A REVIEW of gynaecology services at Letterkenny University Hospital published this morning has found that despite additional staffing and funding resources being given to address serious failings further action is needed to safeguard women in Donegal.

The review, carried out by the Health Information and Quality Authority (HIQA), was undertaken following incidents of delayed diagnosis of endometrial cancer which led to the publication of a damning HSE report in August 2020.

This latest review has found that weaknesses in governance structures and processes and of oversight quality assurance mechanisms at the Saolta Group remain.

HIQA found that although a new ambulatory (outpatient) gynaecology service was established it was not fully operational and was working at only 50 per cent of its potential capacity.

The hospital was given approval for six full-time permanent  clerical, nursing and support staff posts but were unable to fill them and they were relying on locum and agency contracts to sustain the delivery of the service. The hospital failed to meet national HSE and Saolta Group guidance and timelines for the review, testing and diagnosis of some women referred with post-menopausal bleeding. Furthermore, Saolta Group failed to identify cases where non-adherence to timelines had occurred. This was of significant concern to HIQA and was raised with the hospital group. The hospital continues to struggle to recruit and retain medical, nursing and midwifery, and administrative staff which remains a risk to patient safety.

HIQA’s Director of Healthcare Regulation, Sean Egan said if improvements are not made following this intervention the HSE should hold Saolta Group to account.

“A number of women and families raised concerns with us about gynaecology services at the hospital over the past few years. Our priority in this review was to examine the effectiveness and sustainability of measures introduced to improve the quality and safety of gynaecology services for women, and provide them with assurances about the service. We extend our deepest sympathies to the families of those who experienced a delay in diagnosis of endometrial cancer and those who died with the disease,” said Mr Egan.

“Despite the number of initiatives and measures introduced by Saolta Group since 2018, HIQA was not assured that there were sufficient and effective governance and oversight arrangements in place to assure the quality and safety of gynaecology services, which posed a risk to women using the services. Strong and effective governance, leadership and management is needed at the hospital and hospital group to ensure and promote high-quality, safe and reliable services and establish and sustain a culture of patient safety.

“While some measures introduced at the hospital had brought about improvements, such as a new ambulatory (outpatient) gynaecology service, revised procedures for the review and triage of referrals and a decline in waiting lists numbers for women trying to access gynaecology services, these must be sustained in the long term so that women who use and depend on the service can be confident about its quality and safety. If this is not achieved, the HSE should hold Saolta Group to account.”

The full report can be accessed here: https://www.hiqa.ie/reports-and-publications/key-reports-investigations/review-governance-arrangements-gynaecology