Ionising radiation services publication statement 11 February 2021

Date of publication:

The Health Information and Quality Authority (HIQA) has published the first four inspection reports of dental services that use medical exposure to ionising radiation. These inspections are part of the expansion of the inspection programme to include the dental sector.

Medical exposure to ionising radiation is when radiation is used as part of diagnosis such as a dental X-ray or CT scan, or for medical research purposes or the use of radiotherapy as part of cancer treatment at a hospital.

Inspections were carried out of:

  • Smiles Dental, Wexford operated by Xeon Dental Services Limited
  • Rdent, Headford Road, Galway operated by Dr Mamoon Rashid
  • Northbrook Clinic, Ranelagh operated by Northbrook Healthcare Services Limited
  • Gracefield Dental, Portarlington operated by Dr Jerome P Sullivan.

Of the inspection reports published today, good levels of compliance or substantial compliance with the regulations were found. Some examples of good practice seen on inspection included:

  • Smiles Dental, Wexford operated as one service as part of a larger undertaking and there was evidence of shared learnings and clinical governance across other facilities under Xeon Dental Services Limited’s responsibility. Furthermore, Smiles Dental, Wexford and Gracefield Dental had utilised the outcome of a self-assessment questionnaire as a quality improvement tool to address potential gaps in service.
  • Rdent had documented medical physics expertise service to the dental practice for a further two years, demonstrating a commitment to continuity of radiation protection support.
  • Gracefield Dental had displayed written protocols for every type of standard dental radiological procedure prominently in the clinical area to act as a visual reminder to the practitioner.
  • Northbrook Healthcare Services Limited demonstrated evidence of ongoing radiation safety training for staff involved in the exposure of service users to ionising radiation and supplied information to referrers on the manipulation and interpretation of images produced at the service.

There were some areas for improvement seen on all inspections. Information relating to radiation exposure did not always form part of the patient record or report and in three out of the four services inspected, there were an absence of available written protocols on the conduct of standard X-ray procedures on the day of inspection.

Inspectors also found evidence of non-compliances in Rdent, relating to the absence of written procedures and availability of referral guidelines for imaging provided at the service under Regulation 13 and an absence of completed training in the use of cone beam computed tomography. Rdent demonstrated a commitment to return to compliance and HIQA continues to engage with and monitor their progress in this regard.

Read all four inspection reports here.

Notes to Editor:

  • HIQA is the competent authority for patient protection in relation to medical exposure to ionising radiation in Ireland after the EU’s Council Basic Safety Standards (BSS) Directive of 2013 was transposed into Irish law in 2019. These inspections were carried out between October and November 2020.
  • The Environmental Protection Agency (EPA) continues, under separate ionising radiation regulations, to be the competent authority for the protection of workers and members of the public. HIQA and the EPA work together to carry out their separate but parallel functions under the relevant legislation.
  • 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.
  • Medical physics experts are people who have the knowledge, training and experience to advise on matters relating to radiation physics applied to medical exposure procedures.
  • Cone beam computed tomography is a technique for imaging the body in thin sections or slices using specialised computers and imaging equipment.