HIQA report raises five key concerns over hospital A&E

A report from the Health Information Quality Authority (HIQA), following an unannounced inspection at Mayo University Hospital (MUH) last June, has found that its accident and emergency department was “not functioning effectively” and only partially compliant in five key areas.

Overall, the healthcare watchdog said MUH was compliant in three areas and substantially compliant in five areas on the dates of the inspection - June 21 and 22, 2023. The areas in the hospital visited were the emergency department, the orthopaedic ward and St John’s Ward, which is an off-site medical ward located at the Sacred Heart Hospital in Castlebar.

The HIQA inspectors said hospital management needs to continue to address how patient flow and capacity can be enhanced to ensure that admitted patients have timely access to an inpatient bed.

The report found that while overall patient experience times had improved since the previous March 2023 inspection “ambulance turn-around targets at MUH remain outside the HSE targets”.

The HIQA report also said that patients attending the emergency department "may be cared for in designated cubicles or rooms where privacy and dignity can be afforded to all patients including those at end of life”.

MUH was found to be partially compliant in five areas, which included transitions of care, service users’ dignity, privacy and autonomy, and the management of patient safety incidents. The other two partially compliant areas were 'healthcare being provided in a high-quality, safe and reliable physical environment' and ‘staff training and education’.

HIQA said it was aassured by MUH that management arrangements were in place to oversee the delivery of high-quality and safe healthcare, however, "operationally, the emergency department was not functioning effectively".

The HIQA inspection focused on four key areas namely infection prevention and control, medication safety, the deteriorating patient (including sepsis) and transitions of care.

Castlebar-based Independent Cllr Michael Kilcoyne, who believes the situation will not change for 18 months until the new A&E is ready, stressed he has been highlighting the listed failings for a long time but the necessary changes have not been carried out.

“It is just simply not good enough that at the end of life, people are in some cases treated with total disrespect,” he added.

MUH manager Catherine Donohoe said while the hospital was disappointed to have some areas identified as partially compliant, an action plan and improvements have been completed.

“We are confident that many of the identified partial compliance would now be deemed as compliant and we will continue to work toward full compliance on all standards,” she added.