Today, the Health Information and Quality Authority (HIQA) has published 14 inspection reports assessing compliance with medical exposure to ionising radiation regulations in one dental facility and 11 medical facilities. 

Of the 11 medical facilities inspected, HIQA found Alliance Medical @LAYA Health & Wellbeing Limerick, Castlebar Primary Care Centre X-Ray Service, and UPMC Sports Surgery Clinic were fully compliant with all regulations assessed on the day of inspection. High levels of compliance were also found in the Mater Private Cork and Beaumont Hospital.

Following non-compliances identified on inspection by HIQA in Pro-Dental in October 2024, immediate escalation was required with the undertaking, Pro-Riso Dental Clinic Limited, to provide assurances to HIQA. Regulatory engagement continued with this undertaking and included two subsequent inspections, after which HIQA saw a marked improvement and were satisfied that the appropriate steps had been taken to ensure the regulatory requirements for medical radiological procedures were being met in this facility. 

Inspectors observed several examples of good practice in the medical facilities inspected, demonstrating efforts to ensure safe and optimised medical exposures for service users. Examples included:

• the integration of the radiology clinical audit strategy into the wider hospital’s networked group audit strategy, further promoting the safe delivery of radiological services in the Mater Private Cork,
• effective communication pathways between senior management at the Primary Care service at Castlebar Primary Care Centre X-Ray Service and management at Mayo University Hospital, who had overall responsibility for the radiation protection of service users,
• effective multidisciplinary incident reporting strategies employed by the undertaking at UPMC Sports Surgery Clinic to actively improve service user outcomes.

Inspectors followed up on findings from previous inspections in nine of the 11 medical facilities and found effective actions had been implemented to improve compliance with the regulations. For example, Beaumont Hospital demonstrated many improvements in compliance since the previous inspection, such as the inclusion of appropriate staff at the radiation safety committee, the allocation of responsibility for the reporting of accidental and unintended medical exposures and significant events, as well as improvements in the hospital’s document management system.

Similar to previous inspection reports, some areas identified for additional focus in medical facilities included ensuring that: 

• responsibilities are appropriately allocated to staff in line with regulatory requirements, and that 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 14 inspection reports published today relate to 12 facilities, comprising seven public and five private facilities which are listed with their associated undertakings:
  • Alliance Medical @LAYA Health & Wellbeing Limerick (Alliance Medical Diagnostic Imaging Ltd.)
  • Bantry General Hospital (Health Service Executive)
  • Beaumont Hospital (Beaumont Hospital)
  •  Bon Secours Hospital Galway (Bon Secours Health System
  • Castlebar Primary Care Centre X-Ray Service (Health Service Executive)
  • Mater Private Cork (Mater Private Hospital)
  • Pro-Dental (Pro-Riso Dental Clinic Limited)
  • St. James's Hospital (St James's Hospital)
  • St. Luke's Radiation Oncology Network, St. Luke's Hospital (Health Service Executive)
  • St. Luke's General Hospital – Kilkenny (Health Service Executive)
  • UPMC Sports Surgery Clinic (UPMC Sports Surgery Clinic Ltd.)
  • Wexford General Hospital (Health Service Executive)
• 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.
• 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 (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.
• Justification of a medical exposure is the decision whether or not to carry out the medical exposure on the basis that the exposure should do more good than harm. Before a service user is exposed to ionising radiation, the practice of justification of that particular medical exposure determines if the net benefits outweigh the possible risks and if the examination is indicated and useful.
• Optimisation assures service users that the risks associated with an exposure to ionising radiation are minimised while also delivering the required clinical outcome, and that the most appropriate dose for each individual exposure is delivered.