Reforms at cytogenetics lab at Crumlin hospital necessary to meet best practice – HSE

Reforms at the cytogenetics laboratory at Our Lady's Children's Hospital in Crumlin are important and necessary to meet best practice standards and to minimise risk and optimise patient care, the HSE has said.

The HSE also said on Thursday that an external multi-professional team appointed by the hospital would, as part of its work, carry out a broader review of services at the overall department of clinical genetics at Crumlin to assure patient safety systems were in place.

The Irish Times reported on Thursday that a new review, commissioned by the HSE's National Cancer Control Programme (NCCP), had in a draft report raised serious concerns about governance and management at the cytogenetics laboratory at Our Lady's Children's Hospital. The review said without significant changes there were a high risk that the service could fail or result in a serious clinical error.

The cytogenetics laboratory is one division of the overall department of clinical genetics .

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The board of the hospital in recent days suspended one cytogenetic test for a particular form of cancer, which helps clinicians determine the best course of treatment. This is to be outsourced pending the introduction of a more modern system. The hospital also put in place additional supports for its department of clinical genetics including the appointment of the external team.

The HSE in a statement said the cytology lab review identified “concerns about turnaround times and a specific need to upgrade the technique used for testing myeloma samples”.

“We acknowledge that the recommended changes are important and necessary to meet best practice standards and thereby to minimise risk and optimise patient care. Part of the external team’s work will include undertaking a broader review of services in the department of clinical genetics to assure patient safety systems are in place.”

The HSE said in a statement that the draft report of the review commissioned by the NCCP had maintained that “without organisational change and investment, the laboratory will face increasing challenges in providing a timely and safe service”.

“The report makes several recommendations covering staffing, training, accreditation, service provision, test availability, governance and the location and structure of the service. The HSE, Children’s Hospital Group and the NCCP will continue to work with the hospital to ensure implementation of the recommendations and will consider asking the reviewer to return at a future point to assess progress.”

The HSE said that when it received the review the NCCP, along with senior management in the HSE and Children’s Hospital Group , commenced a process of confirming the factual accuracy of the report and providing those who had contributed to the report, the opportunity to provide observations on the draft report. It said this process was still ongoing .

“In the meantime, the NCCP provided the draft report to Our Lady’s Children’s Hospital Crumlin in late July and asked the hospital to commence the implementation of recommendations that fall within its remit. “

In accordance with the HSE incident management framework, a formal review of any risks issues is being carried out under the direction and oversight of the Children’s Hospital Group.