THE HEALTH Information and Quality Authority (Hiqa) has been investigating the quality and safety of services provided by a number of hospitals in the northeast region in recent months, it has emerged.
Correspondence released to The Irish Timesunder the Freedom of Information Act reveals it was particularly concerned about the safety of services at Our Lady of Lourdes Hospital in Drogheda and Our Lady's Hospital in Navan.
Issues of concern included the state of the emergency department at Drogheda hospital (which has since been replaced); the discovery of a national radiology backlog, some of which occurred in the northeast region dating back to 2008 and which came to light after thousands of X-rays were found to have gone unreported at Dublin’s Tallaght hospital; understaffing of anaesthetic services and issues around the provision of emergency surgery in the region, as well as the transfer of some services to Drogheda from Navan hospital without staff being informed in advance.
Hiqa visited the region in June to meet clinical staff and Health Service Executive (HSE) management to discuss its concerns.
A letter from Hiqa on June 15th to the regional director of operations in the northeast, Stephen Mulvaney, confirmed Hiqa “has received a number of pieces of information over the last 18 months which raise concerns about the safety and quality of services at the Louth/Meath hospitals”. Other correspondence released shows a surgeon at Drogheda hospital, Finbarr Lennon, wrote to Hiqa early this year expressing concern at the manner in which the HSE decided to transfer ambulance-borne trauma from Navan hospital to Drogheda in February without consulting staff. It occurred at a time when overcrowding in the emergency department in Drogheda was already “chaotic”.
He claimed there was “no logic” in effecting the transfer before the new emergency department opened in Drogheda. It opened in late June.
The group general manager of the Louth/Meath hospital group, Des O’Flynn, wrote to Mr Lennon in March expressing surprise the HSE did not know he had complained to Hiqa until Hiqa contacted the HSE seeking a response.
Further correspondence, copied to Hiqa, included a letter from Drogheda consultant anaesthetist Michael Staunton about the shortage of junior doctors in anaesthesia at his hospital, and the risks this posed for patient safety. The hospital has been unable to fill nine out of 14 junior doctor posts, which Dr Staunton said “is highly unsafe for patients and staff”.
Hiqa stressed in its letters it was awaiting an update from the HSE on what steps it was taking in the northeast to implement the national recommendations of a report it did on safety of services at Ennis hospital.
That report, published in April 2009, urged the HSE to review the configuration of emergency care services at other smaller hospitals with a view to consolidating emergency services in regional centres, leaving smaller hospitals to deal with minor injuries only. The HSE was also to look at other similar-sized hospitals providing acute surgery and critical care services to ensure they were being provided within safe practice guidelines.
Earlier this month acute surgery was halted overnight by the HSE at Navan hospital, and it is reviewing the files of a number of patients who underwent surgery there.
The HSE said yesterday it provided a comprehensive response to Hiqa on the concerns raised and it believed Hiqa was satisfied with the information provided.
Documentation released shows the HSE has confirmed to Hiqa that, as expected, the 24-hour emergency department at Navan hospital will be converted to a minor injury unit, but it did not say when exactly this would happen.
It also said in one letter in late July that if necessary it would curtail elective surgery at Dundalk and Navan hospitals to free up anaesthetists to cover for shortages in Drogheda.
In addition, it said the radiology backlog in Louth/Meath had been dealt with and “a misdiagnosis incident had been appropriately managed”.
It said every effort was made to communicate key changes as widely as possible in the time available.
“It is entirely understandable that some personnel consider that there should have been more communication,” it said.