HSE devoid of system to analyse risks to patients

The HSE told the Government last September that it was not able to analyse information it was receiving on the quality of services so as to highlight where patient safety risks could be occurring.

In a confidential report to the Department of Health on services that needed to be developed, it said there was no system to support the co-ordination of information which the health service was receiving on the quality and safety of care being provided.

The HSE sought funding to develop a new national framework to receive and analyse such information. It formed part of an overall €600 million bid for money to pay for new and additional services which it believed were needed.

“The chief medical officer’s report into [the] Portlaoise [hospital controversy] and the Hiqa report into same, identify the inability of the health service to analyse and triangulate information that is collected on the quality and safety of services as a serious threat to patient safety,” the report said.

‘No system’

“The director general of the HSE and the national director for quality and safety are exposed to this risk as there is currently no system in place to support the co-ordination and triangulation of information in order to identify where patient safety risk may be occurring,” it said.

Separately, HSE director general Tony O'Brien has said he will commission an independent review "in accordance with disciplinary procedures to look at issues of concern "arising from the controversy over infant deaths at Portlaoise hospital.

“There were many issues escalated; they didn’t always find their way to the right decision-making levels and I need to look at that, including in particular the way that issues escalated to the regional level found their way, only after a very extended period of time, to the national level,” he said.

Regulatory body

It is understood the HSE has also referred the cases of two nurses at the hospital to their regulatory body, the Nursing and Midwifery Board.

In the confidential submission to the Department of Health last September the HSE said it needed more than €1.4 billion in additional funding for this year.

It also warned that there was no more scope for savings to be made.

In its additional allocation for the year the HSE received €635 million and was asked to generate a further €130 million in savings. The submission, which the Department of Health and the HSE had refused to publish, said the health authority believed there had been “an ultimately unsustainable trajectory of budget reductions for health services over the last number of years which has steadily eroded the funding base necessary to deliver the current level of services”.

The submission drawn up by Mr O'Brien was released by the Department of Health to The Irish Times in recent days following the intervention of the Office of the Information Commissioner.

It said the HSE believed “achieving any additional significant level of efficiency is no longer possible and recent data demonstrates a health system under increasing pressure”.

The submission, dated September 9th, warned the department that delayed discharges in hospitals and pressure on home care were increasing.