A new “comprehensive” national framework designed to strengthen patient safety, accountability and quality improvement across surgical services in Ireland has been published.

A Framework for Surgical Clinical Governance was launched by the RCSI following work by the College’s Expert Group on Best Practice in Clinical Governance Surgical Leadership.

Aligned with international best practice, the framework is intended for use across public, voluntary and independent healthcare settings. It outlines four key domains – morbidity and mortality meetings, multidisciplinary team engagement, patient safety and clinical audit, and the governance of innovation, research and new technologies – which are “central to the safe and effective governance of surgical care”.  

The framework provides a “governance maturity model” that surgical services can use to assess the extent to which their governance arrangements are embedded, reliable and integrated within the wider hospital system, and in planning progressive improvement over time. 

Prof Deborah McNamara, President of the RCSI, said: “Surgeons are privileged to care for people at some of the most vulnerable moments in their lives. With that privilege comes the profound responsibility to learn from our experiences, as enabled by safe, transparent and learning-oriented surgical governance.”

“High-quality surgical care depends on strong clinical governance, clear accountability and a culture of continuous learning,” continued Prof McNamara. 

“The public have the right to high quality and safe surgical care. This framework is RCSI’s constructive contribution to the national effort to improve patient safety and support our surgical workforce, providing practical guidance for surgeons, clinical leaders and healthcare organisations to support patient safety and improve outcomes. In particular, the use of the governance maturity model will support our hospitals in reflecting on the areas of improvement they need to prioritise.” 

Mr David Moore, Chair of the Expert Group on Best Practice in Clinical Governance in Surgery and RCSI Council Member, said: “Surgical teams across Ireland are committed to delivering safe, effective care, often under significant pressure. This framework is designed to support that work by providing a clear, consistent structure for governance that is clinically led, evidence-informed and focused on learning and improvement. Our aim is to help surgical services strengthen governance in a way that is practical and sustainable.” 

The framework is now available on the RCSI website here. 

The implementation of the new the Waiting Time Action Plan (WTAP) 2026 will be overseen by the waiting list task force.

Minister for Health Jennifer Carroll MacNeill said the WTAP, which was published on Friday 30 January, “is a multi-faceted approach with one overarching aim, to ensure people get access to faster care and achieve better health outcomes.”

According to the document, the governance structure of the WTAP 2026 “will broadly” follow the model and principles developed for previous action plans, with oversight of its implementation conducted through the task force.

The task force, co-chaired by the Department of Health Secretary General and the HSE CEO, will be comprised of senior representatives from the Department, the HSE Centre and Regions and the National Treatment Purchase Fund (NTPF).

“It will report directly to the Minister for Health, with whom issues will be escalated as required,” reads the plan. “The WTAP 2026 also falls under the broader umbrella of Sláintecare reforms in relation to improving access to care and progress reports will continue to be provided to the Sláintecare Programme Board for discussion at their meetings,” according to the plan.

Minister Carroll MacNeill said: “In order to reduce waiting times we need to see more activity that results in patients receiving care, particularly those waiting the longest. As detailed in the action plan, this will be achieved through a combination of measures including service reforms and innovation; increased productivity and improved performance; investment in infrastructure and staffing; embracing digital solutions; and supplemented by targeted additional capacity via the NTPF.”

According to the Department the WTAP sets out six overarching and interconnected targets, which will be achieved through the delivery of 36 actions under the themes of “reforming planned care”, “enabling planned care” and “capacity optimisation”.

Targets in the WTAP include:

Sláintecare wait time targets: 50 per cent of patients to be waiting less than the Sláintecare wait time targets of 10 weeks for outpatient (OPD) appointments and 12 weeks for inpatient and day case (IPDC) procedures; and 65 per cent of patients to be waiting less than the Sláintecare wait time target of 12 weeks for GI scopes. 

Weighted average wait time: Reducing the weighted average wait time to < 5.5 months for OPD and IPDC and to < 3.5 months for GI scopes.

Patients waiting less than 12 months: 90 per cent of patients to be waiting less than 12 months for first access to OPD services.

The first curative lung cancer surgeries connected to the Lung Health Check pilot programme have taken place in recent months, according to the Irish Cancer Society.

The €4.9 million lung cancer pilot programme is funded by the Society.

The Lung Health Check is an initiative led by the Beaumont RCSI Cancer Centre that was launched last year.

This clinical trial, in collaboration with specific GP practices in North Dublin and the North East region, invited individuals at a high risk of developing lung cancer to attend community-based mobile scanning units for lung health checks.

Currently, six in every 10 lung cancer diagnoses are detected at late stage, when it is harder to treat. 

Thoracic surgeon at St James’s Hospital, Mr Gary Fitzmaurice, who operated on several of the patients identified through the Lung Health Check pilot, said the programme is already demonstrating its value by identifying cancers before symptoms appear, allowing patients to access curative treatment.

He added that the major impact of the pilot is that cancers which would normally be detected at a late stage are instead found at a much earlier point.

 “We’re identifying people who have very early lung cancer who have absolutely no symptoms and without a CT scan would not have been detected,” said Mr Fitzmaurice.  “That gives them the big advantage of having all the potential options for curative intent treatment and the best chance of long-term cure.”

Prof Daniel Ryan, Respiratory Consultant at the Beaumont RCSI Cancer Centre and Clinical Lead of the Lung Health Check Pilot, said: “Lung cancer kills more Irish people every year than any other cancer, mainly because it is diagnosed late when it is difficult to treat. This pilot programme is saving lives by detecting cancer early.”

“Leading a mobile lung health check in the community is a major step forward for lung cancer care in Ireland, and we are proud to have initiated this work in Beaumont RCSI Cancer Centre. This pilot is breaking down barriers that have long stood in the way of early detection of lung cancer, bringing together partners across the healthcare system. The support from the Irish Cancer Society, and our collaboration with Centric Health GP practices, Alliance Medical Diagnostic Imaging, and the GAA clubs in the region, is ultimately saving lives.”

The HSE has published its National Service Plan 2026. The plan sets out the delivery of a range of health and social care services that will be provided “within the budget of €29 billion”. This includes a €3.8 billion investment for disability services, a 20 per cent increase on 2025.

According to the HSE, highlights include:

• 428 community beds and 177 acute beds will be delivered
• Five new surgical hubs will be operational
• National Children’s Hospital Ireland will be completed
• Single point of access to disability, mental health and primary care services will be provided for children to improve timely access to the right care
• Expansion of core disability services including residential supports – delivering 199 residential placements, 58 de-congregation transitions, and 45 transitions from nursing homes for people under 65
• Greater access with more services available in the evenings and on weekends
• The Maternity and Newborn Electronic Health Record system will be deployed in four of the remaining 13 maternity units
• The Shared Care Record will be implemented in the Dublin South East region and implementation will commence in two other regions.

Speaking about the HSE’s priorities for 2026, Mr Ciarán Devane, HSE Chairperson, said: “The 2026 plan represents a continuation of our reform journey towards a health and social care system that is accessible, supportive, sustainable, and responsive to the needs of all. Ireland’s population now exceeds 5.3 million. Life expectancy continues to rise, projected at 82.7 years overall in 2025, placing us among the highest in Europe. Continuing improvement in life expectancy and in healthy life years remains an important goal now and for the long term.

“Our priority for 2026 is to improve access to care by making significant improvements to waiting times for both emergency and scheduled care. Part of this will be expanding and strengthening health and social care capacity to meet the increasingly complex needs of a growing, ageing, and diverse population. More, however, will be using our existing resources to best effect, innovating our processes to ensure our colleagues are supported to have the time and resources to continue to deliver great care.”

Minister for Health Jennifer Carroll MacNeill said: “The Government’s priority for 2026 is to improve healthcare access and quality across all health regions. This will be achieved through targeted investment that supports the shift to community-based care, reduces hospital overcrowding, and delivers services closer to home. Investment will be directed where it delivers the greatest impact for patients and return for taxpayers on the State’s sustained healthcare funding over the past decade.

“Over the past decade, targeted investment has resulted in faster diagnosis, improved outcomes, increases in activity and clearer care pathways for patients. But we still have work to do to make these improvements consistent. In some areas, patients are seen quickly; in others, access is slower. Meanwhile, services such as community therapies face severe backlogs, even in health regions that perform well in other areas. Our goal is that wherever you live in Ireland, you should have timely access to high-quality care.””

Mr Bernard Gloster, HSE CEO, said: “We enter 2026 with the foundations of organisational reform in place and a clear Government mandate to accelerate improvements in service delivery for the people we serve. The establishment of six health regions under Sláintecare and 20 integrated health areas, marks a critical step towards planning and delivering services around the specific needs of local populations leading to better co-ordination of care and improved access to services. This transition to population-focused funding aligns resources with need and empowers health regions to deliver integrated, responsive care, with the ultimate goal of achieving better health outcomes. 2026 is the first year and first major step towards the type of resource allocation and the pathway set by the Minister is clear – we must look at all resources existing and new together to achieve the priorities for the people.

“In addition, the expansion of community-based care and progress in digital transformation have marked important steps in our progress to date. We continue to work to enhance hospital services, improving patient flow, efficiency and capacity, and introducing new models of care to support timely treatment and better outcomes. The goal of right care, right place, right time can be our only real target as we balance the critical success factors of access, safety and outcome.”

The HSE National Service Plan 2026 is available here: HSE National Service Plan 2026

The Mater Misericordiae University Hospital (MMUH) has become the first hospital in Ireland to successfully introduce new cancer tests for personalising treatment for patients with aggressive forms of gastrointestinal and ovarian cancers.

Claudin-18 (CLDN18) and Folate Receptor-1 (FOLR-1) companion diagnostic and therapeutic testing enables clinicians to determine whether patients with certain aggressive cancers may benefit from highly targeted and potentially life-extending cancer immunotherapies.

The newly validated tests, completed by Medical Scientists and Histopathology Consultants in the hospital’s Cellular Pathology Department, identify the presence of specific proteins in tumour tissue, helping to discern whether new, specialised cancer treatments could improve outcomes for individual patients.

“Pathology laboratories play a central role in clinical decision-making. Approximately 70 per cent of all medical decisions are informed by pathology test results,” said Dr Ann Treacy, Consultant Histopathologist at the Mater Hospital.

“By expanding our precision diagnostic capabilities, patients in Ireland can benefit from advanced testing that helps us match the right patient to the right treatment. This level of precision is vital for improving outcomes, particularly for patients with few remaining treatment options.”

Claudin-18 testing helps identify patients with upper gastrointestinal cancers who may benefit from novel immunotherapies. FOLR-1 testing supports precision treatment decisions for epithelial ovarian, fallopian tube or primary peritoneal cancers by determining whether a patient may be suitable for targeted therapies in cases of recurrent or chemotherapy-resistant disease. Together, these tests offer new possibilities for patients who have exhausted conventional treatment options.

“The introduction of these biomarkers represents a meaningful step forward for patients facing some of the most challenging cancers,” said Dr Darren Cowzer, Consultant Medical Oncologist at the Mater Hospital.

“Having rapid access to high-quality local Claudin-18 and FOLR-1 testing allows us to identify candidates for targeted therapies much earlier, ensuring treatment decisions are timely, and precise. These advances give more patients the opportunity to benefit from standard and experimental therapies that may significantly improve outcomes and quality of life.”

The HSE’s new public health strategy is a “bold and timely vision”, according to Professor Mary Horgan, Chief Medical Officer (CMO).

The HSE has launched its new Public Health Strategy 2025 – 2030, setting out a roadmap to improve health outcomes, reduce inequalities, and strengthen Ireland’s public health system over the next five years.

The strategy was developed in consultation with a diverse range of stakeholders, local government and community partners. Its stated aim is to “deliver a high-quality, integrated public health service, and foster a culture of collaboration, innovation, and evidence-informed practice”.

Prof Horgan said the new document “can deliver lasting positive change for individuals, families, and communities”.

“The Department of Health is proud to support a strategy that listens to patients, values evidence, and empowers public health professionals to build a healthier future for everyone.”

Dr Colm Henry, Chief Clinical Officer, HSE, said the strategy “provides clear direction and empowers” the public health workforce to deliver real and sustainable improvements in population health and resilience.

“The strategy will also ensure that public health, within the HSE and embedded in our regions, will play a strengthened and pivotal role in the transformation of healthcare as envisaged by Sláintecare.”

Dr John Cuddihy, HSE National Director of Public Health, described the document as “ambitious”.

“By listening to the voice of patients and communities, and working closely with partners from across society, we are laying the foundation for a public health function that is prepared for the future and driven by measurable impact.”

Central to the new strategy is a commitment to population health and prevention, protecting health, and health equity, focusing on six priority areas;

• Delivering a high-quality and integrated public health function
• Protecting the population from all health threats
• Strengthening action on the wider determinants of health
• Reducing health inequalities across all stages of life
• Strengthening health services to address population needs, emphasising prevention and early intervention
• Leveraging health information, evidence, research, and innovation for better health.

Surgical hubs and elective hospitals, “will go a long way to address the challenges in elective surgery”, the RCSI President Prof Deborah McNamara told this newspaper.

However, Prof McNamara cautioned that even with this extra infrastructure, there remained “a huge need” for the health service to focus on patients who need a longer stay in hospital.

She said these are patients who require “all of the resources of a bigger hospital in order to get the surgical care that they need”.

“And we have major concern about that, I’ll be honest. So, the elective surgical hubs, and elective hospitals will go a long way to address the challenges in elective surgery. But for some of the most complex, elective operations, they won’t address the totality of what we need.

“That needs to be taken into consideration alongside interventions to protect surgical beds and theatre capacity in our [existing] bigger hospitals that have emergency departments.”

Prof McNamara was speaking to the Medical Independent (MI) at the recent annual Millin Meeting held in the RCSI. (Coverage of the Millin meeting will be carried in the 9 December issue of MI).

Separately the HSE told MI the elective hospitals in Cork and Galway are being progressed first.  The design team are actively working on the design for these hospitals, including carrying out necessary surveys and site investigations to inform the design as it develops toward planning permission applications. 

“A key issue emerging for the Cork site is the road access, and the HSE continues to actively engage with Cork City Council to find a solution,” the spokesperson told MI.

In relation to the two Dublin sites, the demand modelling and validation are underway, along with the assessment of current and planned infrastructure for ambulatory care in the catchment area to underpin the scope and scale required.

A total of nine HSE surgical hubs are also at various stages of development nationally, two of which are operational.

The Medical Council has welcomed the publication of the third One Health National Action Plan to address Antimicrobial Resistance (AMR) 2026-2030, known as iNAP3.

CEO of the Medical Council, Dr Maria O’Kane, said increasing awareness of AMR is critical to protecting patients.

“According to the World Health Organisation, antimicrobial resistance is one of the top ten global threats to human health,” said Dr O’Kane. “Continued planning and action against AMR will be essential for patient safety into the future, and we welcome iNAP3 as an important step forward.” 

“For doctors, reducing AMR means ensuring that antibiotic medicines are only prescribed and administered when they are genuinely needed. Antimicrobial medicines should only be used where they are required to treat serious infections.

“For patients, not every illness requires an antibiotic, and your doctor will advise you on the most effective treatment. Avoiding unnecessary antibiotics helps protect their effectiveness for the future.”

Earlier this week, the Minister for Health, Jennifer Carroll MacNeill and Minister for Agriculture, Food and the Marine, Martin Heydon launched iNAP3.

According to the Department of Health, building “on the strong foundations” laid under iNAP1 (2017-2020) and iNAP2 (2021-2025), iNAP3 (2026-2030) “reinforces Ireland’s commitment” to tackling the growing global threat of AMR through a ;One Health approach; – recognising the interconnection between human health, animal health and the environment.

“This [AMR] threat requires a multisectoral approach across human, animal, and environment health to preserve the effectiveness of antimicrobials for future generations,” said the Health Minister.

“With this National Action Plan, iNAP3, we have demonstrated that Ireland is fully committed to a collective approach to combating antimicrobial resistance. However, its success will depend on continued commitment from every sector and from each one of us.

“Since the publication of our first iNAP plan in 2017, significant progress has been made in tackling antimicrobial resistance in the health sector, and I would like to thank all healthcare workers for their efforts in this regard.”

HIQA found improvements across the health services it inspects in 2024.  

That is according to findings in the Authority’s Overview Report of the Monitoring and Regulation of Healthcare Services in 2024, published today (7 November).

While “good standards” of care were observed by HIQA, healthcare remains a challenging environment and a number of key areas require ongoing improvement. The overview report found that hospitals continue to be challenged with suitable infrastructure to support demand, bed capacity, and sufficient workforce among other issues.  

“Our inspectors have spoken to many patients who have praised the healthcare staff who have cared for them. We regularly observe excellent practice from committed staff working in a challenging environment,” said HIQA’s Director of Healthcare Regulation, Mr Sean Egan.

 “While we are seeing tangible improvements in healthcare services, resourcing and capacity requirements, particularly in acute hospitals, need to be addressed to meet service demand. These shortfalls directly affect both patients and the workforce on a daily basis, and this becomes increasingly crucial as we come into the winter months.”

HIQA inspections have shown examples of improved levels of compliance in healthcare services in 2024. In situations where findings from previous inspections facilitated comparison on re-inspection in 2024, 41 per cent of national standards assessed on re-inspection showed improvements.

In addition, in facilities that provide medical exposure to ionising radiation, the number of regulations assessed as not compliant was five per cent, which is significantly lower than the 12 per cent identified between 2021 and 2023.

The Medical Council has condemned the “increasing trend” in targeting of healthcare workers, including “racial abuse of doctors, nurses, and healthcare assistants around the country”, and the deliberate targeting and killing of humanitarian healthcare workers in conflict zones around the world.

Speaking about the rise in racial abuse of healthcare workers in Ireland, Dr Maria O’Kane, CEO of the Medical Council said: “Here in Ireland, we have…seen an increase in reports of racial abuse towards our healthcare workers”.

“Our health service would collapse overnight if it wasn’t for our internationally trained colleagues and friends,” said Dr O’Kane. “It is vitally important that there is a zero-tolerance approach to racial abuse, especially in healthcare settings. I strongly encourage employers to ensure that supports are available and promoted for healthcare professionals who are victims of racial abuse and for those from countries engulfed in conflict.”

According to the Medical Council’s Workforce Intelligence Report 2024, 41.7 per cent of doctors clinically active in Ireland received their primary medical qualification outside of Ireland.

Looking globally, Dr O’Kane said that “we have recently seen blatant breaches of international law in Sudan, Gaza, Lebanon and Ukraine, amongst other countries, with the targeting of healthcare workers and health facilities.”

“Last week, the WHO condemned the killing of 460 patients and their companions in a hospital in El Fasher, Sudan, in addition to the abduction of six healthcare workers. Two days earlier Saudi Maternity Hospital, the only partially functioning hospital in El Fasher, was attacked for the fourth time in a month, killing one nurse and injuring three other healthcare workers. Throughout the conflict in Gaza, hospitals and hospital staff have been regularly targeted, resulting in a situation where healthcare is not accessible for so many due to the destruction of hospitals and clinics.”

According to the Medical Council, there are 1,240 doctors clinically active in Ireland with a primary qualification from Sudan.

“Since the first of January this year, there have been 1,146 attacks on healthcare facilities, healthcare workers, patients, supplies, warehouses and healthcare transport, resulting in 1,785 deaths and 1,014 injuries in 16 countries across the globe, according to the WHO Surveillance System for Attacks on Healthcare,” said Dr O’Kane. “This is simply unacceptable and should be condemned widely.”

“We must be cognisant of doctors from these conflict zones working here in Ireland, caring for us and our families while worrying about their loved ones and families still living in areas impacted by war and aggression, or who have been displaced.”

BowelScreen has announced that it is now offering screening to people aged 58.

This is the third expansion of the screening programme’s offering since October 2023 and makes screening available to men and women aged 58 to 70. Over time, the HSE is expanding the screening programme to people aged 55 to 74.

Around 2,500 people are diagnosed with bowel cancer in Ireland every year. It is the second most common of all cancers in men and the third most common of all cancers in women in Ireland.

BowelScreen Clinical Director Professor Pádraic Mac Mathúna, said that making BowelScreen available to younger people is an important step in preventing and detecting bowel cancer early.

“Our primary goal in BowelScreen is to reduce mortality from bowel cancer. We prevent cancers from developing by finding and removing small growths, which can turn into cancer if left untreated. Every year, around 3,000 people have pre-cancerous growths removed because they did our BowelScreen test.”

He added that a screening test is not a diagnostic test – it looks for a level of blood in your sample.

“Not all cancers or polyps bleed all the time so a normal result does not guarantee that cancer isn’t present. This is why it is so important to be aware of symptoms of bowel cancer and go to your GP immediately, even if you had a recent normal screening result. Do not wait for your next screening test if you have any symptoms of bowel cancer.”

Minister for Health Jennifer Carroll MacNeill said the continued expansion of BowelScreen “is an important step in our ongoing investment in public health and disease prevention”.

“This will ensure that more people across Ireland can benefit from early detection, timely treatment and ultimately better outcomes.”

The Government has announced additional €11 million in recurring funding for drugs and inclusion health services in Budget 2026.

According to the Department of Health, the allocation includes €4m for service enhancement measures and will address regional disparities in availability of drug and inclusion health services, “with a strong focus on the provision of services in disadvantaged and rural areas”. It also aims to enhance prevention measures, including through early intervention measures to improve child health and wellbeing.

“The additional funding I have secured for 2026 will address disparities in the availability of and access to drugs and inclusion health services across the six HSE health regions,” said Minister for Public Health, Wellbeing and the National Drugs Strategy Jennifer Murnane O’Connor.

“We are paving the way for the implementation of our new national drugs strategy, expanding capacity in services all across the country and rolling out successful pilot initiatives to new areas.”

Separately Minister for Older People Kieran O’Donnell announced that there will be an increase of €215 million for older persons services in 2026, representing a rise of over a 7.1 per cent increase on 2025.

“I am delighted to have secured significant additional for older persons services,” said Minister O’Donnell. “This makes Budget 2026 the largest ever budget for older persons services with over €3 billion allocated to maintain and further enhance older persons services in 2026”.