The Health Information and Quality Authority (HIQA) has published eight inspection reports assessing compliance with medical exposure to ionising radiation regulations. 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.

Inspections were carried out between December 2020 and May 2021 of: 

• 3Dental (Dublin)
• Boyne Dental & Implant Clinic
• Department of Radiology, Beaumont Private Clinic
• Dr. Eoin Fleetwood at Eyre Square Dental
• Gorey Family Chiropractic Clinic
• Mater Private Hospital, Dublin
• Smile Design Dental, Baldoyle
• UPMC Whitfield Hospital Ltd at UPMC Hillman Cancer Centre, Waterford.

Of the inspection reports published, good levels of compliance or substantial compliance with the regulations were found in the majority of services. Full compliance was found at Dr. Eoin Fleetwood operating at Eyre Square Dental for the regulations assessed on the day of inspection. Some examples of good practice seen on inspection included:

• UPMC Hillman Cancer Centre used clinical audit to evaluate processes implemented following the occurrence of an incident. This provided the undertaking with an assurance of the safe delivery of medical exposures.  UPMC Hillman Cancer Centre also used different methods to share learnings on incident management, including education sessions, newsletters and presentations to staff. 
• Inspectors found that information relating to patient exposure was included in the patients’ electronic report for each dental radiological procedure that patients underwent at Eyre Square Dental. 
• Associate dentists at 3Dental had signed a code of practice for radiation protection, which was seen as a positive measure to ensure that all persons involved in the conduct of dental exposures at the practice were aware of and agreed to conduct exposures in accordance with policies at 3Dental.
• The Mater Private Hospital ensured that the accountability of individual consultants that work in the hospital had been incorporated into the governance and oversight structures of the Mater Private Hospital for the purposes of ensuring compliance with medical exposure regulations.

Inspectors found evidence of non-compliances in the Department of Radiology, Beaumont Private Clinic, Gorey Family Chiropractic Clinic, Smile Design Dental and 3Dental. 

In Department of Radiology, Beaumont Private Clinic, Gorey Family Chiropractic Clinic and Smile Design Dental, there was a lack of comprehensive oversight by each undertaking to ensure that performance testing or quality control programmes for X-ray equipment were up to date. The Department of Radiology, Beaumont Private Clinic and Gorey Family Chiropractic Clinic also required improvements in the maintenance and update of procedures for each type of standard X-ray undertaken at these facilities. There were also additional deficits found in Gorey Family Chiropractic Clinic relating to the allocation of clinical responsibility for medical exposures to practitioners as defined in the regulations. Furthermore, in 3Dental there was an absence of complete records to demonstrate that training in the use of cone beam computed tomography radiological procedures was in line with the Dental Council guidance. 

HIQA continues to engage with these services to ensure compliance with the regulations. 

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

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 August 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.
• A practitioner is a registered doctor, dentist, radiographer or radiation therapist who can take clinical responsibility for an individual medical exposure.
• Cone beam computed tomography is a technique for imaging the body in thin sections or slices using specialised computers and imaging equipment.