Today, the Health Information and Quality Authority (HIQA) has published 14 inspection reports assessing compliance with medical exposure to ionising radiation regulations in eight public and six private facilities. 

Of the facilities inspected, HIQA found high levels of compliance in Affidea Waterford; Blackrock Health Blackrock Clinic; BreastCheck Group - Eccles Unit; Global Diagnostics Blackrock Hall; Osteoporosis Scanning Centre; University Hospital Galway; UPMC Aut Even Hospital Ltd.; and Vhi Swiftcare Clinic Cork.

Inspectors identified several examples of good practice, showing clear efforts to ensure that patients receive safe and appropriately managed radiation exposures. Examples included:

• Staff and management in several facilities, including BreastCheck Group - Eccles Unit, Osteoporosis Scanning Centre and Vhi Swiftcare Clinic Cork, demonstrated a strong commitment to radiation protection practices.
• Affidea Waterford and Blackrock Health Blackrock Clinic, used clinical audits effectively to support safe care.
• Global Diagnostics Ireland and UPMC Aut Even Hospital Ltd. used radiation dose monitoring systems to help ensure patients receive the lowest dose necessary for accurate diagnosis.
• University Hospital Galway used dose monitoring systems and established diagnostic reference levels for radiotherapy planning scans, demonstrating a proactive approach to patient dose optimisation.

Inspectors followed up on findings from previous inspections in six of the 14 medical facilities. In many instances, facilities had taken effective action to improve regulatory compliance. For example, the undertaking at Blackrock Health Blackrock Clinic introduced effective measures to meet regulatory requirements, including referral practices and procedures for confirming pregnancy where relevant.

However, in some facilities, significant improvements were required to meet regulatory compliance. For example, urgent action was required by Cork University Hospital to address non-compliances identified in the diagnostic imaging department regarding referral practices. The undertaking also needed to ensure the clear allocation of responsibility and effective communication for radiation protection and to strengthen the involvement of medical physics experts in the facility. Similarly, Tallaght University Hospital needs to strengthen radiation safety governance, documentation and oversight to address the non-compliances observed during inspection.

As in previous inspection reports for some medical facilities, inspectors identified incident reporting as an area requiring further attention. Medical facilities need to ensure that all potential incidents and near misses are identified, recorded, reviewed, analysed for patterns and reported in line with HIQA guidance.

Where inspectors identified non-compliance, undertakings were required to submit a compliance plan outlining how they will come into compliance with the regulations. HIQA continues to engage with facilities where non-compliances are found. 

Notes to the editor:

• The 14 inspection reports published today relate to eight public and six private facilities and the associated undertakings, and include the following:
  • Affidea Waterford (Affidea Diagnostics Ireland Ltd)
  • Blackrock Health Blackrock Clinic (Blackrock Clinic)
  • BreastCheck Group - Eccles Unit (Health Service Executive)
  • Cork University Hospital (Health Service Executive)
  • Global Diagnostics, Blackrock Hall (Global Diagnostics Ireland)
  • Osteoporosis Scanning Centre (Digital Diagnostics Ltd)
  • South Infirmary Victoria University Hospital (South Infirmary Victoria University Hospital)
  • St Finbarr's Hospital (Health Service Executive)
  • St John's Hospital (St John's Hospital)
  • St Vincent's University Hospital (St Vincent's University Hospital)
  • Tallaght University Hospital (Tallaght University Hospital)
  • University Hospital Galway (Health Service Executive)
  • UPMC Aut Even Hospital Ltd. (UPMC Aut Even Hospital Ltd.)
  • Vhi Swiftcare Clinic Cork (Vhi Health & Wellbeing DAC).
• These inspections were carried out to assess compliance with the European Union (Basic Safety Standards for Protection Against Dangers Arising from Medical Exposure to Ionising Radiation) Regulations 2018 (S.I. No. 256 of 2018), as amended.
• Since 2019, HIQA is the competent authority for patient protection in relation to medical exposure to ionising radiation in Ireland following the transposition of the European Commission Basic Safety Standards Directive 2013/59/Euratom into Irish law.
• HIQA has established national procedures for clinical audit of radiological procedures involving medical exposure to ionising radiation. The National Procedures for Clinical Audit set out the principles and essential criteria that undertakings must follow to ensure compliance with the requirements of the regulations.
• HIQA has established guidance on radiation incident notifications. Statutory notifications for accidental or unintended medical exposures to ionising radiation provide guidance for undertakings carrying out medical exposures to ionising radiation on the statutory requirement to notify significant accidental or unintended exposure events to HIQA.
• To support services to achieve compliance, the following guidance documents are available:
  • guidance on the assessment of compliance in undertakings providing medical exposure to ionising radiation
  • assessment-judgment framework for undertakings providing medical exposure to ionising radiation.
• Medical exposure to ionising radiation occurs when radiation is used as part of diagnosis such as an X-ray or computed tomography scan, or the use of radiotherapy as part of cancer treatment at a hospital. It also includes radiation received for medical research purposes and radiation received by carers and comforters while attending to a patient. The regulations also include medical exposures used as part of a dental assessment, such as a dental X-ray.
• An undertaking is a person or body who has the legal responsibility for carrying out, or engaging others to carry out a medical radiological practice, or the practical aspects of a medical radiological procedure, as defined by the regulations.