The Health Information and Quality Authority announced today that it is to undertake an investigation into the quality and safety of services and supporting arrangements provided by the Health Service Executive (HSE) at Mallow General Hospital.

In April 2009, the Authority published the Report of the investigation into the quality and safety of services and supporting arrangements provided by the Health Service Executive at the Mid-Western Regional Hospital Ennis. The report contained a number of national recommendations aimed at creating an impetus for systematic review of clinical services in hospitals similar to Ennis. This was to be followed by the mitigation of any immediate risks and then transition where necessary to more sustainable, safer service configuration for patients.

It is of concern to the Authority that there are hospitals that are continuing to provide care to acutely ill patients where the volume of patients is too low or the depth of clinical staffing cover is insufficient for this to be done reliably and safely. With this in mind, the Authority has sought assurances from the HSE as to how the national recommendations from the Ennis report have been implemented. The Authority is not sufficiently assured by the response.

It is in this context that the Authority has identified specific concerns about aspects of the care provided at Mallow General Hospital following receipt of information about the types of patients being treated in that hospital. This has raised concerns about potential risks to the health and welfare of persons receiving certain types of care at Mallow General Hospital centred on the provision of major surgery, the emergency department and critical care services.

The Authority has sought assurances from the HSE, both locally and nationally, regarding arrangements for managing any potential risks to patients receiving these types of services at Mallow General Hospital. However, the information received to date has not provided the Authority with sufficient assurance that these risks are being effectively managed.

The Board of the Authority met on 4 August 2010 to consider this information. Following careful consideration of the information available, the Board is not assured that Mallow General Hospital has the necessary arrangements in place for the provision of a safe high quality service for acutely ill patients and has therefore decided to instigate an investigation under Section 9 (1) of the Health Act 2007.

The purpose of the investigation is to ascertain whether safe, quality services and practices are in place and, where this is not the case, to ensure that where there may be a serious risk to the health or welfare of a person(s) receiving such services from the HSE, these risks shall be identified and recommendations made with a view to eliminating or reducing the risks for patients.

As with any investigation undertaken by the Authority, and in the interest of a fair and thorough investigation, the Authority does not envisage making any further public comment until the investigation has concluded. The investigation report, and its recommendations, will be published following the completion of the investigation.

Further Information: 

Sinead Whooley, Communications Manager

01 814 7488 / 087 9221941 swhooley@hiqa.ie

Notes to the Editor: 

Relevant recommendations from the Report of the investigation into the quality and safety of services and supporting arrangements provided by the Health Service Executive at the Mid-Western Regional Hospital Ennis, April 2009.

• The Health Service Executive should undertake a strategic review of configuration for emergency care services. This should lead to a prioritised programme of service development aimed at consolidating emergency services in regional centres with smaller hospitals (having a similar activity profile to Mid-Western Regional Hospital Ennis) re-designated for minor injuries and non-acute care (Recommendation 1.4)
• A focused review of acute surgical activity should be undertaken as a priority at hospitals with a similar profile to the Mid-Western Regional Hospital Ennis to determine whether they are safe according to international best practice (Recommendation 2.7)
• The Health Service Executive should review the critical care provision in hospitals with a similar resource and activity profile to the Mid-Western Regional Hospital Ennis to ensure that services are being provided within safe practice guidelines. Where this is not the case, appropriate risk management measures, and the necessary service changes, should be implemented and managed to protect patients (Recommendation 4.5).