Minutes of HSE Board Meeting 22 October 2025

Present

Mr Ciarán Devane (Chairperson), Mr Brendan Whelan, Mr Tim Hynes, Ms Anne Carrigy, Mr Matt Walsh, Mr Michael Cawley, Mr Kenneth Mealy and Ms Lily Collison.

Apologies

Dr Yvonne Traynor and Mr Aogán Ó Fearghail

In Attendance for Board Meeting:

Mr Bernard Gloster (CEO), Mr Damien McCallion (CTTO), Mr Stephen Mulvany (CFO), Ms Kate Killen White (REO Dublin & Midlands), Ms Sara Long (REO Dublin & North East), Ms Martina Queally (REO Dublin & South East), Dr Andy Phillips (REO South East), Mr Joseph Duggan (Chief Internal Auditor), Dr Colm Henry (CCO), Mr Patrick Lynch (ND Planning & Performance), Mr Joe Ryan, (National Director, Public Involvement, Culture and Risk Management), Brian O’Connell (ND Strategic Health Infrastructure and Capital Delivery), Gareth Morton (ND Procurement), Ms Eithne Fox (AND HR Recruitment Reform and Resourcing), JP Nolan (AND Access and Integration), Dr Catherine Peters (Regional Clinical Director), Mr Ben Cloney (AND Communications and Digital Services), Miin Alikhan (AND Planning), Ms Niamh Doody (CEO Office), Mr Brian Murphy (CEO Office), Ms Niamh Drew (Deputy Corporate Secretary), Ms 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 Chairperson welcomed members to the meeting and provided an update to the Board during their private session.

2.1 Declarations of Interest

No conflicts of interest were declared.

2.2 Chairperson’s Remarks

The Chairperson provided an update to the Board on a number of matters that would be discussed during the meeting.

2.3 Minutes of Board meeting

The Board approved the minutes of the Board meeting of 26 September 2025.

3.1 Audit and Risk Committee

Ms Anne Carrigy, on behalf of the Committee Chairperson, provided an overview to the Board on the matters considered at the Committee meeting that took place on 17 October 2025.

The Board held a discussion on the following areas:

• The high number of consultants not included in the Irish Medical Council Specialist Register, the urgent focus required, and the risks involved in the resourcing of hospitals including surgical hubs.
• HSE’s financial position, both year to date and regarding the end of year projection.

Appointment of External Member

Ms Carrigy requested that the Board approve the appointment of Mr Peter Lynch as an external member of the Audit and Risk Committee for a term of 3 years until 22 October 2028, which the Board approved. Board Decision No.: 221025/49.

3.2 Performance Committee

The minutes of the Committee meeting of 19 September 2025 were noted. The Committee Chairperson provided an overview to the Board on the matters considered at the Committee meetings that took place on 09 October and Special meeting re draft National Service Plan (NSP) 2026 on 21 October 2025.

The Board held a discussion on the following areas:

• National Performance Report (NPR).
• The operation of the fraud policy relating to home care services.
• The provision to reduce costs in relation of home care services.

4.1 CEO briefing to Board

The CEO briefed the Board in relation to two separate issues relating to the Irish Voluntary Healthcare Association / Section 38 agencies; and the existence of certain Orders of the High Court pertaining to a matter. The CEO also provided an update on matters related to UHL and HR Process.

4.2 CEO Monthly Report

Members of the Senior Leadership Team joined the meeting

The CEO reported to the Board on a number of the key significant areas as set out in the CEO Monthly Report.

The CEO reported to the Board on Urgent Care, outlining the trolley performance for August and September compared to 2024, with University Hospital Waterford continuing to report no trolleys this year. For the month of September, Emergency Department (ED) attendances increased by 7.6%, the equivalent of 328 additional patients attending the ED each day, 15% of all people attending were over the age of 75 years, of which 51% were admitted. Overall, this increase in demand means attendance have grown by +4.4% for the year to the

end of September, and based on early data, attendances are likely to continue growing in October.

The CEO outlined his concern at the challenge in a number of sites, and that there has been a continued focus with daily calls with sites recording Amber or Red at 8 am, and noted that with the opening of 96 beds at UHL is showing positive signs of impact however it is too early to be definitive on the exact reduction in pressure. He outlined that with the winter period ahead, with flu yet to feature strongly, it will be a challenging period however there is focus from CEO to Ward level.

The CEO reported to the Board on Urgent Colonoscopy breaches, noting that against a zero-breach target, the total number of urgent colonoscopy breaches has increased from 2,393 in 2024 to 4,807 in 2025 (+100.9%), with 27 hospitals reporting breaches in 2024 compared to 19 in 2024, and 7 hospitals have reported zero breaches. Overall there has been some visible improvement since the escalation of this issue and there is a way to go to correct to target. The Board noted the CEO’s concern at referral patterns and the definitions being applied to urgent and that further monitoring is required.

The Board welcomed the launch of the National Endometriosis Framework and other supports on 18 October 2025, which aims to build capacity for endometriosis care and will have an immediate impact with 100 additional surgeries before the end of the year and a new Endometriosis Surgery Abroad Interim Scheme to operate in parallel with services in Ireland. This new scheme is a targeted response to the urgent need for timely surgical intervention for women with moderate to severe endometriosis, while domestic services are further developed and scaled up under the National Endometriosis Framework.

In relation to the National Children’s Hospital (NCH), the Board noted the Lead Director’s Report to the National Oversight Group (NOG) for the NCH and that the NOG are due to meet on 22 October 2025.

The CEO advised the Board that Paul Connors BL, former National Director of Communications, has recently re-joined the HSE following career break and takes a new role reporting to the Chief People Officer as HSE in house Counsel, Employment Law Matters, The Board welcomed the development for this strategically important area of work, noting that it will also reduce costs over time in respect of outsourcing in employment matters.

The CEO reported that the National Electronic Health Record (EHR) Programme Preliminary Business Case (PBC) is in the final stages of the DPENDR Major Projects Advisory Group (MPAG) Process. The MPAG Report has been received and recommendations are being considered for incorporation. The MPAG Report will form part of the Memo to Government from the Department of Health, for which the target is November. The Department of Health and HSE are also working with DPENDR to establish the Peer Review Group.

The Board noted the update in relation to the implementation of the Maternity and Newborn Clinical Management System (MN-CMS) which provides a single EHR for all women and babies in Maternity, Gynaecology and Neonatal services in Ireland, to six stand alone maternity hospitals. This brings coverage close to 70% of births and 65% of Neonatal Intensive care activity nationally. This ensures that gynaecological patients, expectant mothers and their babies have complete health records that are accessible, regardless of where they receive care, a Maternity and Newborn EHR hospital or in their affiliated community services.

The CEO provided an outline of key engagements made, all of which contribute to the process of improved performance and public confidence, which included Cabinet Committee on Disability; patient and family member meetings on topics including disability; Public Accounts Committee and Joint Committee on Health.

National Performance Report

The monthly National Performance Report (NPR) August 2025 data was presented to the Board. The Performance Committee also reviewed this at its meeting on 09 October 2025. The Board approved the August 2025 NPR for submission to the Minister for Health, and Department of Children, Disability and Equality, and noted that once submitted, the NPR will be published on hse.ie.

5.1 Contracts & Properties

As recommended by the Audit & Risk Committee for approval, the Board considered and approved the following proposed contracts and properties:

1. 1. 1. Disposal of land O’Reilly Avenue, Mount Brown, Dublin 8 Decision No.: 221025/50
      2. Surgical Hubs – Proposal for Additional Operating Theatres Decision No.: 221025/51

6.1 National Service Plan 2026

The CEO advised the Board that this was the second Strategic Focus session to consider the development of the National Service Plan (NSP) 2026; and asked the Board to review the approach, structure and provide guidance on the next steps and priorities for the NSP.

The Board noted that the NSP is a formal agreement between the Minister for Health and Minister for Children, Disability and Equality and the HSE on the type and volume of services to be delivered within the allocated budget, reflects the strategic commitments of the HSE’s Corporate Plan 2025–2027.

He advised the Board that the Department of Health had provided a draft Letter of Determination (LoD), and outlined some of the main implications which included the Minister’s priorities; devolved Accountability; Workforce Expansion; Cost Containment; Productivity Gains; and Performance expectations. The Board noted that the CEO had not yet sight of the Department of Children, Disability and Equality’s draft LoD.

The National Director Planning and Performance advised the Board with formal LoDs from both Ministers pending, preparatory work for the NSP was well underway and that the briefing presented to the Board was an early pre LoD draft of the NSP.

The Board discussed the structure and content of the draft presented, noting that the NSP 2026 will see a shift toward a more measurable, action-oriented plan. The Board noted that the NSP will be delivery-focused: emphasizing what will be done, with clear activity levels and targets; will be specific and measurable: including quantifiable actions and KPIs; and will be regionally integrated: enabling translation into Regional Operational Plans.

The Board held a discussion in relation to the core components of the NSP including the service area chapters detailing planned activity and outcomes; the resources outlined including budget and workforce; and the performance framework, KPIs and projected activity levels.

An outline of the next steps and timeline was noted and the Board will continue to be consulted as the NSP develops, particularly the next version which will reflect the priorities set out by both Ministers in the LoDs due by the 28 October 2025.

There was no further business. The meeting concluded at 2pm