Hiqa launches second review of Letterkenny gynaecology services

This second review will focus on governance support given to the hospital by the Saolta hospital group and the HSE, as well as internal governance. Picture: North West Newspix

The Health Information and Quality Authority (Hiqa) is to begin a second review of gynaecology services at Letterkenny University Hospital today, as a follow-up to a probe into cases of delayed cancer diagnosis.

Concerns about services at the hospital were first raised 2018 and an external review into the totality of post-menopausal bleeding services within the gynaecology services at Letterkenny University Hospital was commissioned by the HSE in 2019.

That review, published last year, followed revelations by a doctor that her sister had missed important stages in her treatment. 

It found a pattern of delayed diagnosis among some women attending the hospital for gynaecological services. 

Carol MacMahon's endometrial cancer diagnosis was missed for two years, and her sister Dr Margaret MacMahon claimed other families contacted her with similar fears. 

Hiqa said today that was linked to “poor follow-up practices, sub-optimal triage, and administrative practices, which were further compounded by ineffective communication". 

This second review will focus on governance support given to the hospital by the Saolta hospital group and the HSE, as well as internal governance.

Hiqa Head of Healthcare Sean Egan said: “It is essential that women accessing gynaecology services are assured that the service is safe and that they are being protected and safeguarded.” 

He said the review will assess “the effectiveness and sustainability of the governance and oversight arrangements”.

It will target the list of recommendations from the original work “Letterkenny University Hospital: Review of the Gynaecology Service, with a particular focus on post-menopausal bleeding pathways report (Price et al. 2020).” 

A HIQA spokesman said this will include assessing whether the HSE, Saolta and the hospital are “implementing recommendations of an external review into gynaecology service failures at Letterkenny University Hospital.” 

The review will be published later this year. 

Terms of reference, available on the HIQA website, include a review of how women’s feedback and their families has been taken on board in addressing the failings identified last year. 

Anonymised healthcare records will be used as part of the review.

Interviews will also be done with staff members at Letterkenny, Saolta and the HSE departments connected to the hospital.

Last year the Irish Cancer Society welcomed the fact that some improvement measures were already underway at the hospital but said the delivery of those should be underscored by comprehensive and regular audits and commitment to meet performance targets.

It called for greater investment in services for gynaecology to ensure these delays do not happen again.
The Irish Examiner reported last month that more than 30,000 women were on gynaecological waiting lists up to January.