Health watchdog’s hospital concerns

ACUTELY ill patients are being treated in hospitals where the volume of patients is too low or the depth of clinical staffing cover is insufficient for care to be provided reliably and safely, according to the health watchdog.

The Health Information and Quality Authority (HIQA) said this concern was not unique to Mallow General Hospital (MGH) – targeted for investigation by HIQA – but that it had identified “specific concerns” about aspects of the care at the north Cork hospital following “receipt of information” about the types of patients being treated there.

HIQA said this information, in the form of patient complaints, raised concerns about potential risks to people receiving certain types of care – the provision of major surgery, the emergency department and critical care services.

Yesterday, HIQA announced the terms of reference of its planned investigation into MGH, including:

* The measures taken by the hospital and HSE to implement the nationalrecommendations from the authority’s April 2009report into services at Ennis General Hospital, specifically whether risks to patient safety had been identified, assessed and mitigated.

* Whether current arrangements for management and provision of clinical services at MGH minimise risks to patient safety, including, but not limited to, critical care and anaesthetic, surgical and emergency services.

* Whether HSE local,regional and national clinical and managerial governance arrangements support safe care and transition towards new models of service provision.

HIQA also said it will broaden its investigation if further evidence came to light that there were otherserious risks to patients.

In a statement yesterday, the HSE said it had advised HIQA that the implementation plan for the reconfiguration of acute hospital services in Cork and Kerry “will address the national recommendations” of the Ennis report in respect of MGH, including:

* The introduction of an advanced paramedic service in north Cork to be in place by March 2011.

* A review of emergency departments and pre-hospital emergency care in Cork and Kerry which has been undertaken. The HSE said the review would “ensure that MGH will continue to have a 24/7, 365 days a year service for patients with appropriate general medical emergencies needing urgent admission”.

* The future of critical care will be provided in line with the recommendations of the National Critical Care Programme.

The Irish Hospital Consultants Association said the HIQA investigation team should now quantify the impact of HSE policy on other hospitals throughout the country.