Today, the Health Information and Quality Authority (HIQA) has published nine inspection reports assessing compliance with medical exposure to ionising radiation regulations in medical facilities. These inspections, carried out between June and September 2023, assessed 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.

Of the nine facilities inspected, five facilities had previously been inspected as part of HIQA’s monitoring programme. Two of these, the Department of Radiology at Beaumont Private Clinic and St. Columcille's Hospital were found to be fully compliant with the regulations assessed on the day of inspection. Alliance Medical @ Bon Secours Diagnostic; Royal Victoria Eye and Ear Hospital; and Tallaght University Hospital were found to have taken steps to address previously identified gaps in compliance. For example, since the inspection in 2020, Alliance Medical @ Bon Secours Diagnostic had taken steps to come into compliance with Regulation 8: Justification, however, further improvements were required in order to become fully compliant. Similarly, the Royal Victoria Eye and Ear Hospital and Tallaght University Hospital had made improvements to come into compliance with the regulations, but further steps were required to become fully compliant with, for example, Regulation 6: Undertaking.

 Reports on four other facilities have also been published: Beacon Limerick; Alliance Medical @ Mater Private Hospital Cork; St Luke's Radiation Oncology at Beaumont Hospital; and St. James's Private Clinic Radiology Department. St. James's Private Clinic Radiology Department was found to be fully compliant with the regulations assessed on the day of inspection.

Some examples of good practice observed across the nine services by HIQA included:

• The document control system in place in St.Columcille’s Hospital ensured all policies, procedures, protocols and guidelines (PPPGs) used in the radiology department are reviewed and approved by a multidisciplinary team within their specified review dates.
• The multidisciplinary committee in St Luke's Radiation Oncology Network shared learning across facilities and contributed to minimising the likelihood of incidents for patients undergoing medical exposures in this facility.
• The approach taken by staff to training in Tallaght University Hospital ensured the prospective continuity of medical physics expert involvement at the hospital.

Overall, the main area identified for additional focus includes ensuring that the justification process for medical exposure to ionising radiation, which ensures that the benefit of a medical exposures outweighs the risk of the exposure, is clearly documented in policies and procedures. These processes should be known by staff and a record of the justification for all patients undergoing medical exposures should be available for every type of medical exposure.

HIQA continues to engage with undertakings where non-compliances are found.

Read all reports at the link below.

Notes to the 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 Directive of 2013 was transposed into Irish law in 2019. 
• 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.
• A medical physics expert is an individual having the knowledge, training and experience to act or give advice on matters relating to radiation physics applied to medical exposure and whose competence is recognised by the Minister for Health.