The COO Report, Operational Service Report (May Data), Performance Profile (May Data), National Performance Oversight Group (NPOG) Meeting Notes (May Data), and the PMO Report - Winter/NSP 2022-23, 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 (UEC) and Child and Adolescent Mental Health Services (CAMHS).
In relation to Scheduled Care, the COO advised that activity has been increasing year-on-year however referrals are also increasing. An element of this is backlog is the Covid-19 pandemic and similar situations are being observed internationally.
The Committee sought detail on waiting list management, particularly actions being taken to provide care for patients who have been on waiting lists for extended periods of time. The ND Acute Operations advised that dynamic purchasing solutions (DPS) are being utilised as a short term solution.
The Committee expressed concern about a potential drift towards privatisation and emphasised the importance of ensuring that this is monitored. The ND Acute Operations confirmed very strict monitoring of the DPS is in place through the monthly access meetings.
She assured the Committee that it is not a sustainable solution and only used in specialities where there are significant numbers of patients waiting extended period. It will be reviewed at year end as to it continued utilisation.
In relation to UEC, the COO advised that the system has stabilised over the past number of months although it remains challenged by KPIs as they are based on best practice.
The Committee discussed whether zero tolerance in relation to certain KPIs should be the aim and the culture shifts that may be necessary in some sites to achieve this. The COO advised that work is ongoing in relation to identifying initiatives which have improved compliance with targets and whether these could be rolled out throughout the system.
The COO advised the Committee that the Mental Health Commission (MHC) report on CAMHs was due to be published in the following week. The COO confirmed that clinical leads for CAMHs and the adult mental health services have been appointed and they will be driving the implementation of the report’s recommendations.
The ND Community Operations provided an update on an agreement reached in relation to an older persons home care staffing tender process which was previously discussed at the Committee’s April meeting. This tender process aims to improve staffing levels and provide more home help hours for older persons. The ND Community Operations confirmed that the Minister has provided sanction for the HSE to progress to an Authorisation Scheme for the provision of home support services.
The Contract Approval Request and associated approval documentation have been submitted for the Board meeting on 28th July. The outcome of the tender process will be communicated to the successful Providers and to Chief Officers following Board sign-off and the Authorisation Scheme is due to commence on 14th August 2023. A similar process for home support in disabilities services will be engaged with soon.
The COO also presented information on Urgent Colonoscopy and Cancer Services in addition to updates on Therapy Waiting Lists, Serious Incident KPIs, Disability Services Assessment of Need, and escalation to National Directors under the Performance Accountability Framework 2023 which was noted by the Committee.