'Serious incidents or injuries' risk due to issues in HSE's internal health and safety system

AN INTERNAL AUDIT has found that the HSE section tasked with ensuring compliance with health and safety standards is falling short of its targets, with a high risk that “identified issues may not be properly addressed, potentially leading to serious incidents or injuries”.

The audit into the HSE’s National Health and Safety Function (NHSF) also found that while it was first established in 2015, a comprehensive management review that was to be conducted by the end of 2016 has not taken place.

The audit also found that the NHSF is operating without a mandate.

It comes after The Journal Investigates recently revealed that almost 20,000 incidents of challenging behaviour, aggression and violence have taken place across the hospital system in the past three years – including a spike in incidents in maternity hospitals, and alongside a rise in recorded incidents of racism against staff.

The HSE has also confirmed that 16 of its 33 acute hospitals do not have a health and safety officer – otherwise known as a competent person – appointed to them, as required. Those 16 hospitals include larger hospitals such as University Hospital Limerick, University Hospital Waterford and Galway University Hospital.

The HSE said: “Against a backdrop of a difficult recruitment space internationally for Health and Safety Officers, the National Health and Safety Function (NHSF) ensure that any hospital without a current H&S officer has access to resources such as the NHSF National Helpdesk, and to Safety Clinics which are facilitated by a H&S professional.”

‘High’ and ‘Medium’ risks

Yet the NHSF is itself dealing with some issues.

On foot of an independent report the NHSF was set up in 2015 along with the HSE Health and Safety Management Advisory Committee (HSMAC).

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But the internal audit from last November, released under Freedom of Information, uncovered one high risk and another medium risk in how it is currently operating.

“In 2024 two specific Audit Programmes conducted totalling 174 audits across the six Health Regions generated over 2,000 Quality Improvement Plans (QIPs) to address health and safety issues identified,” it said.

“However, due to the lack of a formal centralised tracking system, it is currently not possible to fully monitor, verify, or report on the status and completion of all corrective actions.

“This poses a risk that the identified issues may not be properly addressed, potentially leading to serious incidents or injuries,” it added, rating the risk factor as ‘High’.

The ‘Medium’ risk was associated with the failure to conduct a review of the NHSF 12 months after it was established – or at any point since.

“Clearly defined governance arrangements for health and safety within the Health Regions have not been established.

This gap poses a significant challenge, to the coordination of health and safety efforts across the HSE.”

The NHSF was set up to help the HSE ensure it complies with the Safety, Health and Welfare at Work Act 2005 by providing a safe working environment. But the audit report, provided to HSE Chief People Officer, Anne Marie Hoey, said that “it currently operates without an approved mandate.”

The report said HSE management has confirmed it is in the process of developing
a formal mandate.

Lack of compliance “hugely disappointing”

The Irish Nurses and Midwives Organisation (INMO) said: “Given the high level of assaults on nurses, midwives and other healthcare workers, it is hugely disappointing that the HSE has not ensured full compliance with this basic requirement under the Safety, Health, and Welfare at Work legislation.

“As the country’s biggest employer, the HSE needs to ensure that it has the right people and systems in place to protect and promote a safe working environment. We are therefore calling on the HSE to take the necessary steps to ensure full compliance.”

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A HSE spokesperson said the number of health and safety audits and Quality Improvement Plans in 2024 “reflects the organisation’s 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

“The HSE is enhancing governance structures and clarifying responsibilities at national, regional and service levels, particularly in light of the new regional health structures.”

Some ‘surge’ hospitals got no extra security

Meanwhile, data released to Sinn Féin TD Pádraig MacLochlainn shows that despite 29 major hospitals around the country using surge capacity in January and February, most did not employ additional security.

Surge beds are additional inpatient beds put in place in other sections of a hospital, such as day wards and treatment rooms.

The responses from the HSE regions to MacLochlainn showed that while some hospitals did allocate additional security for these areas – among them Tallaght University Hospital and St Luke’s General Hospital – others either said they provided additional security on foot of specific security issues, or not at all.

Among the larger hospitals that specified that no additional security was provided were Cork University Hospital, Mercy University Hospital, St James’s Hospital, University Hospital Waterford and Galway University Hospital.

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