The Health Information and Quality Authority (HIQA) has published 12 inspection reports on compliance in healthcare services with the National Standards for Safer Better Healthcare. 

Most healthcare services inspected were found to provide person-centred care and support that upheld people’s dignity and promoted a culture of kindness, consideration and respect. 

While some areas of attention were identified in Carechoice Parnell Road Stepdown Facility, Carlow District Hospital, and the National Maternity Hospital, good overall levels of compliance were found in these services. 

In 11 of the 12 services inspected, some degree of improvement was required to ensure people using the services were protected from the risk of harm associated with the delivery of healthcare services and clear formalised governance arrangements were in place to assure the delivery of high quality, safe and reliable healthcare. 

In 10 of the 12 services, improvements were required to the physical environment to varying degrees. For example, in Charter Medical Private Hospital, inspectors noted that some clinical areas physical environment did not fully support infection control practices with limited hand hygiene sinks, inadequate facilities for waste disposal and outdated infrastructure that required upgrading. In Mercy University Hospital, the inadequate number of toilet and shower facilities and the lack of single rooms with en-suite facilities posed a risk of transmission of communicable infectious diseases. In University Maternity Hospital, Limerick, the age and current footprint of the hospital’s physical environment presented many challenges to the delivery of high-quality, safe healthcare services. In the Rotunda Hospital, the service had implemented a range of good practices and, at the time of inspection, demonstrated a proactive approach to developing the campus and managing the risk related to the ageing infrastructure. The limitations of the existing physical environment in these hospitals persists, and impacts their ability to fully mitigate the risks to women and their babies.  

Only two out of 12 inspections found full compliance with the standard relating to workforce arrangements. Since HIQA’s previous inspection in Letterkenny University Hospital, inspectors found that absenteeism levels remained high and data on compliance with mandatory training reflected a deterioration from the training levels noted from the inspection in 2023. In Midlands Regional Hospital Portlaoise, staffing challenges posed a risk to the hospital’s ability to consistently deliver safe, high-quality care across all services, with staffing shortfalls and reliance on agency staff and overtime in some clinical areas, and gaps within the senior management team. In St Colmcille’s and the St. Patrick’s Cashel, better training compliance was identified as an area for improvement. The three maternity hospitals inspected, University Maternity Hospital, Limerick, Rotunda and National Maternity Hospital, had applied mitigating actions to manage the risks arising from midwifery and nursing staff shortfalls, however while being actively managed on a daily basis by the hospitals’ management, the sustainability of contingency arrangements for midwifery and nursing staffing levels will require ongoing attention. 

The inspection at Our Lady’s Hospital Navan in June 2024 identified that improvements were required in areas such as governance and management arrangements, workforce arrangements, physical infrastructure and the clinical environment. Inspectors also identified risks associated with the presentation of undifferentiated surgical patients to the hospital as acute surgical services are not provided on-site. These risks were formally communicated by HIQA to hospital and senior management in the HSE Dublin North East health region. Subsequent monitoring was conducted by HIQA to assess the hospital’s progress in addressing the identified risks. Additionally, the follow-up inspection in November 2025 found evidence of progress with actions set out in the compliance plan, with the exception of those related to medication safety. However, HIQA also found that the patient safety risks associated with the hospital not providing acute surgical services on-site persists and remains to be fully addressed by the HSE. 

HIQA continues to engage with each service where non-compliance was identified to ensure compliance with the national standards.

Notes to Editors:

• HIQA is responsible for monitoring compliance with national standards in publicly-funded healthcare services and private hospitals. Using these powers, HIQA may make recommendations for improvement of care, but under current legislation HIQA cannot enforce their implementation.
• HIQA inspects against the National Standards for Safer Better Healthcare which describe a vision for consistent, high-quality, safe healthcare and provide a roadmap for improving the quality, safety and reliability of healthcare. 
• HIQA judges the service to be compliant, substantially compliant, partially compliant, or non-compliant with the standards. These are defined as follows:
  • Compliant: A judgment of compliant means that on the basis of this inspection, the service is in compliance with the relevant national standard.
  • Substantially compliant: A judgment of substantially compliant means that on the basis of this inspection, the service met most of the requirements of the relevant national standard, but some action is required to be fully compliant.
  • Partially compliant: A judgment of partially compliant means that on the basis of this inspection, the service met some of the requirements of the relevant national standard while other requirements were not met. These deficiencies, while not currently presenting significant risks, may present moderate risks, which could lead to significant risks for people using the service over time if not addressed.
  • Non-compliant: A judgment of non-compliant means that this inspection of the service has identified one or more findings, which indicate that the relevant national standard has not been met, and that this deficiency is such that it represents a significant risk to people using the service.