Welcome to the latest issue of our newsletter.

We were all deeply saddened by the passing of our Chairperson, Professor Pat O’Mahony, in August. When I took on the role of HIQA CEO back in early 2022, Pat was a trusted sounding board and valued ballast for the organisation and quickly became a firm friend as well. His extensive experience, his political judgment and calm demeanour always guided his advice and support. Pat was always generous with sharing his time, wisdom and experience and took the time to get to know both staff and Board members personally. One of Pat’s last contributions to HIQA’s mission was the publication of our Corporate Plan 2025-2027, which was developed under his leadership and vision. 

Pat’s influence on the plan is clear throughout the document, which we published recently. The focus of this Corporate Plan and our work over the next three years is on enabling the best possible outcomes for all who use health and social services through our regulatory, standard setting and providing evidence to inform decision-making roles. A core commitment within this Plan is to keep people at the centre of what we do to ensure we continue to make a meaningful impact across the health and social care sector. 

We recognise that this Plan is ambitious in terms of its outcomes focus and scope, and therefore investment in our organisation structure, our people and our technology is central to its success. These will ensure we have the organisational and governance cornerstones in place to deliver on our remit to improve outcomes for people at individual and population level. 

We recently published our independent review to inform decision-making on the design and delivery of urgent and emergency healthcare services in the HSE Mid West health region. This review is underpinned by our commitment to providing robust evidence to inform policy and practice, and our regulatory lens with first-hand experience in assessing the care provided in healthcare services to ensure the best possible outcomes for the people who use healthcare services. We were requested to undertake this review by the Minister for Health due to our role as an independent regulator and our expertise in carrying out similar complex and multifaceted reviews in the past. Our evidence synthesis function played a central role in our approach by ensuring that our recommendations were based on the best available research and international best practice. We also engaged widely with key stakeholders, both regionally and nationally, to find out their views and experiences. This in-depth engagement process included a public consultation which received over 1,100 responses from patients and families, healthcare professionals, patient and community organisations, members of the public and other interested parties and assisted greatly with capturing the real-word experiences of people using healthcare services in the region.

We found that the core issue impacting urgent and emergency healthcare delivery in that region is the significant inpatient bed capacity deficit relative to demand from patients presenting with more serious or complex care needs. Our advice to the Minister highlighted a need for immediate action and investment to address current risks to patient safety in the shortest time frame and safest way possible, and we presented three options to the Minister on how this could be achieved. We would like to thank all of the organisations and individuals, including patients and their families, for their valuable contributions to this review.

We hope that this report, and our recently published report on our monitoring of healthcare services in 2024, will inform policy and decision-making for the healthcare sector. 

It has been a challenging year for the organisation. Recent events remind us of the need to challenge ourselves to continue be a learning organisation, to be open and accountable and to continually review our practices and adapt how we work. Our priority is the safety, dignity and wellbeing of residents and we have conducted a series of inspections in all nursing homes operated by the parent company that was subject to the RTÉ Investigates programme earlier this year. Where we found deficits in care, we took regulatory action to enable the providers to make improvements for residents. 

We are working closely with the Minister for Older People and the Department of Health to look at areas where the regulatory and policy framework for nursing homes can be strengthened. We have also committed to review how we inspect and regulate nursing homes and use the learning to strengthen our regulatory role and its impact. Everyone working at HIQA is driven by our shared mission to deliver the best outcomes for all who use health and social care services, and we remain committed to driving continuous improvements in overall experiences of those using health and social services. 

We will continue to work with Government, the Department of Health, nursing home providers, residents and their families towards highlighting the need for these reforms which will allow us to continue to do our work effectively in a rapidly-changing environment and act swiftly when standards fall short.

Recently, I attended the Nursing Homes Ireland annual conference where I met with Minister for State with responsibility for Older People Kieran O’Donnell TD and took part in a panel discussion which focused on the area of continuous improvement in care, a topic that lies at the heart of delivering high-quality services in nursing homes.

We also had further opportunities to engage with the nursing home sector as well as those working in disability services through recent learning events we held across the country. We would like to thank everyone who took the time out to attend these events and contribute to excellent discussions on how to improve and strengthen services across both sectors.
Listening to the voices and feedback of people who use services is at the core of what we do in HIQA. 

Public and patient involvement is crucial in improving the delivery and standard of healthcare in Ireland, and we aim to consistently integrate the voices of both the public and patients into all aspects of our work. One example of this in practice was the recent Centre in Ireland for Clinical guideline support and Evidence Reviews (CICER) conference ‘Our Healthcare System, Our Voices: An Evidence-Based Approach for Healthcare’ which took place last month. Hosted jointly between us and RCSI University of Medicine and Health Science, it brought together patients, members of the public, health professionals and researchers and focused on stakeholder involvement in the development of both clinical guidelines and health technology assessments. I would like to thank all of our speakers, including Professor Mary Horgan, Interim Chief Medical Officer at the Department of Health and Dr Colm Henry, Chief Clinical Officer of the HSE, and all attendees for taking the time to come together to discuss how together patients and the public can actively shape the better delivery of healthcare services in Ireland. 

Our report on what people living in residential disability services told us through a series of resident forums also reflects this ethos of amplifying the voices of people using services within our work. In these meetings, residents told us about their rights, their understanding of HIQA inspections, and other areas of importance to them. They highlighted the vital importance of having access to information in a format that meets their needs, and we worked with residents to develop accessible tools as a result. I would like to thank the residents who took part, the staff members and advocates who supported them, and the service providers who facilitated the forums.

Our work in providing evidence to inform decision-making continues and enables us to contribute to improved outcomes for people using services through substantial engagement with key stakeholders. In January this year, the EU Health Technology Assessment Regulation (HTAR) came into effect. We continue to work towards the successful implementation of HTAR through the Coordination Group and its Joint Clinical Assessment and Methodological and Procedural Guidance (subgroups, as well as the Secretariat of the Heads of HTA Agencies Group. We have supported greater European cooperation and coordination since 2007 through our work with the EU network for HTA (EUnetHTA) and will continue to support the implementation of HTAR through the conduct of Joint Clinical Assessments and contributing to the HAG Insight consortium (Head of Agencies Group Initiative for Knowledge and Skill Enhancement in Health Technology Assessment Regulation). 

We also continue to work at European level to prepare for the implementation of the European Health Data Space (EHDS) Regulation, a major health information initiative in all EU countries. In collaboration with the HSE, Department of Health, Health Research Board (HRB) and other key stakeholders across the health system, we are coordinating a number of key programmes of work under the HealthData@IE project, which will support the establishment of health data access body services in Ireland. This will facilitate wider secondary use of data and provide secure access to data to support research and innovation, education and training, policy-making, health service management, and so on. Two recent collaborations we have worked on in this regard are an international review of approaches to registries in health and social care, which will inform national policy on how Ireland responds to the EHDS legislation; and a review of current international evidence identifying examples of good practice in the exchange of health-related data for secondary use purposes in six EU jurisdictions. We look forward to continuing this work as we support the shared European vision of a more efficient, innovative and responsive healthcare system that benefits everyone.

We recently launched a public consultation seeking your views to inform the development of a health technology assessment of teledermatology to support the management of primary care referrals. This assessment is being undertaken at the request of the HSE to inform its Model of Care for Dermatology, which identifies teledermatology as a potential strategy to improve access to care, and to increase dermatologists' capacity to triage referrals effectively. We are seeking your feedback by 18 December to inform this. 

As we continue to support the move to electronic health records, we recently held a consultation on the Draft National Standard for Hospital Discharge Information aims to gather all the necessary information needed to ensure that continued safe quality care and support is provided to patients by their primary healthcare setting when they are discharged from hospital. All feedback received is now being used to finalise the standard for implementation in the sector. 

In this newsletter, you will also find details of our recent appearances at the Oireachtas and pictures from a range of learning events and conferences hosted or run by HIQA over the last few months. 

Until next time,
Angela