarised the proposed timelines for completing the National Service Plan within 21 days of receiving the final Letter of Determination (LoD). The Committees noted the key milestones and dates for delivery of the plan, including the ICT and Capital Plan, which assume the LoDs are received on Friday 17 November. The CFO updated the Committees on the workforce position including level of WTE growth, estimate of posts not yet recruited, pausing of recruitment and planned new service developments. He also advised the Committees of the impacts and Risk Assessment of the requirement to pause recruitment for development posts in 2024.

The Committees discussed the service implications and risks, mitigations and areas of service to be considered in the recruitment ceiling for 2024. The Committees were advised that the final Letters of Determination (LoD) have not been received from the DoH or DCEDIY. It is intended, following discussion at tri-lateral meetings, that both Departments will issue their LoDs on the same day which will start the 21-day statutory timeline within which the HSE is required to submit the NSP to the respective Ministers. The ND Operations Planning confirmed that meetings are continuing to discuss and align Departmental and HSE thinking on service priorities, workforce numbers and financial tables. The HSE has fed back to both Departments in relation to the content likely to be included in the final LoDs. Of particular note for NSP 2024 is the implementation of the Health Regions, already commenced.

In relation to the Capital ICT and Estate Plans, the Committees were advised that first drafts of both Capital Plans 2024 are being completed and engagement with the DoH and DCEDIY is ongoing. Activities to finalise both drafts are underway to ensure alignment with the relevant approval processes (including approval by the Technology and Transformation Committee for the eHealth and ICT Capital Plan). It is expected that drafts of both plans will be available for sharing with the HSE Executive Management Team / Senior Leadership Team (EMT/SLT), P&P Committee and Board in alignment with NSP 2024 timelines.

No matters arose under this item.

The meeting ended at 13:50.