Today, the Health Information and Quality Authority (HIQA) has published 20 inspection reports assessing compliance with medical exposure to ionising radiation regulations in three dental facilities, six private medical facilities and 11 public medical facilities. These inspections, carried out between May and August 2022, assessed 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).

Inspectors found evidence of good levels of compliance or full compliance with the regulations in the three dental undertakings, namely: Cobh Dental Clinic; Dental Care Ireland - Reva Kells; and Douglas Village. 

Inspectors found varying levels of compliance following inspections of the medical facilities. Two of the 20 inspections were conducted to follow up on the outcomes of previous inspections. Rowe Creavin Medical Practice was found to be fully compliant with the assessed regulations. Similarly, the inspection of the Mercy University Hospital was conducted to follow up on the outcomes of a previous inspection. While good progress had been made in this facility, including allocating responsibilities to a medical physics expert (MPE), having a system in place for policy development, oversight and approval, and a positive approach to incident management, some further work is required to sustain the progress made and to come into full compliance with the regulations.

An area that requires additional attention in most undertakings inspected involves the requirement to include information relating to radiation dose in the report of the procedure, as per Regulation 13: Procedures. In total, only five undertakings were found to be fully compliant with this regulation. 

HIQA continues to engage with undertakings where non-compliances are found.

Some examples of good practice observed by inspectors included:

The use of digital platforms which delivered bespoke local training for referrers and practitioners, and an information sharing platform which made all radiation safety information, policies, procedures and guidance readily available to all staff, in Beaumont Hospital. 

A clear allocation of responsibilities, including MPE responsibilities, with evidence of the MPE’s involvement in training staff on radiation protection, in Douglas Village, a dental facility.

In CHI at Temple Street, inspectors were informed of the alternative non-ionising imaging modalities that are considered where possible, such as ultrasound and magnetic resonance imaging (MRI), to limit exposure to ionising radiation in children.

Mechanisms implemented by Dental Care Ireland - Reva Kells, who configured their electronic patient record system to incorporate information about medical exposure into patients’ reports. 

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 after the EU’s Council Basic Safety Standards (BSS) Directive of 2013 was transposed 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 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.
• A medical physics expert (MPE) is an individual having the knowledge, training and experience to act or give advice on matters relating to radiation physics applied to medical exposure and whose competence is recognised by the Minister for Health.