NOHC Chair raised need for ‘more clinical expertise’

The Chairperson of National Orthopaedic Hospital Cappagh (NOHC) expressed concern about the board’s ability to “manage clinical risks effectively” at a meeting earlier this year.

Mr Colin Byrne made the comment following a presentation on risk management by NOHC’s Clinical Risk Manager and Health and Safety Officer, according to minutes of the meeting in April 2025.

The presentation outlined the risk management framework and the importance of risk assessment and risk registers. The key risks included: Clinical risks (eg, patient safety incidents); compliance and regulatory risks; financial and operational risks; and infrastructural risks.

The Clinical Risk Manager discussed the incident management process and the legal requirements pertaining to open disclosure. The Health and Safety Officer also noted the board’s role in the “strategic oversight of risk management processes”.

“He noted the board’s responsibilities include governance and compliance, financial and operational oversight, and stakeholder communication,” stated the minutes, which were obtained under Freedom of Information law.

Following the presentation, the Chairperson “expressed concerns about the board’s ability to manage clinical risks effectively”. He suggested “involving more clinical expertise on the board to better manage clinical risks”.

The minutes released to the Medical Independent (MI), which related to board meetings held from November 2024 to May 2025, did not list any medical doctors among the non-executive directors.

A NOHC spokesperson informed MI: “A medical professional (GP) was appointed to the board in July 2025. Three executive medical professionals are also in attendance at board meetings.”

Asked about the process for board appointments, the NOHC spokesperson said expressions of interest from suitable candidates are sought based on skillset requirements identified by the board. Applications are considered and progressed (where appropriate) by the board’s remuneration and nominations committee. “Applications are then brought to the hospital’s board for approval, and where appropriate a recommendation is made to the hospital’s parent company for appointment, in line with the hospital’s constitution.”

The spokesperson noted that all members of the medical board are required to participate in the hospital’s clinical risk and clinical management programme. There are clinical directors for the adult and the paediatric services who oversee risk management in their areas. There is also a clinical risk and clinical governance committee, which includes medical board representation.