Further improvements are needed in the governance and management of gynaecology services at Letterkenny University Hospital to ensure the safety of women using them, according to an official report.
The hospital received significant extra funding and staffing to improve gynaecology services, yet weaknesses remained in governance structures and oversight, according to the Health Information and Quality Authority (Hiqa).
Letterkenny failed to meet national Health Service Executive (HSE) and Saolta Group timelines for the review, testing and diagnosis of some women referred with post-menopausal bleeding, the report found.
Saolta group, which includes the hospital, failed to identify cases where the hospital had failed to adhere to these timelines, a finding which was “of significant concern” to Hiqa and was raised with the group.
With the hospital continuing to struggle to recruit and retain medical, nursing and administrative staff, this remains a risk to patient safety, according to the watchdog’s report.
The hospital has transitioned to a new outpatient gynaecology service, but Hiqa found the expected number of women that could be managed in this service fell short of that estimated by the HSE. “The ambulatory gynaecology service at the hospital was not fully established and was working at only 50 per cent of its potential capacity,” the report says.
The report was carried out on foot of complaints by women and their families stretching back to 2018. Some had suffered delays in the diagnosis of endometrial cancer and died with the disease.
“Despite the number of initiatives and measures introduced by Saolta group since 2018, Hiqa was not assured there were sufficient and effective governance and oversight arrangements in place to assure the quality and safety of gynaecology services, which posed a risk to women using the services,” according to Sean Egan, Hiqa’s director of healthcare regulation.
“Strong and effective governance, leadership and management is needed at the hospital and hospital group to ensure and promote high-quality, safe and reliable services and establish and sustain a culture of patient safety.
“While some measures introduced at the hospital had brought about improvements, such as a new ambulatory (outpatient) gynaecology service, revised procedures for the review and triage of referrals and a decline in waiting lists numbers for women trying to access gynaecology services, these must be sustained in the long term so that women who use and depend on the service can be confident about its quality and safety. If this is not achieved, the HSE should hold Saolta Group to account.”
