HSE Planning and Performance Committee Meeting Minutes 19 April 2024

Committee Members Present

Brendan Whelan (Acting Chair), Sarah McLoughlin, Joan Johnston, Sarah Barry (left approx. 12:30), Anne Carrigy (left approx. 12:20).

Apologies: Fergus Finlay (Chair).

HSE Executive Attendance

Damien McCallion (COO), Dara Purcell (Corporate Secretary), Rebecca Kennedy (Office of the Board).

Joined the Meeting

Mark Brennock (ND Communications - Item 2.3), Ciara Ni Ruairc (Head of Press and Media – Item 2.3), Orla Treacy (Items 3-5), Sonya Cotter (AND Performance and Analytics - Items 3-5), Robert Kidd (AND Acute Operations – Item 3), David Walsh (ND Community Operations – Items 4-5), Patrick Lynch (Acting CSO/-CRO – Item 6-7), Elaine Kilroe (AND Enterprise Risk Management – Item 6), Miin Alikhan (Assistant National Director National Strategic Planning and Reporting – Item 7).

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 16 February 2024.

2.3 Matters for Noting

i) Correspondence re Joint S&Q/P&P meeting March 2024

The above correspondence was noted by the Committee.

2.4 HSE in the News

ND Communications and C Ni Ruairc joined the meeting.

The ND Communications and C Ni Ruairc presented to the Committee on the ongoing proactive media work being undertaken by HSE Communications. This presentation covered good news stories, the tone of voice in media channels, and integration between regional and national communications.

The Committee discussed this work and expressed its full support for proactive media engagement, while recognising that there are also serious and damaging situations that require sincere media engagement. It was agreed that Communications would return to the May meeting for a full agenda item which would allow sufficient time to answer the various queries raised during the discussion.

ND Communications and C Ni Ruairc left the meeting.

S Cotter, R Kidd and O Treacy joined the meeting.

The COO Performance Report and Performance Profile (February Data) which had been circulated prior to the meeting, were noted. The COO confirmed that Regional performance meetings commenced in April. This is an interim process pending the ongoing work on developing a new Performance and Accountability Framework (PAF) which will reflect new governance arrangements and replace prior performance management of hospitals and CHOs from the Centre. The new process is being developed on behalf of the CEO by the Health Regions Programme with input from the incoming National Director, the REOs, Department of Health (DoH) and Department of Children, Equality, Disability, Integration and Youth (DCEDIY). The majority of performance information used relates to February 2024 and any available real time data was also utilised.

The COO updated the Committee on the key strategic and operational updates outlined in the COO Performance Report and Performance Profile, focusing in particular on Scheduled Care, Urgent and Emergency Care, Cancer Services, and Therapy Waiting Lists. The COO advised that overall, performance in February 2024 is better than February 2023 but many target performance metrics for 2024 are being missed.

Regarding Scheduled care, the COO updated the Committee on the 2024 Waiting List, 2024 NSP Targets including focus on patients waiting over 3 Years. He advised that most targets are being achieved but the level of success is being impacted by growth in demand. The COO confirmed that access performance is being actively monitored across HSE Regions and all Regions are finalising their Scheduled Care Plans for 2024.

In relation to Urgent and Emergency Care, the COO updated the Committee on four key UEC metrics: the average 8am weekly trolley count in the year-to-date; the target for patients experience time for people aged over 75; the total number of Delayed Transfers of Care (DTOCs) not to exceed 350; and the average length of stay (LoS) for those over 14 days not exceeding 28 days. The Committee noted there are 8 Hospital/CHOs formally escalated performance under the Performance Accountability Framework (PAF) as the level of improvement required has not been achieved. The COO advised that Performance will be reviewed such that sites will be considered for de-escalation.

Regarding Cancer Services, the Committee were advised that some sites remain in escalation but improvements in performance are being seen, particularly in Cork where all KPIs with the exception of non-urgent breast cancer and radiotherapy are now achieving green rated performance. The COO acknowledged the work completed by the local teams and NCCP in achieving these improvements.

Following a request for update from the Committee, the COO confirmed that the National Radiology Review Steering Group and Working Group were both established in late 2023. The early focus for both groups was the development of a Service Improvement Plan, this draft plan is currently being finalised. The Steering Group and Working Groups have now shifted their focus to the development of a 5 Year National Strategic Plan for Radiology Services. This plan along with the accompanying workforce plan will both be delivered in 2024 and a further update will come to the Committee.

In relation to Therapy Waiting Lists, the Committee discussed the functioning of the current KPIs and advised that there are improvements required to ensure effective performance reflective of the patient and service user perspective. The Committee also queried the mapping of the Health Regions and whether they are effectively aligned with the Children’s Disability Network Teams (CDNTs). The COO advised that this will be aligned unless there are exceptional reasons preventing it and the topic will be included for discussion when Primary Care and ECC is next taken as a focus area by the Committee.

R Kidd left the meeting.

ND Community Operations joined the meeting.

The COO and S Cotter presented to the Committee an overview of (i) the Multiannual Urgent and Emergency Care (UEC) Plan 2024-2026 and (ii) the Urgent and Emergency Operational Plan 2024. The Committee noted the briefing paper and both draft reports which were circulated in advance of the meeting.

The Committee was advised that the multiannual UEC Plan has been developed in response to record UEC pressures which are presenting almost all year round. It will provide direction on the actions taken over the next three years to improve UEC services on an incremental and sustained basis. Priority actions for year 1 of the plan have been set out in the National Service Plan (NSP) 2024 and UEC Operational Plan 2024 and will input into 2025 and 2026 iterations of both plans. The UEC Operational Plan 2024 covers the period from Q2 2024- Q1 2025. It sets out the priorities and actions required at a local and regional service level, in the HSE Centre and during periods of surge, to deliver on the objectives of the multiannual UEC plan and support UEC delivery and performance from 2024-2026.

The Committee expressed its full support for the development of the multi-year plan and provided feedback on the draft. The expected timelines to see the impact of these plans and how patient outcomes will be captured were emphasised as areas which should be developed further. Delayed transfers of care were discussed and patient flow was highlighted as an area requiring focus.

The Committee noted that subject to final feedback from the Minister for Health a final Draft of each plan will be brought to the Board for approval prior to publication. The Committee thanked S Cotter for the presentation and the work completed to date on the Multiannual UEC Plan 2024-2026 and the UEC Operational Plan 2024.

ND Community Operations, S Cotter, O Treacy and S Barry left the meeting.

CRO and E Kilroe joined the meeting.

The CRO presented the new Corporate Risk Register (CRR) to the Committee. In 2023, the CRO agreed with the EMT, the Audit and Risk Committee and the Board that a fundamental review of the HSE’s corporate risks and by extension the CRR would be undertaken. The review was conducted in a number of stages with workshops, briefing sessions and meetings held with EMT members, their risk teams, subject matter experts including clinicians and with Board Committees. The penultimate version of the new CRR was considered by the EMT at a special meeting on the 25 January 2024 and the final draft approved by them on the 13 February 2024.

The Committee discussed the new CRR and there was general agreement that the revision has delivered a better document which will be more useful going forward. It was acknowledged that the CRR is subject to change as it is used by senior management and overseen by the Board and its committees.

E Kilroe left the meeting.

M Alikhan joined the meeting.

The ACSO presented the draft Annual Report 2023, which had been circulated in advance of the meeting, to the Committee. The ACSO confirmed that the feedback which had been received by Board members F Finlay and B Whelan in the weeks prior to the Committee meeting had been incorporated.

The Committee considered the content of the draft AR 2023 and made final suggestions which would be incorporated as part of the Chairperson’s statements. It was agreed that there was a need to emphasise patient involvement along with the theme of reform and commitment to improvement.

The Committee noted the outlined timeline for finalisation of the Annual Report and thanked the ACSO and the national strategic planning team for their work on the report. The Committee recommended that the final draft of the Annual Report be submitted to the next meeting of the HSE Board on 26 April for consideration.

ACSO and M Alikhan left the meeting.

No matters were raised under this item.

The meeting ended at 13:08.

Terms of Reference: Planning and Performance Committee