HIQA will assert independence and strive for accountability

Phelim Quinn, appointed new Chief Executive of the Health Information and Quality Authority in November 2014, outlines his vision for the Authority over the next 3-5 years.

Phelim Quinn, HIQA Director of Regulation
Phelim Quinn, HIQA Director of Regulation

It is clear that Ireland’s health services are in a period of significant reform and are challenged by the impact of a range of austerity measures which require greater efficiency and value for money. Added to that, recent events, highlighted by the Primetime Investigates programme into Bungalow Three in Aras Attracta, have brought into sharp focus the requirement for us all to be particularly vigilant in monitoring the delivery of services to people who may not be able to clearly articulate to practitioners, managers, their relatives or us – the regulator, vital information on what their experience of services is like.

I consider my appointment to the post of CEO of HIQA as a great privilege at a critical time in the evolution of the Irish health and social care system and I believe that our role in HIQA is to improve the quality, safety and experience of people using these services.

In 2015, we will also monitor the first of our specific ‘patient experience reviews’ into the nutrition and hydration of dependent people in acute hospital wards.

In the next three years, we plan to do this using the key activities of regulation and the oversight of services, setting standards and providing strategic advice to Government and national provider organisations.

When the Authority began regulating designated centres for adults and children with disabilities in November 2013, we understood there would be significant challenges ahead. The key motivation behind the Government introducing a programme of regulation within the sector was the vulnerability of residents. At that time, we assumed responsibility for the registration of nearly 1,000 centres of varying sizes across the country, while recognising the need to respond to risks within centres outside the registration programme.

We understood the regulation process would uncover examples of unacceptable practice. The events that were unfolding at Aras Attracta and other designated centres highlight the challenges for providers, commissioners and HIQA as a regulator. I believe that we must respond with continued vigilance, robust inspection methods and the application of a rights-based approach to regulation that promotes the core principles of privacy, dignity, respect, autonomy and fairness for all adults and children using services.

In HIQA we will be unequivocal in the application of our powers under the Health Act in the enforcement and prosecution of those providers who put the health, welfare and safety of residents at risk.

In 2015, we will also monitor against the National Standards for Safer Better Healthcare and undertake the first of our specific ‘patient experience reviews’ into the nutrition and hydration of dependent people in acute hospital wards. Our monitoring programme will also focus on patient safety and, over the course of the next year, we will conduct an assessment of the safe use of antibiotics in our hospitals to reduce healthcare associated infection and antibiotic resistance.

It is my personal aim to ensure our approaches and interventions in the Irish health and social care sector are conducted intelligently, compassionately, independently and excellently. One key element of our regulation programme will be information and intelligence, how it helps inform our view of risk or harm within services, and how we subsequently respond. I am committed to ensuring that we progress our remit and functions in a way that promotes best use of information and evidence within the health and social care sector.

We rely on the eyes and ears of people who use health and social care services, their relatives, staff and managers to report concerns and complaints to HIQA and other relevant agencies.

I want to reassure all people who use health and social care services, and the public, that all information we receive is assessed and acted upon. This can include referral of complaints and concerns to other agencies that have a responsibility to deal with them. Receipt of such information can also lead to specific action by our inspection teams, ensuring that services are safe and compliant with regulations and standards through on-site inspections. We cannot be present in services on a continuous basis. Therefore we rely on the eyes and ears of people who use health and social care services, their relatives, staff and managers to report concerns and complaints to HIQA and other relevant agencies.

This focus on information and intelligence will not only be confined to frontline services. Our work continues to highlight the critical nature of health information in the delivery of safe, effective healthcare. As evidence points towards the benefits of an eHealth pathway for Irish healthcare, the demand for technical standards and guidance around the gathering, use and storage of information increases.

In the next year, we will lead on the development of standards guiding the implementation of Individual Health Identifiers and national dataset collections while continuing to work with Government on forthcoming policies and initiatives arising from the implementation of the eHealth strategy for Ireland.

The Authority will continue its important role producing health technology assessments (HTA) to inform national health policy and service decisions. As demand for health technology assessment advice increases and exceeds our capacity to deliver, the Authority is now looking at innovative ways to meet this challenge through the streamlining of our HTA processes and products, collaborative working with experts in the system, and offering guidance to support those undertaking health technology assessment activities.

We will also take a more strategic approach to service and quality improvement through the development of standards and guidelines. In recent years, our reviews and investigations have highlighted the need for service-specific standards and associated guidelines to improve the quality and safety of services. In 2015, as an extension to the National Standards, we hope to develop the first service-specific standards.

During my time as CEO, my aim is to ensure that HIQA continues to have a positive and constructive impact on Irish health and social care services. We will continue to assert our independence and strive for accountability among providers in the delivery of safe and effective services.