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. 

Most healthcare services inspected were found to provide person-centred care and support that upheld people’s dignity and promoted a culture of kindness, consideration and respect. In addition, all services inspected had good arrangements in place to respond to complaints and concerns. While some areas for improvement were identified in St John’s Hospital, Limerick, and Bon Secours Hospital, Galway, good overall levels of compliance were found in these services.

Improvement was needed in workforce planning arrangements to ensure the delivery of high-quality care across all services inspected. In Tallaght University Hospital, enhanced care observation was not fully resourced in line with hospital policy in two of the clinical areas visited, and the oversight of mandatory and essential training required focus as low compliance rates were noted, particularly among doctors and in the emergency department. Similarly, in Midland Regional Hospital, Tullamore, absenteeism across all staff grades was 8.71%, which was over twice the HSE’s target absenteeism rate. There were some positive developments since the previous HIQA inspection, with progress in filling consultant and some pharmacy posts; however, considerable staffing level deficits remained when comparing approved levels to actual staff employed across key healthcare professions. Improvements were also required in Wexford General Hospital, where staffing deficits and training compliance issues have persisted since the previous inspection. 

The provision of healthcare in a physical environment, which supports the delivery of high-quality, safe, reliable care, was identified as needing improvement across all the services inspected. During the inspection of St James’s Hospital, there was overcrowding and inadequate spacing between trolleys in the emergency department, insufficient single rooms to support infection prevention and control and instances of inappropriate or unsafe storage practices. Issues were also identified with the physical environment of St John’s Hospital, Limerick, as the legacy infrastructure presented challenges to infection prevention and control and operational safety due to restrictions in space throughout the hospital.

The inspection of the Rehabilitation Unit on St Joseph’s Ward, Sacred Heart Hospital, Castlebar, identified several areas for improvement. There was no agreed approach or policy on the recognition of sepsis or deterioration in patients in the unit, and inspectors found that the physical infrastructure was in a poor state of physical repair as several significant infrastructural issues had the potential to impact on cleanliness and infection prevention and control measures. 

Across all services inspected, some degree of improvement was required to ensure people using the services were protected from the risk of harm associated with the design and delivery of the healthcare service. In the Royal Hospital Donnybrook, deficiencies were identified in clinical governance of the neuro rehabilitation unit, and the governance, management and oversight of policies, procedures, protocols and guidelines (PPPGs) and infection prevention and control. 

The inspection of University Hospital Kerry (UHK) found significant requirements for improvement in several areas, including formalised governance arrangements and their effectiveness, monitoring of the quality of service, physical hospital environment and responding to patient safety incidents. Corporate and clinical governance arrangements were in a state of transition as the hospital continued to move towards a clinical directorate structure. Challenges in service demand regularly diverted the focus of the executive management team, and operational measures to assist with patient flow did not address the difference that existed between service demand and in-patient capacity. Despite efforts by the hospital to recruit key clinical personnel, notable deficits remained in the number of medical consultants, senior pharmacists, physiotherapists, dietitians and healthcare assistants in post, with an overreliance on agency staff. While the physical environment was generally clean, the provision of high-quality, reliable and safe care was compromised due to the insufficient number of single-bed isolation rooms and storage available in clinical areas. Overall, inspectors saw limited evidence of progression in relation to the compliance plan submitted to HIQA following the previous inspection in 2025. These findings were escalated to regional management in HSE South West and a regional improvement plan to support UHK was provided to HIQA.  

HIQA continues to engage with each service where non-compliance was identified to ensure compliance with the national standards.

Notes:

• 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.
• HIQA inspects against the National Standards for Safer Better Healthcare which describe a vision for consistent, high-quality, safe healthcare and provide a roadmap for improving the quality, safety and reliability of healthcare. HIQA can include or exclude any of the national standards as deemed necessary based on the nature of the target issue to be explored on inspection.
• HIQA judges the service to be compliant, substantially compliant, partially compliant, or non-compliant with the standards. These are defined as follows:
  • Compliant: A judgment of compliant means that on the basis of this inspection, the service is in compliance with the relevant national standard.
  • Substantially compliant: A judgment of substantially compliant means that on the basis of this inspection, the service met most of the requirements of the relevant national standard, but some action is required to be fully compliant.
  • Partially compliant: A judgment of partially compliant means that on the basis of this inspection, the service met some of the requirements of the relevant national standard while other requirements were not met. These deficiencies, while not currently presenting significant risks, may present moderate risks, which could lead to significant risks for people using the service over time if not addressed.
  • Non-compliant: A judgment of non-compliant means that this inspection of the service has identified one or more findings, which indicate that the relevant national standard has not been met, and that this deficiency is such that it represents a significant risk to people using the service.