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‘Suboptimal’ equipment and ‘constrained’ colposcopy infrastructure raised

Asked if the reference to “suboptimal equipment” related to clinical risk or general concern about the age of the equipment, a Rotunda spokesperson told the Medical Independent (MI): “It is both, and equipment was prioritised to be replaced by the Rotunda Executive, despite not having capital funding provided to do so.”

Minutes of the hospital’s Board meeting in June stated: “Reference was made to the last Board Quality and Safety Walk-Round, which included the Colposcopy Department and the constrained infrastructure and suboptimal medical equipment being used.

“The National Screening Services Programme does not fund the cost of equipment replacement. Funding for the replacement of colposcopy equipment was escalated to the HSE and highlighted for funding in 2019. Due to the high risks involved, the [Rotunda] Executive has agreed that the Mediscan equipment should be funded immediately from the hospital’s own resources.”

CervicalCheck staffing was also raised, but a large section of the ensuing discussion was redacted.

The discussion on the Colposcopy Department was preceded by reference to “extensive lists” having been allocated by the HSE CervicalCheck call-back helpline to the maternity hospitals for response.

“The substantial support provided by the hospital’s Colposcopy Department to provide reassurance to patients was outlined; however, lists/logs continue to be allocated to the maternity units. The impact of this extra work on staffing resources and impact on current services was raised at the recent Dublin Joint Maternity Hospitals meeting.”

A Rotunda spokesperson said no additional staffing had been provided by the HSE.

Due to the increased demand for repeat cervical screening tests, there had been a resultant demand on colposcopy services, according to the HSE. A meeting had taken place between the Dublin maternity hospitals and National Screening Service “to understand the impact on services following the increased demand”, added the HSE’s spokesperson.

The HSE said that notifications from laboratories provide the most accurate information in terms of number of smear tests being processed under CervicalCheck. ‘Notification’ denotes when CervicalCheck is informed by a contracted laboratory that it has received a smear test and transferred the sample to a slide. There were 32,568 notifications in July 2018, compared with 19,778 in July 2017.

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