“Ineffective” HR systems at Children’s Health Ireland (CHI) hospitals have caused “considerable distress” among doctors, some of whom went months without being paid, according to a new inspection report.
CHI hospital sites at Crumlin, Tallaght and Temple Street were inspected by the Medical Council last September following “significant concerns” from multiple sources regarding findings in a previous internal CHI examination.
In a report published on Wednesday, inspectors said HR management across the three sites emerged as a “significant and consistent source of frustration” for staff, having a negative impact on trainees and “potentially patient safety”.
Both trainees and trainers consistently reported difficulty in obtaining responses from HR, with attempts to resolve issues during working hours “detracting from patient care”.
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Issues faced by staff included prolonged delays in receiving employment contracts that, in some cases, lasted weeks and months post commencement.
There were also issues with some staff being placed on incorrect pay scales, while some doctors reported not being paid for up to three months after starting, according to the report.
Staff reported junior doctors being assigned to incorrect departments, the wrong doctors being appointed to posts and some staff commencing employment without a contract in place.
“These issues have led to considerable distress amongst doctors, with some choosing to leave CHI for other opportunities,” the report reads.
Management acknowledged that the “intense focus” on CHI’s capital development projects may have “diverted attention from workforce and operational priorities”, inspectors said, impacting staff morale and retention.
The Medical Council said HR management across the CHI sites requires “immediate attention”, saying a plan to address widespread inefficiencies, poor communication and potential patient safety issues was required.
Another significant issue raised by doctors of all levels was poor access to ICT systems, with staff reporting being unable to access patient data and records on occasion.
Some told inspectors they had to borrow other colleagues’ login details for access, “presenting potential data protection and patient-safety concerns”.
Doctors across all grades voiced “significant frustration” over the need to use up to six separate passwords for different systems, according to the report, with others reporting needing four different sets of login details to access clinical results.
“In one instance, multiple logins and systems are required just to create and send one discharge letter. This inefficiency contributed to a substantial backlog in issuing discharge letters,” the report reads.
The Medical Council said the inability to generate or transmit such letters due to ICT issues “poses a serious patient safety risk”, particularly for cases requiring follow-up communication with GPs.
Some staff also reported delays in receiving ICT passwords, with one doctor receiving login credentials in mid-September despite starting in July.
ICT issues affected doctors at all levels, from consultants to junior doctors, and contributed to delays in care and communication, the Medical Council said.
CHI Connolly has implemented a single sign-on system to streamline access. However, management told inspectors that extending this solution to other sites is “not currently realistic due to budget limitations”.
This will only be possible following the move to the new hospital, management said.
Alongside addressing HR deficiencies, the Medical Council issued a range of recommendations, including implementing a clear and accessible process for raising and escalating concerns.
This was in response to reports that some historic cases of unprofessional behaviour raised to senior management were not “appropriately addressed”.
Inspectors noted that one site in particular showed some evidence of ongoing bullying and harassment, alongside a perception that little or no action was taken on complaints relating to such behaviour.
Some doctors also described “waiting it out” until their rotation ended.
In a statement, CHI said many of the challenges relating to HR and ICT systems stem from CHI operating across three legacy hospital sites.
“CHI acknowledges these challenges and notes that many ICT-related issues will be resolved through the planned move to the National Children’s Hospital (NCH), which will provide a modern, unified digital and clinical infrastructure. CHI is actively improving current HR processes and trainee induction,” it said.
CHI added that it was “reassured by the Medical Council’s findings that its training programmes are robust, well governed and highly regarded by trainees”.
