The Regulation and Quality Improvement Authority (RQIA) is Northern Ireland's independent health and social care regulator. In its work RQIA encourages continuous improvement in the quality of health and social care services through a programme of inspections and reviews. Visit our about us section to find out more.
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Latest News (Updated 25 March 2015)
RQIA Review of the Care of Older People in Acute Hospitals - Overview Report, March 2015
RQIA has published the findings of its Review of the Care of Older People in Acute Hospitals.
RQIA conducted unannounced inspections at Northern Ireland's 11 acute hospitals, speaking to over 350 patients and their relatives, observing practice and reviewing patients' notes.
RQIA found good practice in each of the areas examined, however, there is room for improvement in a number of areas.
This review makes 14 regional recommendations across the areas to improve the quality of care for older people in Northern Ireland's hospitals. In addition, a series of recommendations were made to each hospital inspected, which are being addressed through individual quality improvement plans published with the reports.
You can read the overview report here.
Individual inspection reports for each of Northern Ireland's 11 acute hospitals can also be viewed here.
Mental Health and Learning Disability Inspection Roadshow - Change of Date
Due to the implications of the proposed industrial action and the disruption to public transport, the RQIA MHLD inspection roadshow due to take place this Friday, has been postponed.
The roadshow will now take place on Monday 13 April 2015 in Mossley Mill at 9.30am. It is important that attendees reconfirm attendance with the MHLD team.
RQIA Recruiting Peer Reviewers
In April 2014 the Health Minister outlined that, from 2015-16 onwards, RQIA should undertake a rolling programme of unannounced inspections of the quality of services in all acute hospitals in Northern Ireland.
RQIA is now seeking peer reviewers to join our inspection teams. The Deputy Chief Medical Officer is fully supportive of this approach, and asked that professionals across the HSC respond favourably to this recruitment campaign. By taking part in inspections staff will have a chance to learn more about the way other health and social care organisations work while helping to improve the quality of services in Northern Ireland.
RQIA invites interest from a wide range of HSC professionals including clinicians, nursing, social workers, pharmacists and allied health professionals to join the inspection team as a peer reviewer.
For further information and to download an application form, click here.
Report on Unannounced Inspection of Magilligan Prison, 27 May - 5 June 2014 (Updated February 2015)
An inspection report of Magilligan Prison has been published today. The prison was inspected over the course of several days in May and June 2014 by a multidisciplinary team of inspectors from Criminal Justice Inspection Northern Ireland, Her Majesty's Inspectorate of Prisons for England and Wales, RQIA and the Education and Training Inspectorate. RQIA welcomes the publication of this report, particularly the recommendations made in relation to healthcare within the prison. The report can be accessed here.
Guidance on Safeguarding of Service Users’ Finances within Residential and Nursing Homes and Supported Living Settings
The Department of Health, Social Services and Public Safety has recently published guidance (financial circular) to remind organisations to ensure that service users’ finances are safeguarded in residential and nursing homes and supported living services within the statutory and independent sectors.
RQIA welcomes the publication of this guidance, which is available here.
RQIA E-Zine Published (Updated December 2014)RQIA's latest E-Zine, Assurance Challenge Improvement, providing an update on the latest RQIA activities has now been published.
To access this E-Zine, click here.
Mental Health Part IV Medical Practitioners
RQIA is inviting applications for Medical Practitioners to undertake second opinions in accordance with Part IV of the Mental Health Northern Ireland Order 1986. For further information on how to make an application click on the document below:
RQIA publishes the findings of its Review of Implementation of GAIN Guidelines on Caring for People with a Learning Disability in General Hospital Settings (18 December 2014).
The Guideline on Caring for People with a Learning Disability in General Hospital Settings was published by GAIN in June 2010, detailing specific requirements for people with a learning disability who use general hospital settings. These include: communication; training for hospital staff; attendance at emergency care services; discharge planning; and support for carers.
“People with learning disabilities are very clear that healthcare staff should look at, and speak to them first, and focus on them, rather than directing attention to carers or parents. Service users who contributed to the review expressed their negative experiences of staff talking around the person with learning disabilities. Using terminology that does not devalue or stigmatise individuals is an important element in ensuring that people with learning disabilities feel included and valued when they are in receipt of services. During the review, this was raised frequently by service users and carers as a problem that immediately creates barriers to good therapeutic and respectful relationships. The only acceptable term is “person with a learning disability”.
The review team raised concerns around misunderstanding and poor practice in relation to consent, capacity assessment, best interest decisions and resuscitation orders. While the review team was satisfied that there is sufficient guidance, policy and professional codes to inform and guide clinical practice, on many occasions these were not followed. The review team found that linkages and liaison between general hospital services and learning disability services was variable and dependent on the insight of individual members of staff, rather than a structured and formalised process. RQIA recommends that each HSC trust should ensure that there are clear lines of communication and robust linkages between learning disability services and general hospitals.
While all health and social care trusts have processes in place to implement GAIN guidelines, RQIA considers that trusts need more robust procedures for monitoring progress, ensuring there are appropriate reporting mechanisms in place at director and trust board level.
RQIA makes 19 recommendations, which, if implemented we believe will improve the level of care experienced by people with a learning disability in general hospital settings.
You can read the full report here.
RQIA Calls For Improvements in Northern Ireland’s Stroke Services
RQIA has published the findings of its review of Stroke Services in Northern Ireland.
Since 2008, the Regional Stroke Strategy Implementation Group has taken forward the implementation of the Northern Ireland stroke strategy with the HSC trusts. While much progress has been achieved, further work is required in the implementation of a number of the strategy’s recommendations.
While most patients were admitted to stroke wards, some were initially transferred to other wards due to bed capacity pressures. In cases where stroke patients were placed in outlying wards, their level of stroke care and rehabilitation was not always as comprehensive as that received in a dedicated stroke unit.
The team found that communication with patients regarding their condition, treatment and support needs to be improved, an area that could also benefit from a regional approach. They also noted there was evidence of limited engagement and communication between secondary and primary care. For improved patient outcomes, this is an area that needs to be reviewed and developed.
Across Northern Ireland, stroke teams were found to be committed and enthusiastic, and they demonstrate a genuine sense of teamwork and willingness to provide high quality stroke care.
This review makes 22 recommendations to improve the quality of stroke services across Northern Ireland for all those requiring this care.
You can read the full report here.
RQIA Publishes Review of the Implementation of the Royal Dental Hospital Inquiry Action Plan
RQIA has published its Review of the Implementation of the Royal Dental Hospital Inquiry Action Plan. The review was commissioned by DHSSPS in November 2013 following the publication of the Dental Hospital Inquiry Action Plan (July 2013). RQIA examined the implementation of specific actions relating to the Belfast Trust and the Health and Social Care Board, and found that of these 22 actions, 15 were fully implemented, while seven required further work.
RQIA notes strengthened governance arrangements at the Royal Dental Hospital, and welcomes that staff are clearer in their roles and responsibilities in relation to patient safety. However, long-term staffing arrangements to ensure sustainability of oral medicine and other dental services should be reviewed, as should arrangements for succession planning at the hospital. The review team has recommended that the Belfast Trust focuses on completing the refurbishment of the Royal Dental Hospital; developing the patient and staff outcome measures; and the involvement of service users in planning, developing and monitoring the services at the Royal Dental Hospital.
RQIA will conduct a further assessment of progress against the action plan during 2015-16.
You can read the full report here.
RQIA Publishes Review of Discharge Arrangements
RQIA has just published the findings of its Review of Discharge Arrangements from Acute Hospitals.
The review team noted that, at present, elements of the patient journey leading to discharge are fragmented, and recommended that trusts resolve the obstacles hindering effective discharge planning. Delays ranged from two hours to several days. Health and social care trusts should provide a system that allows discharges to take effect across a seven day working week. They should plan for discharge from the point of admission and coordinate arrangements for the provision of medicines, discharge letters, and transport for patients who require help going home.
The review team also noted that some discharge summaries continue to be handwritten - in contravention of accepted guidance. The review team recommended that all trusts should fully implement electronic production and transmission of discharge summaries and ensure that no hand written summaries are produced. These should be sent directly to GPs, and not sent home with patients to pass on to their GP.
The review report makes 20 recommendations to improve discharge arrangements from hospitals across Northern Ireland.
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