03-06-2025
Department of Health bypassed own regulator over report into the Royal's cardiac unit
A leaked report made headlines last week after it found an 'intolerable working environment and a pattern of consistently poor behaviour within the unit'.
It indicated operations had been cancelled due to 'personal grievances' between staff and that four consultants had been working from home, citing 'safety and wellbeing' concerns.
Chair of the health committee, Sinn Féin's Philip McGuigan, has called on the department to publish the report 'in the interest of transparency', adding that he had not yet seen it.
Northern Ireland's health watchdog, the Regulation and Quality Improvement Authority (RQIA), has confirmed it was not approached to carry out a review into the issues at the cardiac surgery unit.
A spokesperson said: 'RQIA has not been asked to produce any such report recently.'
The body had previously inspected the unit in December 2021.
It came a year after a Royal College of Surgeons invited service review report which found a 'breakdown of communication and working relationships within the service'.
The invited service review was completed in March 2020, just weeks before the Covid-19 pandemic took hold, and made 37 recommendations relating to interpersonal and behavioural issues within the service.
RQIA's review found some improvements had been made.
'RQIA were pleased to see early signs of change and improvement whilst cognisant that it takes time to make cultural changes and embed these fully within a service; it is a journey that requires strong and resilient leadership to embed the vision, align behaviours accordingly and instil robust systems of monitoring and accountability,' concluded the regulator.
It recommended that the Trust should 'ensure the cardiothoracic management team involves and actively engages with all staff disciplines and groups'.
'Meetings should be structured to promote constructive discussion and collaboration to address the recommendations of the invited service review,' added the review team.
It is understood the leaked review was commissioned by the Public Health Agency (PHA) working alongside the department.
A Department of Health spokesperson said 'expert input' from other parts of the UK was required to complete the report.
'Cardiac surgery is a highly specialised service and the Royal Victoria Hospital is the only unit in Northern Ireland to deliver this service,' they said.
'For this reason, securing expertise from people experienced in the area means going outside Northern Ireland.
'An earlier external review had been undertaken in the Royal Victoria Hospital by the Royal College of Surgeons. That review confirmed the cardiac service was safe, but highlighted areas for improvement. Whilst Belfast Trust subsequently undertook work to address issues raised, the department and PHA obtained further external expertise to help support the team with a focus on two metrics — patient safety and team working.
'It was agreed to engage an experienced team with specific expertise involving senior clinicians who had completed similar work in the UK, including in other cardiac surgery units.'
Mr McGuigan told the BBC Sunday Politics programme that the report had led to 'very many public trust issues'.
'We are told there are recommendations and an action plan contained within the report.
'I think for proper scrutiny and to restore public trust, what we need to see is the report in the first instance published so we can interrogate the recommendations for restoring public trust in this issue,' he said.
Health Minister Mike Nesbitt has said he wants to place the report in the library of the Assembly, but is currently receiving legal advice.
'People need to have confidence when they go to a hospital or whatever health setting that they are going to be looked after properly,' added Mr McGuigan.
'One of the things in the report was that the behaviour of the staff was posing a risk to patient safety, so that in itself is very concerning.'
