Terms of Reference: Performance Committee

The Board is empowered under Section 16T of the Health Act 2004 to establish committees, consisting in whole or in part of persons who are members of the Board, to assist and advise it in relation to the performance of any of its functions.

This document sets out the Terms of Reference of the HSE Performance Committee, including responsibilities of the Committee as approved by the Board of the Health Service Executive on 23 October 2024.

The Performance Committee will be responsible for oversight of the in-year performance of the HSE with an 18 month horizon scan view. Its primary focus will be on execution and delivery of the NSP.

The Committee works in concert with, and takes comfort and assurance from, the work of other Board Committees, each of which has a specific remit as documented in their own Terms of Reference.

The Strategy and Reform Committee will have oversight of the HSE Corporate Plan with a 3-5 year horizon view. The relationship between the Performance and Strategy and Reform Committees will be managed by the Committee Chairs who will attend meetings of both Committees. This will ensure that agenda items are aligned and resolve any potential issues of overlap.

The role of the Committee is to advise the Board on all matters relating to performance by the HSE in relation to delivery of the annual National Service Plan (NSP) including annual Ministerial priorities as set by the Minister for Health and the Minister for Children, Equality, Disability, Integration and Youth in their respective Letters of Determination.

The NSP is a legislative requirement, setting out the type and volume of health and social care services to be provided by the HSE within the funding allocated over the course of the year. The NSP provides clarity on in-year actions, service priorities and related performance indicators linked to corporate and multi-annual priorities of the HSE

In discharging its role, the Committee will review HSE performance. The Committee will receive and consider the National Performance Report prior to approval and submission to the Board.

The HSE’s Performance and Accountability Framework (PAF) sets out the means by which the HSE’s services and in particular the HSE Regions, Integrated Health Areas [IHAs] and National Services and Schemes and individual managers within the HSE Centre or HSE are held to account for their performance and the performance of the services for which they are responsible. In line with the PAF, performance is viewed through the following four lenses:

• Quality: quality and Safety of services,
• Access: access to and Integration of those services,
• People: effectively harnessing the efforts of our workforce
• Money: achieving this within specific financial, governance and compliance requirements

The emphasis in the Performance and Accountability Framework is on having clear accountability and on achieving and improving performance at all levels of the health service. The Performance and Accountability Framework is explicit in its intent that performance be managed across the four domains set out above. The Performance Committee will consider performance under the Quality, Access and People lenses, while the ‘Money’ lens will be covered by the HSE Audit and Risk Committee.

At each meeting, a specific focus will be placed on services using Quality and Safety of Services, Access to and Integration of services and; People and effectively harnessing the efforts of our Workforce. These focus areas will include, but are not limited to, those set out in Appendix 1.

Additional focus will also be placed on ICT annual performance based on the HSE annual eHealth & ICT Capital Plan. The ICT Capital Plan is prepared by the Technology and Transformation function in conjunction with the Services, taking account of contractual commitments, investment priorities and funding available. This plan is provided alongside the National Service Plan in response to the Letter of Determination from the Minister of Health and is aligned to the Digital Health Strategic Implementation Plan (“DHSIP”).

The Committee will be responsible for:

1. Advising the Board on all matters relating to performance within the health service to ensure that such performance is optimised across all relevant domains to ensure better experience for patients and service users
2. On behalf of the Board, reviewing that performance against the above plans is being achieved and where not, that any necessary corrective action is being planned, implemented and monitored to ensure achievement of objectives; and
3. Reporting to the Board on performance, highlighting matters which need to be brought to the attention of the members of the Board
4. Overseeing the development and continued refinement of performance reports and associated dashboards and key performance indicator

In relation to the HSE Corporate Risk Register, the Board Audit and Risk Committee will be responsible for the allocation of oversight of risks to the Committee, as it is for other committees of the Board.

The Committee is authorised by the Board of the Health Service Executive to use its oversight role in relation to:

• all aspects of performance and delivery within the public health service as set out in the NSP
• seeking any information or explanations that it requires from any employee of the HSE or agency totally or partially funded by the HSE
• obtaining independent legal or professional advice procured in accordance with the HSE’s procurement policy
• seeking the attendance of persons with relevant experience and expertise at the Committee meeting as necessary
• reporting on and escalating any matter it deems relevant to be brought to the attention of the Board

The scope of the Committee’s authority extends to all aspects of performance within the public health service.

1. Membership and operation of the Committee

Membership

The Performance Committee will be appointed by the Board and will consist of:

1. three members of the HSE Board
2. up to two non-Board members, who in the opinion of the Board, have the relevant skills and experience to perform the functions of the Committee.

Executive attendance at meetings

The National Director Performance and Planning, the National Director Access and Integration, and a Regional Executive Officer will be the primary HSE attendees at Committee meetings and the Chief Technology and Transformation Officer, Chief Clinical Officer, Chief People Officer and National Director National Services and Schemes will attend as required. The Committee however will have the right to request the attendance of any executive required to support its deliberations.

Frequency of meetings

The Performance Committee will meet as required, determined at its own discretion, but not less than ten times a year.

Further provisions

• a person is not eligible for appointment to the Performance Committee if that person is an employee of the HSE
• a quorum will consist of three members, two of which are to be Board members.
• in the absence of the Chairperson from a meeting of the Committee, an acting chairperson will be selected from amongst the Board members attending.
• the Committee will normally operate on the basis of consensus. In the event of a vote being required on any matter a simple majority of all members present, including the Chairperson, will carry the motion with the Chairperson of the meeting having a casting vote in the event of a tie
• the Chairperson will provide Committee members as necessary with an appraisal of their performance as Committee members

2. Relevant skills and experience

The Performance Committee members should collectively possess an appropriate range of skills to perform its functions to the required standard. At least one member should have recent, relevant ICT experience and other members should have experience in the core areas of the Committee’s role and an understanding of the public sector environment, in particular governance, accountability structures, and current public sector reform initiatives.

On commencement, new members of the Committee should benefit from an induction process

3. Chairperson of the Performance Committee

The Chairperson will be one of the Board members on the Committee. The Chairperson will report to the HSE Board on its work. The Chairperson will also attend meetings of the Strategy and Reform Committee.

The Chairperson of the Performance Committee has particular responsibility for ensuring:

• that the Committee fulfils its role and responsibilities
• that the Committee is appropriately resourced
• reports to the Committee contain relevant information and are provided at the right time in an appropriate format
• that he/she ensures that a report is made at Board meetings
• matters arising are reported on at each subsequent meeting
• he/she is involved in the appointment of new Committee members.

4. Secretariat to the Performance Committee

The secretariat to the Performance Committee should:

• commission papers as necessary and support the Chairperson in preparing reports; circulate documents and prepare and circulate minutes of meetings to Committee members and to internal and external audit as necessary 5 working days in advance of meetings
• for any agreed actions, document the owner, deadline and any advice given by stakeholders and monitor between meetings
• keep the Committee abreast of developments in the HSE
• maintain a record of members’ appointments and termination/renewal dates and ensure that appropriate appointment procedures are initiated when necessary
• ensure absent Committee members are briefed on meetings and attendance records are maintained and reviewed annually

5. Indemnification

The HSE will arrange for each external member of the Performance Committee to receive an indemnification in accordance with the conditions laid out in the appendix to the General Council Report 1357 of the Civil Service, against liabilities which may arise from his or her membership of the Performance Committee.

6. Tenure

A Board member of the Performance Committee will hold office for the period determined by the Board when appointing that person. An External member may be reappointed by agreement of the Board for one additional year. A member of the Performance Committee may resign from the Committee by letter addressed to the Chairperson of the Board or may at any time be removed as a member of the Committee by the Board for stated reasons.

7. Conflicts of Interest

Committee members are required to advise the Chairperson of any potential conflicts of interest on appointment and make annual declarations under the Ethics in Public Office Acts.

Each member of the Committee should take personal responsibility to declare any potential conflict of interest arising in relation to any items on the agenda for Performance Committee meetings. A register of Performance Committee members’ interests will be maintained by the Secretary. Where a conflict of interest arises the relevant member should bring this to the attention of the Chairperson and, where necessary, leave the room for the duration of the discussion and not take part in any decisions relating to the discussion. Similar arrangements will apply in relation to meeting documentation, where such documentation will not be made available to the member. This will be noted in the minutes of the meeting.

8. Meetings

The agenda for each meeting will be finalised by the Chairperson of the Performance Committee and circulated with all relevant papers by the Secretary to all members of the Performance Committee (and other attendees, as appropriate) 5 working days in advance of each meeting. Papers provided to the Committee should clearly communicate all relevant information.

No person other than the Performance Committee members will be entitled to attend Performance Committee meetings. The Performance Committee may invite any person it considers appropriate (whether that person is or is not an employee of the Executive) to attend specific meetings.

All members of the Performance Committee will be expected, whenever possible, to attend its meetings whether by physical attendance, by video conference or by telephone connection so long as this will allow live exchange of views by the members of the Performance Committee.

The Chairperson or Secretary of the Committee will ensure that members who have missed a meeting are appropriately briefed on the business conducted in their absence.

9. Minutes

The Secretary will circulate draft minutes of meetings of the Performance Committee to members as soon as possible after each meeting. The minutes will be presented for formal approval at the next Performance Committee meeting. Once approved by the Performance Committee, the minutes will be circulated to the Board.

10. Reporting

The Performance Committee will provide its advice to the Board principally by way of its minutes.

At the end of each year the Committee will also prepare an annual report to the Board on its role and responsibilities, and the actions it has taken to discharge those responsibilities. Such a report should specifically include:

• a summary of the role of the Performance Committee;
• its performance against key performance indicators set for the year;
• the names and qualifications of all members of the Committee during the period;
• the number of Committee meetings and attendance by each member; and
• the way the Committee has discharged its responsibilities.

The Performance Committee will provide the Board an Annual Report, timed to support finalisation of the HSE Annual Report and Financial Statements.

11. Other matters

The Performance Committee will review its Terms of Reference annually and report the results of that review to the Board. Any changes recommended will be presented to the Board for approval.

The Performance Committee will undertake an annual self-assessment evaluation of its performance and report the results of that review to the Board.