Northern Ireland

Clash between trust bosses and RQIA at private meeting over staffing pledges

Dr Lourda Geoghegan, medical director of the RQIA watchdog, was highly critical of standards at Muckamore Abbey hospital following inspections since February this year
Dr Lourda Geoghegan, medical director of the RQIA watchdog, was highly critical of standards at Muckamore Abbey hospital following inspections since February this year Dr Lourda Geoghegan, medical director of the RQIA watchdog, was highly critical of standards at Muckamore Abbey hospital following inspections since February this year

ASSURANCES given by Belfast health trust that it would hire seven extra nurses at Muckamore hospital to improve safety were not met, leaked minutes have revealed.

Trust bosses were told by the Regulation and Quality Improvement Authority (RQIA) that they urgently needed to employ additional staff following its critical inspection in February this year - or else receive "improvement notice" warnings.

During a private meeting held on April 17 between the regulator and the trust's top bosses, RQIA medical director Dr Lourda Geoghegan said she had been "advised" that the seven specialist nurses had been "recruited and inducted" and would take up post on March 11.

"Dr Geoghegan was therefore surprised to note on this (follow-up inspection in April) that the seven additional nursing registrants had not in fact been in post since 11 March," the minutes state.

"Over the two days of the inspection, conflicting information in respect of the actual members of new staff recruited and in post was given to inspectors."

It was subsequently discovered that four agency staff had instead been employed.

When the trust raised concerns about attracting nurses, Dr Geoghegan told senior trust bosses that the pledge to recruit extra staff had been a "key factor" in the organisation not receiving enforcement action.

The watchdog chief warned its latest inspection had found an "almost constant deficit" - "sometimes of up to five staff".

"RQIA sought but could find no evidence of other measures of safe staffing used on site - specifically any evidence of matching patient need to staff levels," Dr Geoghegan told the meeting.

Concerns were also raised over pledges given by trust bosses on the management of patients' money.

"Previously RQIA had found that referrals to the Office of Care and Protection (OCP) were required for (four/five) patients. In correspondence to RQIA, the Trust Chief Executive advised that these referrals had been made," the minutes details.

"However, inspectors could find no evidence of this being done. Trust colleagues advised that a member of staff had contacted OCP by telephone and that they advised that referrals were not in fact required."

Trust bosses said they had sought legal advice on the issue and this had already been conveyed to RQIA by phone.

"Dr Geoghegan advised that there was no recollection of such a telephone call from the Trust."

While trust bosses said it had revised its 'seclusion' policy - a move welcomed by the RQIA - its medical director raised concerns that it still taking place in rooms that did "not meet the required environmental standards" and was therefore "ineffective".

The minutes reveal that Trust bosses have the "ultimate intention to eliminate the use of seclusion".

Sinn Féin's Pat Sheehan, who met with the RQIA last month to discuss the use of seclusion at Muckamore, said the watchdog's findings expose a "dysfunctional" health trust.

"It seems clear that the Belfast health trust doesn't have a plan to deal with the crisis that has developed. Morale of staff appears to be at rock bottom," he said.

"They refer to one patient who has been in seclusion 73 times in the past month - they haven't got to grips with this issue or the management of patient finances."

Mr Sheehan said it was also "worrying" that the RQIA as the health regulator hadn't made its concerns public.

"The RQIA has a very important role in terms of governance and holding public bodies to account. This also raises the issue of transparency and we will be seeking a further meeting with the watchdog."

The Irish News asked the RQIA last night why it hadn't published it findings.

A spokesman said that following its "feedback" meetings with the trust, it was awaiting a response.

"We will then consider what further action is required by RQIA, to ensure the safety and wellbeing of all those receiving care and treatment at Muckamore Abbey Hospital. Reports of these inspections are currently being prepared."