Latest inspection reports on ionising radiation exposure published

HIQA has published eight inspection reports assessing compliance with medical exposure to ionising radiation regulations.

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.

Inspections were carried out between December 2020 and May 2021 of 3Dental (Dublin); Boyne Dental and Implant Clinic; Department of Radiology, Beaumont Private Clinic; Dr Eoin Fleetwood at Eyre Square Dental; Gorey Family Chiropractic Clinic; Mater Private Hospital, Dublin; Smile Design Dental, Baldoyle; and UPMC Whitfield Hospital Ltd at UPMC Hillman Cancer Centre, Waterford.

Of the inspection reports published, good levels of compliance or substantial compliance with the regulations were found in the majority of services. Full compliance was found at Dr Eoin Fleetwood operating at Eyre Square Dental for the regulations assessed on the day of inspection.

Some examples of good practice seen on inspection included:

-UPMC Hillman Cancer Centre used clinical audit to evaluate processes implemented following the occurrence of an incident. This provided the undertaking with an assurance of the safe delivery of medical exposures. UPMC Hillman Cancer Centre also used different methods to share learnings on incident management, including education sessions, newsletters and presentations to staff.

-Inspectors found that information relating to patient exposure was included in the patients’ electronic report for each dental radiological procedure that patients underwent at Eyre Square Dental.

-Associate dentists at 3Dental had signed a code of practice for radiation protection, which was seen as a positive measure to ensure that all persons involved in the conduct of dental exposures at the practice were aware of and agreed to conduct exposures in accordance with policies at 3Dental.

-The Mater Private Hospital ensured that the accountability of individual consultants that work in the hospital had been incorporated into the governance and oversight structures of the hospital for the purposes of ensuring compliance with medical exposure regulations.

Inspectors found evidence of non-compliances in the Department of Radiology, Beaumont Private Clinic, Gorey Family Chiropractic Clinic, Smile Design Dental and 3Dental.

In the Department of Radiology, Beaumont Private Clinic, Gorey Family Chiropractic Clinic and Smile Design Dental, there was “a lack of comprehensive oversight by each undertaking to ensure that performance testing or quality control programmes for x-ray equipment were up to date”.

The Department of Radiology, Beaumont Private Clinic and Gorey Family Chiropractic Clinic also required improvements in the maintenance and update of procedures for each type of standard x-ray undertaken at these facilities. There were also additional deficits found in Gorey Family Chiropractic Clinic relating to the allocation of clinical responsibility for medical exposures to practitioners as defined in the regulations.

Furthermore, in 3Dental, there was an absence of complete records to demonstrate that training in the use of cone beam computed tomography radiological procedures was in line with the Dental Council guidance.

HIQA said it continues to engage with these services to ensure compliance with the regulations.

All eight inspection reports can be accessed at https://www.hiqa.ie/