External reviews can be ‘expensive’ and ‘time consuming’ – Saolta

The “expensive” and “time consuming” nature of some external reviews of adverse incidents was discussed by Saolta University Health Care Group’s board quality and patient safety committee.

According to the committee’s meeting in March, the minutes of which were obtained under Freedom of Information law, there were “quite a number of external reviews ongoing”. “It was advised that a consultant is entitled to €1,250 per day plus expenses. Most reviews could take up to 10-to-12 days, however, some do not take that long.”

“An invoice for €30,000 was received recently, but this is not the norm…. There is a process in place with regards to approval, whereby [Group Clinical Director] Prof Pat Nash approves the invoices and they are subsequently sent to the finance department for processing. Auditors have not queried this to date.”

The meeting heard that the HSE incident management framework provided guidance on managing incidents. “There are a number of reasons why a decision would be made to undertake an external review, including the need for independence and visible impartiality and in the event the required expertise does not exist [within] the Hospital Group. Furthermore, some legislation demands external reviews,” the minutes added.

The committee agreed that “it should be acknowledged that there is a cost to the work carried out with respect to these reviews”. A Saolta spokesperson told the Medical Independent independent experts were sourced through the Forum of Irish Postgraduate Medical Training Bodies.

According to Saolta, the term ‘external review’ may also refer to a review carried out by the Group, but external to the hospital concerned. Independent external reviews usually related to incidents categorised as major or extreme. There are currently two independent external reviews in progress.