HSE Safety and Quality Committee Meeting Minutes 16 December 2020

Committee Members Present

Prof Deirdre Madden (Chair), Dr Yvonne Traynor, Prof Fergus O’Kelly, Ms Anne Carrigy, Dr Chris Luke, Ms Margaret Murphy, Dr Cathal O’Keeffe.

HSE Executive Attendance

Dr Colm Henry (CCO, Item 6), Mr Patrick Lynch (ND QAV), Dr Philip Crowley (ND QID), Ms Niamh Drew (Secretary), Ms Rebecca Kennedy.

The Committee met in the absence of management at the start of the meeting for a discussion on the draft 2021 Committee workplan.

D Madden took the Chair at 12.30pm and welcomed members of the Executive to the meeting.

The following items were discussed and noted:

• minutes of the Meeting on 11 November 2020 were approved subject to amendment
• no conflict of interest was declared

2.1 Quality Profile Report

The ND QID presented the December 2020 quality profile report, updating the Committee on a number of areas including flu vaccination; healthcare worker absenteeism due to COVID-19; and antimicrobial resistance and infection control. The Committee welcomed the update highlighting that as previously agreed, a workshop with the Committee and QID team to identify more in-depth Safety and Quality data should be arranged for early 2021.

3.1 Update on Implementation of Medication Safety Strategy

The ND QID provided an update on the implementation of the Medication Safety Strategy, following its consideration by EMT, as requested by the Committee at its meeting of 13 October 2020. He advised that the EMT has endorsed the establishment of an integrated action group, reporting to the CCO, to oversee implementation of recommendations and best practice initiatives to address the important safety priority of reducing medication-related harm. The ND QID highlighted that there are gaps in the services available nationally to reduce medication-related harm and that the appropriate HSE structures and approach to plan and deliver reductions in medication-related harm are being considered.

The Committee recognised medication safety as a significant patient safety issue and welcomed the proposed establishment of the integrated action group, noting that the recommendations from HIQA’s medication safety monitoring programme in public acute hospitals should be included in the Terms of Reference of the group if possible. The Committee emphasised that the utilisation of e-health procedures should play a key role in the implementation of the medication safety strategy. The Chair agreed to raise the Committee’s view on the importance of the roll out of e-health strategies at the next Board meeting.

The ND QAV updated the Committee on the October 2020 review of the Corporate Risk Register which had been completed and approved by EMT in November 2020. He confirmed the reassessment of the risks has considered the feedback and advice received from each of the Board committees between July and October 2020.

The Committee queried what criteria are used in downgrading the risk ratings. The ND QAV confirmed that a wide range of performance data is considered, and it is ultimately for the relevant EMT risk owner to assess whether either the impact of the risk or the likelihood of the risk occurring has changed as a result of the controls in place and/ or the additional mitigating actions taken. Any proposal to amend a risk rating is agreed by the EMT in their review of the register. Following discussion on what the Committee’s role should be in the risk oversight process, it was agreed that where required, the relevant EMT risk owners for the risks within the Committee’s oversight should be invited to attend the Committee after each CRR review to brief the Committee on any amendments to the risk profile.

5.1 Update on Implementation

The ND QAV briefed the Committee on the current status of the implementation of the National Patient Safety Strategy. He noted that progress continues to be made in the area of patient safety at both national and service levels, however, while there are a number of national initiatives continuing to support the implementation of the Strategy, COVID-19 related redeployment has resulted in limited national coordination of strategy related activity.

The Committee emphasised the importance of redeployed QPS teams returning to their substantive posts and the Chair agreed to highlight this issue to the Board at its next meeting.

The CCO joined the meeting

The CCO presented his monthly report to the Committee beginning with a COVID-19 update. The CCO noted that the five-day moving average and positivity rate of tests are both rising. However, Ireland’s incidence rate is low compared to other European countries and transmission rates are currently following predictions.

The Committee discussed the data provided as part of the National Screening Service Update and noted their concern in relation to a number of metrics, in particular one which stated that the number of women who had a complete mammogram in the period October 2020 was 0 against a target of 17,000. The data reflects the fact that breast screening recommenced on the 27th of October. The CCO noted that as screening looks at a healthy population, the concern is that many people are not attending for their appointments due to a worry of contracting COVID-19. He noted that it is expected there will be an increase in cancer patients presenting through smaller access paths as a result of reduced numbers availing of screening.

The CCO updated the Committee on the work completed to date by the Oversight Group established to ensure the implementation of the recommendations made in the LUH Gynaecology Service Review. He also confirmed that the national review of timelines related to all diagnoses of endometrial cancer in 2019 is under review and that the recruitment of the Clinical Lead and Programme Manager for Guideline Development in NWIHP is also underway.

The Chair acknowledged the dedication of the EMT, Committee and Secretariat and thanked them for their work in 2020.

Date of Next Meeting: 19 January 2021 (TBC).

The meeting concluded at 4.15 pm.

Terms of Reference: Safety and Quality Committee