A meeting of the HSE Safety and Quality Committee was held on Tuesday 19 January 2021 at 10am via video conference.
From: HSE Board
Published: January 2021
Updated: November 2024
Prof Deirdre Madden (Chair), Dr Yvonne Traynor, Prof Fergus O’Kelly, Ms Anne Carrigy, Dr Chris Luke, Ms Margaret Murphy, Dr Cathal O’Keeffe.
Dr Colm Henry (CCO, Item 2), Dr Philip Crowley (ND QID), Ms Anne Marie Kiernan (Head of Quality, Safety and Risk, NSS, Item 3), Ms Niamh Drew (Secretary), Ms Rebecca Kennedy.
Mr Patrick Lynch (ND QAV).
The Committee met in the absence of management at the start of the meeting.
D. Madden took the Chair at 10.15am and welcomed members of the Executive to the meeting.
The following items were discussed and noted:
The CCO presented his monthly report to the Committee beginning with a COVID-19 update. The CCO noted that reports and trends in this area are changing day by day but the number of patients with COVID-19 in hospital and in ICU are rapidly rising and the 14-day incidence rate in Ireland is one of the highest in Europe.
The CCO confirmed that ICU capacity has been built up over the past number of months and there is a surge plan to provide for 350 ICU beds.
These will be staffed with a redeployed workforce who have become available due to curtailment of certain health services. The agreement with private hospitals will also assist surge capacity by providing up to 44 ICU beds.
The Committee discussed whether future COVID-19 surges can be avoided. The CCO advised that the vaccine rollout should help lessen the impact of future surges as once vulnerable people and healthcare workers are vaccinated, we should see lower disease burden. However, evidence regarding transmissibility post-vaccination is still lacking.
In relation to the vaccination programme, the CCO advised that the National Immunisation Office has devised specific training for the COVID-19 vaccines and guidelines which will need to be abided by at all times. The CCO emphasised the need for all vaccination sites to adhere to the priority lists provided to them.
The Committee discussed the importance of clearly communicating the timeline of the vaccination programme and the rationale of the prioritisation lists to the public and the CCO agreed that this is critical. The Committee discussed the data provided as part of the National Screening Service Update and noted their concern in relation to the pausing and scaling back of screening programmes.
The CCO advised that in the current COVID environment, it is not possible to continue these services at their usual capacity given the potential risk to healthy people.
He confirmed that BreastCheck is paused but clinicians are supporting symptomatic women. In the early resumption of screening there appeared to be a hesitancy among the public to attend for appointments.
CervicalCheck continues to run, whilst there had been some public hesitancy to attend appointments; following a public campaign by CervicalCheck this has improved vastly and the last few months of 2020 saw a doubling of expected activity.
This has fallen slightly in the New Year due to a reduce availability of GP appointments, but women are still being encouraged to book appointments and there remains considerable activity ongoing.
The Committee queried whether there is an intention to ‘catch-up’ on the lists of people who would have been due to attend a screening appointment. The CCO advised that the continuation of cancer services for symptomatic people is the current priority. 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 confirmed that although there was a significant outbreak of COVID-19 in LUH, the Special Measures Team (SMT) have remained on-site.
The CCO advised that although there is evidence of progress in implementing the Price Report recommendations, the sustainability of these improvements will likely be challenged once the SMT is withdrawn.
The Committee expressed great concern in relation to the potential lack of sustainability of progress. The CCO confirmed that there is no time limit on the work of the SMT and they will not be withdrawn from LUH until assurances can be given to women that they will receive the required level of care.
It was agreed the CCO would provide an update on the matter at the next meeting.
The CCO provided the Committee with an outline of the work being undertaken in relation to the development of a Patient Engagement Framework. The Committee commended the work being done here and asked that the team leading consider utilising progress which has been made in this area abroad. The ND QID confirmed that they will be doing this and have already been in touch with the NHS.
The CCO left the meeting.
A McKiernan joined the meeting
The Committee discussed the reduction in risk score of the CRR Screening Services risk and emphasised their concern that the risk score had been reduced as a result of the EMT CRR review.
A McKiernan noted that though the risk score has been reduced, this review was completed at a time when all screening services were fully operational.
It also took into account the publishing of the Expert Reference Group Interval Cancers Reports which are thought to have given some assurance to staff working in these programmes. She advised that although screening programmes are running at a lower capacity, they are not as restricted as they were in the beginning of the COVID-19 pandemic.
It was felt that given the reduction in screening services currently available and the current legal environment in which screening is operating the risk score is not an accurate reflection of the risk in this area.
The Committee was not satisfied with the reasoning used to reduce the risk score for screening services and requested that it be reconsidered by the EMT.
A McKiernan left the meeting.
The ND QID presented the December 2020 quality profile report, updating the Committee on a number of areas including flu vaccination; day of surgery admission rate; delayed transfers of care; and antimicrobial resistance and infection control.
In relation to the metric for Disability Act Compliance: percentage of child assessments of need completed within the timelines, the Committee expressed extreme concern that there has been no marked improvement here since 2017.
It was agreed that the Chair would raise this matter at the Board and convey the Committee’s strong views that more focus should be directed here which the ND QID supported.
The Committee also requested that a COVID-19 vaccination metric be included in Quality Profile going forward if possible.
The ND QID briefed the Committee on the work being completed by the HSE National Office for Human Rights and Equality Policy in reviewing the National Consent Policy and supporting systems around the Assisted Decision Making Act 2015. He noted that thought the act is still not in force, a lot of work is underway in preparation for its commencement which the Government has committed to in June 2022.
The ND QID also updated the Committee on the review of the HSE National Consent Policy noting that COVID-19 has impacted on the progress of this work, but it is now almost complete. He advised that the issue pertaining to whether 16/17 year-olds can consent to treatment is still unsettled and this matter has been escalated to the CCO and the CEO for a decision.
The Committee noted the importance of these developments, confirmed their support for them and thanked the ND QID and his team for the work completed to date.
Date of Next Meeting: 16 February 2021 (TBC).
The meeting concluded at 12.40 pm.
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