Today, the Health Information and Quality Authority (HIQA) has published 17 inspection reports assessing compliance with medical exposure to ionising radiation regulations in five public and 12 private facilities. 

HIQA found Complete DXA Solutions and Bon Secours Killarney Outreach Clinic were fully compliant with all regulations assessed on the day of inspection, and very high levels of compliance were found in Mercy University Hospital, Mobile Medical Diagnostics Ltd. and UPMC Bon Secours.

Due to the non-compliances identified at Friary Dental Clinic, Lion Medical and Radetal Ltd. immediate engagement was required with the undertakings to provide assurances to HIQA that the non-compliances identified during the inspection had been addressed.  

Examples of good practice observed by inspectors during these inspections included efforts to identify and promote patient safety through implementing clinical audit in respect of medical exposures and using diagnostic reference levels (DRLs). For example: 

• A multidisciplinary team in UPMC Bon Secours completed an audit to review the optimisation of medical exposures delivered during computed tomography (CT) planning scans to monitor the doses delivered and ensure they were comparable with international data;
• In Mercy University Hospital, considerable improvements in overall levels of compliance with the regulations were found since the last inspection, in particular with the establishment, review and use of DRLs. 

However, further work is required in some facilities to come into full compliance with the regulation on DRLs.

Inspectors noted that HIQA’s National Procedures for Clinical Audit, published in November 2023, had been implemented in most facilities with four facilities fully compliant with this requirement of the regulations; Complete DXA Solutions, Bon Secours Killarney Outreach Clinic, Limerick Clinic and UPMC Bon Secours. However, further work is required across many facilities to fully implement meaningful and sustainable clinical audit to facilitate and enhance continuous improvement in the delivery of medical radiological procedures.

Other areas identified for additional focus in facilities included ensuring that: 

• responsibilities are allocated appropriately to staff in line with regulatory requirements, and this allocation is accurately documented and known by staff
• Information relating to patient exposure is included in the report of the procedure.

Where non-compliance with the regulations was identified, 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 17 inspection reports published today for five public and 12 private facilities, and the associated undertakings, included the following:
  • Alliance Medical @Cork University Hospital (Alliance Medical Diagnostic Imaging Ltd.)
  • Belmullet Community Hospital (Health Service Executive)
  • Blackrock Health Hermitage Clinic (Blackrock Health Hermitage Clinic)
  • Bon Secours Killarney Outreach Clinic (Bon Secours Health System)
  • Complete DXA Solutions (Complete DXA Solutions)
  • Friary Dental Clinic (Ruta Zaronskiene)
  • Limerick Clinic (Galway Clinic Doughiska Unlimited)
  • Lion Medical (Lion Medical)
  • Mater Private South (Mater Private Hospital)
  • Mercy University Hospital (Mercy University Hospital)
  • Mobile Medical Diagnostics Ltd. (Mobile Medical Diagnostics Ltd.)
  • Peamount Healthcare (Peamount Healthcare)
  • Radetal Ltd. (Radetal Ltd.)
  • The Coombe Hospital (Coombe Lying-In Hospital, T/a Coombe Women & Infants University Hospital)
  • University Hospital Kerry (Health Service Executive) 
  • UPMC AUT EVEN Affidea (Affidea Diagnostics Ireland Ltd.)
  • UPMC Bon Secours (Cork Radiation Oncology Associates Ltd.).
• 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. 
• Medical exposure to ionising radiation is when radiation is used as part of diagnosis such as an X-ray or computed tomography (CT) 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.
• Diagnostic reference levels (DRLs) are estimates of representative radiation dose levels for typical medical radiological procedures.
• 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.