Today, the Health Information and Quality Authority (HIQA) has published 23 inspection reports assessing compliance with medical exposure to ionising radiation regulations in 16 dental facilities and seven medical facilities. These inspections, carried out between December 2021 and April 2022, 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).

Of these 23 inspections, inspectors found a good level of compliance with the regulations in 10 undertakings, including: Bon Secours Hospital Cork; Department of Radiology, Beaumont Private Clinic; Dexascan & Bone Health Unit; MRH Mullingar; Phibsboro Dental Care; Smile Hub; Sports Surgery Clinic; St Luke’s Radiation Oncology Network at St James’s Hospital; The Plaza Dental Practice; and University Hospital Kerry.

Some examples of good practice observed by inspectors included:

• In St Luke’s Radiation Oncology Network at St James’s Hospital, there were procedures in place to ensure special attention was given to patients who required high doses of radiation, for example, for paediatric patients or for patients undergoing complex radiation therapy.
• In the Sports Surgery Clinic, an initiative to include all staff in clinical audits had a positive impact, increasing compliance rates in all audits reviewed on the day of inspection.
• A periodic newsletter was published in MRH Mullingar, focusing on topics relating to the radiation protection of patients and the public. It was made available to staff to encourage ongoing radiation protection training and education in the hospital.

The inspection of University Hospital Kerry took place to follow up on the findings of a previous inspection in July 2021, and inspectors found it to be either compliant or substantially compliant with the regulations. Since the previous inspection, the undertaking had increased the level of multidisciplinary involvement in the local governance structures in the hospital. Additionally, the medical physics expert (MPE) resourcing had improved but this was only a temporary arrangement and was reliant on outsourcing. The long-term sustainability of this arrangement for MPE resourcing requires further consideration.

Similarly, the inspections of two undertakings, Dexascan & Bone Health Unit and Department of Radiology, Beaumont Private Clinic, were conducted to follow up on the outcomes of previous inspections and these undertakings were found to be fully compliant with the regulations assessed.

To summarise some of the findings in other dental facilities: 

• Eight undertakings were found to be non-compliant with the following regulations: undertaking; equipment; recognition of medical physics experts; responsibilities of medical physics experts; and involvement of medical physics experts in medical radiological practices. These undertakings were: Annesley Dental Clinic; Ballsbridge Dental Clinic; Cabra Dental Centre; Dental Surgery - John Canavan; Dental Tech; Dr Michael Gibson; Fairview Dental Clinic; and Swords Village Dental Practice.
• Seven undertakings were found to be non-compliant with diagnostic reference levels. These undertaking were: Annesley Dental Clinic; Ballsbridge Dental Clinic; Cabra Dental Centre; Dental Surgery – John Canavan; Dental Tech; Dr Michael Gibson; and Fairview Dental Clinic.
• Five undertakings were found to be non-compliant with the equipment regulation: however, these undertakings had engaged or re-engaged the services of an MPE in advance of inspection. These undertakings were: Castlemill Dental Clinic; Clontarf Aesthetic Dentistry; Dalkey Dental; Dun Laoghaire Dental; and Stillorgan Village Dental.

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 (BSS) 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 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 (MPE) 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.
• Diagnostic reference levels (DRLs) are estimates of representative radiation dose levels for typical X-ray examinations.