Recurring and persistent issues hamper delivery of the best possible care in our hospitals

HIQA carried out 38 inspections in public acute hospitals in 2018 to assess the quality of care in internationally-recognised areas of patient safety risk, including infection prevention and control, and medication safety.

HIQA’s Head of Healthcare, Sean Egan, said, “Our findings in 2018 demonstrate improvements in how a number of key patient-safety concerns were managed — in what is often an extremely challenging environment for patients, staff and management.

“In particular, the enhanced national approach taken by the HSE in response to the increase in the superbug CPE (Carbapenemase Producing Enterobacterales), together with a targeted increase in public funding to address this issue, played a significant role in improving the management of this key risk to patients.

“However, recurring and persistent issues continue to hamper the delivery of the best possible care in our hospitals. During 2018, HIQA repeatedly found widespread variation in the effectiveness of medication safety programmes across the hospitals inspected. Medication safety has a near universal impact on patients and therefore must be better prioritised across all Irish hospitals. Ensuring best practice in medication safety in hospitals warrants urgent and more ambitious attention at a national level within the HSE, similar to the approach being applied to managing CPE.”

In the report, HIQA also highlights the need for further initiatives to promote patient safety in the absence of regulation in public and private healthcare services.

Mary Dunnion, HIQA’s Director of Regulation, said: “While we escalate high risks to the HSE and the Department of Health, HIQA’s powers in relation to healthcare settings remain limited. We do not have the same powers of regulation within healthcare services as we have for older persons’, disability and children’s services. We welcome the proposals to expand our remit to monitor the private sector in the Patient Safety Bill, and to then regulate public and private healthcare as envisioned in the Patient Safety (Licensing) Bill.

“In the interim, while waiting for the implementation of policy developments, the Irish health service continues to face significant challenges. HIQA believes that more can still be done in the short-term to improve patient safety in key priority areas such as medication safety through better national leadership and investment.”

During 2018, HIQA also commenced an inspection programme of maternity hospitals and units. Following completion of this programme, an overview report and individual hospital or unit inspection reports will be published.

In January 2019, HIQA assumed responsibility for the regulation of medical exposure to ionising radiation in both public and private healthcare and dental services in Ireland.

In 2018, HIQA prepared for the inspection of 23 public rehabilitation and community inpatient healthcare services. These are neither acute services nor based in acute healthcare settings, but provide a range of vital healthcare services. Inspections of these services recently commenced.