Today, the Health Information and Quality Authority (HIQA) has published 26 inspection reports assessing compliance with medical exposure to ionising radiation regulations in dental and medical facilities. These inspections were carried out to assess compliance with the European Union (Basic Safety Standards for Protection Against Dangers Arising from Medical Exposure to Ionising Radiation) Regulations 2018 (S.I. No. 256 of 2018), as amended.

Eleven of the reports relate to eight dental facilities.

Significant levels of non-compliance were found at Dublin Dentist Clinic (Dublin 1) in January 2023. Subsequent engagement and re-inspections of Dublin Dentist Clinic (Dublin 1), most recently in February 2024, identified that the undertaking is now in full compliance with the regulations for the types of medical exposures being conducted at this facility. The undertaking has provided assurance to HIQA that cone-beam computed tomography (CT) scans will not be carried out in this facility until such time as the relevant staff receive the required training for these types of scans. 

Non-compliances were also found in ACD Practice Management Ltd. The undertaking failed to submit a compliance plan to identify how the non-compliances found on inspection would be addressed following the inspection. However, through further engagements with the undertaking, HIQA has been assured that medical exposures to ionising radiation are no longer being provided at this facility.

Three dental facilities — Dental Care Ireland at Killarney, and two HSE Dental Clinics at Birr and Cappoquin — were found to be fully compliant with the regulations assessed. Good levels of compliance were found with a number of regulations in both Dental Options (Clane) and Pembroke Dental Bagenalstown; however, further improvements were required for full compliance for example, in relation to the monitoring of equipment. 

HIQA identified good practice in a number of the 15 medical facilities inspected. Full compliance with the regulations was found in the Mater Private Northern Cross and in Alliance Medical @Mitchelstown Cork, while very good levels of compliance were identified in a number of facilities, including Dexa Protection which was fully compliant in all but one of the regulations assessed.

Some examples of good practice observed by inspectors included:

• the practices in place for optimisation (ensuring the dose is as low as possible while still achieving the desired outcome) along the pathway for patients undergoing radiotherapy at St Vincent's Private Hospital and the focus of clinical audit on optimisation in Alliance Medical @ Mitchelstown Cork
• the strong commitment shown by staff towards improving the radiation protection of people using services, in particular the neonatal population, at The National Maternity Hospital
• the measures implemented to address gaps in compliance previously identified in Portiuncula University Hospital and in Sligo University Hospital; however, further improvements were required in both facilities to become fully compliant with the regulations assessed during the recent inspections.
• Overall and similar to previous inspections, the main areas that were identified for additional focus for undertakings included: 
• ensuring that responsibilities are allocated appropriately as per the requirements of the regulations, are known by staff, and are documented accurately and reflective of local practice
• ensuring that information relating to patient exposure is included in the report of the procedure.  

Where non-compliance with the regulations was identified, undertakings were required to identify how they will come into compliance with the regulations. HIQA continues to engage with undertakings where non-compliances are found. 

Read all reports at the link below.

Notes to the editor:

• HIQA is the competent authority for patient protection in relation to medical exposure to ionising radiation in Ireland following the transposition of the EU’s Council Basic Safety Standards (BSS) Directive of 2013 into Irish law in 2019. 
• Medical exposure to ionising radiation is when radiation is used as part of diagnosis such as an X-ray or computed tomography (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. The regulations also include medical exposures used as part of a dental assessment, such as a dental X-ray.
• 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.