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 29 July 2015)
RQIA Review of Medicines Optimisation in Primary Care (Updated 29 July 2015)
RQIA has published the report of its Review of Medicines Optimisation in Primary Care. Northern Ireland has an ageing population, which is likely to increase the number of people with multiple medical conditions, leading to greater use of complicated medicines regimens. RQIA assessed present medicines optimisation processes in Northern Ireland, aligned to DHSSPS’s Medicines Optimisation Quality Framework for Northern Ireland, and this report makes 16 recommendations to improve medicines optimisation processes in primary care.
You can read this review report here.
Animated Summary of RQIA's Independent Inquiry into Child Sexual Exploitation (CSE) in Northern Ireland (Updated 16 June 2015)
In November 2014 the findings of the Independent Inquiry into Child Sexual Exploitation in Northern Ireland were published. During the inquiry, it was agreed that a child/young person friendly summary would be produced. Include Youth brought together a group of young people who have made a short animation on the inquiry’s key messages and contact details for
help and support
on CSE. Watch the animation here:
RQIA is Seeking Peer Reviewers for Acute Hospital Inspections (Updated 25 June 2015)
RQIA is currently seeking peer reviewers to join our acute hospitals inspection team who are examining the quality of services in all acute hospitals in Northern Ireland. We are seeking interest from a wide range of HSC professionals including clinicians, nursing, social workers, pharmacists and allied health professionals to join the inspection team as peer reviewers.
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.
Closing date for applications is 28 August 2015.
For further information, and to download an application form, click here.
RQIA Publishes Review of Risk Management in Addiction Services (Updated 03 June 2015)
RQIA has just published the findings of its Independent Review of Risk Assessment and Management in Addiction Services.
During the review, RQIA audited 100 patient files and held focus groups with service users to examine risk management processes in Northern Ireland’s addiction services.
While some service users told reviewers of their positive experiences of addictions services, others complained about delays in getting timely and appropriate support and treatment, which left them at risk of further relapse.
Variation was noted within GPs referrals to addiction services, particularly in terms of the detail of the intervention by the GP and information to inform a risk assessment.
Records of service users examined by the review team indicated that half of service users with addiction problems demonstrated a history of mental ill health. These patients reported that they would receive treatment for either their addiction or their mental ill health, but not both conditions.
The review team found that less than one third of initial assessments by addiction services were completed accurately, with significant sections not completed, and limited evidence of the use of recommended psychological interventions.”
However, service users reported positive experiences of treatment and support in inpatient units, with examples of support and counselling provided by trusts as part of the addiction treatment programme.
This review makes 15 recommendations to support improvements in risk assessment and risk management in addiction services.
Joint Inspection report of Woodlands Juvenile Justice Centre Announced published (Updated 29 May 2015)
The report of a joint inspection of Woodlands Juvenile Justice Centre led by the Criminal Justice Inspection, in partnership with RQIA and the Education and Training Inspectorate, is now published.
Whilst Woodlands Juvenile Justice Centre has been praised by inspectors for its role in improving the child custody system, the team found that changes are required within the centre to meet future challenges.
The report recommended steps be taken to improve the clinical leadership and governance for healthcare staff in order to maintain and improve the quality of nursing at the Bangor facility. Inspectors recognised healthcare staff’s rapport with the children, but gaps in their ability to access continuous professional development and mandatory training should be addressed.
The report makes four strategic recommendations and 20 strategic recommendations for improvement.
You can read the report here.
RQIA Publishes Review of the Diabetic Retinopathy Screening Programme (Updated 22 May 2015)
People with diabetes are at risk of developing retinopathy, a condition which can damage their vision. In 2007, an annual regional diabetic retinopathy screening programme was introduced for people with diabetes aged 12 years and over. This programme aims to ensure early diagnosis and treatment to reduce visual morbidity caused by diabetic retinopathy.
As part of RQIA’s Three Year Review Programme 2012 to 2015 we conducted a review of the Diabetic Retinopathy Screening Programme, which is published today. RQIA’s expert review team included members with extensive experience in diabetic eye screening services in England.
The review team found a committed and enthusiastic workforce, whose main challenge is to provide a safe and effective service whilst dealing with the rapid and continuing rise in the number of people needing screening.
The team assessed the service against 14 standards within the programme’s quality assurance framework. The review team found the programme compliant with three standards; partly compliant with four standards; and non-compliant with seven standards.
Although the service has continued to provide screening to a considerable volume of people, a reliance on a predominantly paper based administration systems has created issues in relation to oversight of the programme, implementation of further developments; and inconsistent comparison of achievements against the programme’s standards.
At the time of the review, the Public Health Agency indicated that it had recognised these concerns, and had commenced a modernisation plan to address these issues.
The review team has made 40 recommendations for improvement, which are detailed within the report, and can be accessed here.
RQIA E-Zine Published
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.
Guidance for Service Providers - 2015-16 Inspection Year
RQIA has published guidance for service providers for the 2015-16 inspection year. This guidance can be accessed here.
Mental Health and Learning Disability Inspection Roadshow - 13 April 2015
The roadshow took place on Monday 13 April 2015 in Mossley Mill.
The presentations for this event are now available to download here.
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.
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.
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