The inability to track the implementation of health service quality improvement plans could lead to “serious incidents or injuries”, an internal audit has found.
Under 2005 legislation, Health Service Executive (HSE) managers are responsible and accountable for a safe working environment and systems of work and rest.
In 2015, the organisation established the national health and safety function to assist in the management of and compliance with occupational health and safety requirements.
An audit, dated November 24th last, and published on Monday, sought to examine the effectiveness of the safety function, and found that it “primarily operates as defined”.
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However, the audit it highlighted one medium risk and one high risk to the HSE.
The audit said in 2024 there were 29,598 staff-related incidents, of which the vast majority were “negligible/minor” in severity.
Of those incidents, 69 per cent related to violence, aggression and harassment, while 7 per cent related to slips, trips and falls.
In the evaluation, the auditors said that when this team was established more than 10 years ago, it was recommended that after 12 months a post-implementation management review would be carried out. However, this review has not yet happened.
“Following the Sláintecare reforms, and the establishment of the HSE health regions, clearly defined governance arrangements for health and safety within these regions have not yet been established,” the audit report states. “This gap poses a significant challenge.”
The auditors also highlighted that there was no central tracking mechanism to monitor the implementation of quality improvement plans.
In 2024 there were two audit programmes that totalled 174 audits and 2,000 quality improvement plans to address the health and safety issues identified. However, the lack of tracking mechanism meant it was not possible to fully monitor, verify or report on the status and completion of the actions required to address these concerns.
“Key issues identified by audits may remain unaddressed, leaving gaps in controls and potential for repeated issues and escalation,” the report says. “Corrective actions may be poorly implemented resulting in serious incidents or injury.”
In a statement following the publication of the audit, a HSE spokesman said the volume of improvement plans in 2024 reflected the “proactive approach to identifying risks and driving improvements”.
“Although a single national system to track the implementation of all audit recommendations was not previously in place, work is now progressing to strengthen oversight, reporting and monitoring of corrective actions,” he said.
“The HSE is enhancing governance structures and clarifying responsibilities at national, regional and service levels, particularly in light of the new regional health structures.”
The spokesman added that the organisation is committed to ensuring “safe environments for patients, staff and visitors” and ongoing audit and reviews are “central to this commitment”.
