HSE Planning and Performance Committee meeting minutes 8 December 2023

Committee Members Present

Fergus Finlay (Chair), Brendan Whelan, Sarah McLoughlin, Joan Johnston (left approx. 11:25), and Sarah Barry (left approx. 9:55).

Apologies

Anne Carrigy.

HSE Executive Attendance

Damien McCallion (COO), Tony Canavan (CEO Saolta Hospital Group), Joe Ryan (ND Operational Performance and Integration), Orla Treacy (Operational Performance and Integration), Mary Day (ND Acute Operations), Niamh Drew (Deputy Corporate Secretary), Rebecca Kennedy (Office of the Board).

Joined the Meeting

Mark Brennock (ND Communications - Item 2.3), Stephen Mulvany (CFO – Item 3), Stephanie O’Keeffe (ND Operations Planning – Item 3), Philip Crowley (ND Strategy and Research – Item 3), Miin Alikhan (AND Nat Strategic Planning and Reporting – Item 3), Sarah McBride (Chief Officer CHO8 – Item 4).

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 17 November 2023.

2.5 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 winter vaccine programmes, the current spike in RSV, and projected hospital attendance over the Christmas period.

ND Communications and S Barry left the meeting.

CFO, ND Operations Planning, ND Strategy and Research, and AND Nat Strategic Planning and Reporting joined the meeting.

The ND Operations Planning and CFO updated the Committee on the development of draft 1 of the NSP 2024 following receipt of the Letters of Determination (LoDs) from both Department of Health (DoH) and the Department of Children, Equality, Disability, Integration and Youth (DCEDIY) on 29 November and 4 December respectively. The draft NSP 2024 and its current timeline were circulated to the Committee in advance of the meeting for review and consideration.

The Committee noted the timelines for completing NSP 2024 with submission on 20 December 2023. The ND Operations Planning summarised the work that is continuing to close out on the financial and workforce positions and associated service considerations and provided a summary of the content of the NSP.

She advised that exchanges with both Departments have been ongoing since August to support a shared understanding of planning assumptions, expectations and key requirements set out in the LoDs. In relation to content, the Committee were advised that the NSP 2024 aims to be clear on productivity and efficiency actions that will be taken in 2024 to maximise service activity and volume, particularly in relation to access, improved waiting list performance and urgent and emergency care.

In this regard, work continues to examine targets and KPIs with a detailed process underway across service areas and functions to finalise target levels of activity and performance for 2024.

The Committee were advised that the draft 2024 eHealth & ICT Capital Plan was approved by the Technology and Transformation Committee on Friday 1 December following a full review undertaken with the DoH. The plan is presented through the perspective of the single vision, six principles and 48 initiatives of the Digital Health Strategic Implementation Plan. The draft Estates Capital Plan has also been through a feedback process with the DoH and is being considered by EMT and by the Audit and Risk Committee. Both Plans will accompany the NSP 2024 for submission to the Ministers on 20 December.

The Chair invited Committee members to provide comments on the draft NSP.

The Committee discussed the provisions outlined in the Financial Management Framework, particularly the focus on improving productivity seen in this section and throughout the draft. The Committee emphasised that the tone of this measure should be reconsidered overall and should convey a supportive message for staff working in challenging environments. The Committee also emphasised that the level of financial risk needs to be clarified in this section.

The Committee discussed the provisions in the draft NSP relating to disability services, highlighting that priorities need to be clearer in this section, as does the level of new investment. Regarding the reduction of agency staff, the Committee requested that the risks for services carrying out agency conversion be clearly defined in the next draft.

In response to questions from the Committee regarding the resourcing of change management as it applies to the upcoming implementation of the Health Regions, the ND Operations Planning advised that the funding implications for restructure and regional developments would be clarified.

The Committee discussed the sections of the NSP that deal with Urgent and Emergency Care, particularly the focus on hospital avoidance. The ND Operations Planning advised that this section would be reviewed and the integrated efforts between community and hospital staff to provide the correct care for service users in the correct place will be highlighted.

In relation to the language used in the plan, the Committee requested that the patient focus should be highlighted throughout. The Committee also emphasised that the CEO and Chair introductions will be key in setting the overall tone of the document and they should be provided for review in the next draft.

The ND Operations Planning thanked the Committee for their comments and advised that they would be reflected in the next draft of the NSP which would be discussed at a special meeting of the Committee on 14 December.

CFO, ND Operations Planning, ND Strategy and Research, AND Nat Strategic Planning & Reporting, and J Johnston left the meeting.

The COO Performance Report, HSE Hi-level KPI Report (previously OSR), and Performance Profile (October Data), which had been circulated prior to the meeting, were noted. The Committee noted that due the FORSA industrial action in relation to recruitment pause, data is unavailable for Finance, Older Persons, Primary Care/ECC, PCRS, Palliative Care, Mental Health, Disability, Social Inclusion, Acute HCAI (partial), Cancer Services RACs (partial) and Absenteeism.

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, Human Resources; Pay and Numbers Profile, and Escalation under Performance and Accountability Framework (PAF) 2023.

In relation to Cancer Services, the Committee were advised that Cork remains in escalation to the National Performance Oversight Group although performance trends are positive and an improvement plan has been provided. Regarding the upcoming Diagnostic Review, the COO advised that this has not commenced as a co-chair has not been appointed yet and he will provide an update to the Committee. An update will also come to the Committee on issues surrounding replacement of essential equipment in St Luke’s Radiation Oncology Network which have been escalated.

The Committee discussed the data in relation to Disability Act Compliance and the potential for reaching the target which is set at 100% compliance as set out in the Act. The COO advised that there is engagement ongoing on this issue but significant development will require legislative change. It was agreed that the COO would provide more information on the key strategic elements being undertaken in 2024 to improve access to disability services.

In relation to Escalation under PAF 2023, the COO advised that though the policy was updated this year it will need to be revised in 2024 as the Health Regions are implemented. The Committee discussed the impact of escalation on the ground and were advised that sites generally do seek to stay off the escalation list and it serves as an improvement initiative.

No matters arose under this item.

The meeting ended at 12:50.

Terms of Reference: Planning and Performance Committee