The Health Information and Quality Authority (HIQA) has published 10 inspection reports on compliance in healthcare services with the National Standards for Safer Better Healthcare. Inspections were carried out in 10 public hospitals between August and December 2024 at:

• Connolly Hospital Blanchardstown
• Midland Regional Hospital Tullamore
• National Orthopaedic Hospital Cappagh
• Royal Victoria Eye and Ear Hospital
• Sligo University Hospital
• St Finbarr’s Rehabilitation Unit, Cork
• St Vincent’s University Hospital
• Swinford District Hospital
• The Incorporated Orthopaedic Hospital of Ireland, Clontarf.
• Waterford Residential Care Centre - Rehabilitation Unit

Inspectors found good levels of compliance in St Finbarr’s Rehabilitation Unit which was found to be compliant or substantially compliant with all national standards assessed, while mixed levels of compliance were found among the other hospitals inspected. 

Good governance and management arrangements to ensure the delivery of high-quality, safe, and reliable patient care were found in St Finbarr’s Rehabilitation Unit, Midland Regional Hospital Tullamore, St Vincent’s University Hospital and Connolly Hospital Blanchardstown, while oversight arrangements were identified for improvement in the other hospitals inspected. 

All hospitals inspected promoted a culture of kindness, consideration and respect for patients and this was clear to inspectors with good compliance generally seen in respect of person-centred care and support. While improvements had been made in Sligo University Hospital since the previous inspection, the inspection identified ongoing emergency department overcrowding which remains an issue. Admitted patients were still placed on trolleys in a main corridor impacting on their privacy and dignity. 

Arrangements to support the management of patient safety incidents and to respond to complaints and concerns were in place in most hospitals, with further work required in these areas for some services such as Midland Regional Hospital Tullamore. While the physical environment supported the delivery of high quality, safe, reliable care in most services, a need for further improvement was identified in a number of hospitals including the National Orthopaedic Hospital Cappagh, Royal Victoria Eye and Ear Hospital, Sligo University Hospital, and St Vincent’s University Hospital. 

Most hospitals inspected had adequate mechanisms in place to plan, organise and manage their workforce, however further work was required to address clinical staff vacancies in Connolly Hospital Blanchardstown and Midland Regional Hospital Tullamore and records of training in the National Orthopaedic Hospital Cappagh. While Sligo University Hospital had improved staffing in medical and nursing in the emergency department, vacancies in physiotherapy, pharmacy and medical social work remained unfilled and this situation was impacting the patient flow through the emergency department and the quality of service throughout the hospital.

For hospitals with emergency departments, Connolly Hospital and Midland Regional Hospital Tullamore were performing well with the targets set by the HSE for emergency department patient experience times, while further improvements were required in Midland Regional Hospital Tullamore to ensure that all targets were met for patients aged over 75. In St Vincent’s University Hospital, inspectors noted improvement in patient experience times for patients presenting within nine hours and 24 hours respectively after registration. Sligo University Hospital had made little progress in reducing patient experience times since the last inspection of the hospital, with the exception of the patient experience times for the non-admitted patients in the emergency department. On the day of inspection, St Vincent’s University Hospital and Sligo University Hospital did not meet any of the patient experience targets. 

In eight of the 10 hospitals inspected, improvements were identified to ensure service users from risk of harm associated with the delivery of healthcare services. Examples of areas identified that required further risk mitigation included comprehensive arrangements to identify and manage deteriorating patients, clinical pharmacy service supports and advancement of medication reconciliation practices. 

HIQA continues to engage with the services to ensure compliance with the national standards. 

Notes to Editors:

• As of 26 September 2024, under Section 8 of the Health Act 2007 (as amended), HIQA is responsible for monitoring compliance with national standards in publicly-funded healthcare services and private hospitals. Using these powers, HIQA may make recommendations for improvement of care, but under current legislation HIQA cannot enforce their implementation.
• The National Standards for Safer Better Healthcare describe a vision for high-quality, safe healthcare and provide a roadmap for improving the quality, safety and reliability of healthcare. They aim to ensure consistent quality care across both public and private hospitals.
• HSE patient experience times is a metric used by health services to quantify the length of time patients wait in an emergency department before they are either discharged or admitted to hospital.