Ionising radiation services publication statement 21 October 2020

Date of publication:

The Health Information and Quality Authority (HIQA) has published 10 inspections reports on services that use medical exposure to ionising radiation. 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 January 2020 and July 2020.

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

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

  • St Columcille’s Hospital had integrated medical physics involvement with a teaching hospital from the same hospital group. Furthermore management at St. Columcille’s had used the outcome of a self-assessment questionnaire to address potential gaps in service as a quality improvement tool. 
  • Portiuncula University Hospital had identified a decrease in typical radiation doses delivered in one particular procedure type from 2018 to 2019 as a proactive approach to demonstrate the benefit of establishing and reviewing diagnostic reference levels without affecting the diagnostic outcome of the exposure.
  • The Mater Misericordiae University Hospital held a fortnightly multidisciplinary quality assurance and risk assessment meeting to assess performance of quality assurance programmes and performance testing in relation to equipment. 

Inspectors found evidence of non-compliances in three services, University Hospital Limerick (UHL), Mallow General Hospital and Nenagh Regional Hospital. 

The inspection of UHL found non-compliances in relation to the adequacy of medical physics involvement in the service which had an effect on the service’s ability to fulfil comprehensive diagnostic reference level reviews and to maintain a proactive approach to equipment quality assurance. Similar issues in relation to medical physics involvement and regular review of diagnostic reference levels were also noted in Mallow General Hospital and Nenagh Regional Hospital. 

HIQA continues to engage with and monitor each undertaking’s progress in coming into compliance. 

Read all 10 inspection reports at www.hiqa.ie. 

Notes to Editor:

  • Inspections were carried out at: 

o    Affidea Diagnostic Ireland Limited at Affidea Cork.
o    Alliance Medical Diagnostic Imaging at Bon Secours Diagnostic
o    Connolly Hospital, Dublin
o    Mallow General Hospital, Cork
o    Mater Misericordiae University Hospital, Dublin
o    Nenagh Regional Hospital, Tipperary
o    Portiuncula University Hospital, Galway
o    St Columcille’s Hospital, Dublin
o    St Vincent's Private Hospital, Dublin
o    University Hospital Limerick, Limerick. 

  • 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. 
  • Diagnostic Reference Levels are a measure of typical dose levels received by patients for a particular type of procedure. They are used to as an audit tool of diagnostic and interventional medical exposures to help optimise the radiation protection of patients undergoing medical radiological procedures.