Special HSE Performance and Delivery Committee meeting minutes 16 November 2021

Committee Members Present

Tim Hynes (Chair), Brendan Whelan, Brendan Lenihan, Sarah Barry.

Apologies

Sarah McLoughlin, Louis Flynn, Fergus Finlay

HSE Executive Attendance

Anne O’Connor (COO), Dean Sullivan (CSO), Stephen Mulvany (CFO), Marie Carroll (Planning Specialist), Philip Crowley (ND Strategy & Research), Stephanie O’ Keeffe (ND Integrated Operations & Planning),Patrick Lynch (ND Gov & Risk), Yvonne Goff, Fran Thompson (CIO), Michael Redmond (OCIO), Niamh Drew, Jaymie Crone

The Committee Chair welcomed members to the meeting noting that the purpose of this meeting is to provide the Committee with further updates on the NSP and ICT Capital Plan and to provide feedback to the EMT.

No conflict of interest was declared.

2.1 National Service Plan Update

The CSO provided an overview on the draft 2 of the NSP which had been circulated for consideration and review by the Committee. He thanked the Committee for reviewing the NSP draft 1 (post-LoD) at their meeting on 9 November.

The CSO informed the Committee that Draft 2 NSP 2022 continues to evolve and a detailed process was underway between strategy and planning, operations and clinical colleagues all working closely with the BIU and Finance, to finalise target levels of performance and activity for 2022. He also noted the ongoing work to finalise the Resource Strategy and to close out the Appendices in the NSP.

The CSO confirmed that the updated draft had been shared with the Department of Health on Friday 12 with feedback due by Tuesday 16 November.

It was noted that the NSP as drafted is in line with the National Strategies and Ministers priorities as set out in the Letter of Determination and the NSP supports the advancements of programs of work in line with Sláintecare The Committee suggested that the level of work that is being carried out to improve the relationships with S38/S39’s at the Dialogue Forum be included in the NSP. This work aims to identify practical means to improve relationships, review service level agreements and create better structures around accountable autonomy. The Committee considered that the issue of staff retention should also be included and monitored alongside staff recruitment.

The Committee also discussed capturing regionalisation structures and reinforcing areas such as mental health and clinical leadership and requested that the strategic context within the NSP reflect the innovative changes brought about through the current COVID 19 Pandemic response which the COO noted will impact on the year ahead with challenges in the Acutes areas and from the cyberattack. The importance of having frameworks for risk management, business continuity management, governance and compliance that will allow the HSE to anticipate and prepare for significant threats before they occur was highlighted.

The CFO informed the Committee that the Financial text and tables are been finalised and would be circulated shortly for review.

The CSO thanked the Committee for the comments and feedback which will be addressed in the next draft and noted that the next version of the document will be issued for review to the Board and DoH by Friday 19 November with the final version to be adopted by the Board Tuesday 23 November and submitted then formally to the DoH.

The CIO provided a high level overview of the eHealth and ICT Capital Plan 2022 that was circulated prior to the meeting to the Committee for their consideration. He stated it provides public investment in health infrastructure to meet the current needs of the healthcare sector and enables the realisation of a vision for a high quality, safe, accessible and sustainable healthcare system.

The CIO noted that the ICT and eHealth capital funding available in 2022 is €130m, an increase of €10m on 2021. It is less than what was requested to complete the planned projects for 2022 and it was noted balancing the investments across the demands of both the Foundational, and the Transformational strategic imperatives simultaneously is the challenge of the 2022. It will be difficult to achieve completion of all agreed projects while continuing to deliver on the multiple priorities that the organisation has articulated. The current focus is to decide on which programmes will proceed and which will have to be held off. The challenge is to balance the available ICT Capital, ICT staffing, associated service staffing and the ability to absorb change to deliver the ICT change programmes and at the same time continue to deliver services.

It was noted that the capital plan has to remain aligned with the DOH priorities as articulated in the Letter of Determination while maintaining priority on Cyber and foundational infrastructure to reduce cyber risk and increase security profile. The CIO noted that significant unmet demand being articulated within the Acute sector which is not included in the plan is currently being monitored and assessed.

The Committee discussed how projects will be managed to reach the reduced level of funding allocation. The CIO informed the Committee all projects are split into three categories, Foundational Infrastructure & Cyber Technology, Existing National Programs and HSE Transformation Priorities and noted prioritisation (or de-prioritisation) and programme delivery shaping has always allowed the HSE to deliver on the ICT capital budget while managing a large number of projects. This shaping was normally undertaken within the OoCIO and submitted to the EMT and Board. In previous years projects would have been elongated including the infrastructure replacements to manage the overall capital allocation and prioritise eHealth projects.

The Committee discussed how cyber security is being addressed in the ICT Capital Plan. The CIO noted the HSE is moving their infrastructure to a predominately cloud based infrastructure and that reducing on premise footprint is critical to improving the overall security profile. All new solutions will be cloud based wherever possible and existing solutions will also be moved to the cloud wherever possible while managing the disruption that can be the cause. This will take a number years and will require investment in several areas within the infrastructure area.

The CIO thanked the Committee for their contributions and agreed to come back with a further update on the ICT Capital Plan as the Committee requests.

The meeting concluded at 6pm.