The Faculty of Pathology of the Royal College of Physicians of Ireland (RCPI) welcomes the report’s findings and fully endorses the recommendations.
The Faculty wishes to convey its appreciation to Ms. A for her courage and determination.
While incidents of misdiagnosis can never be eliminated entirely, every effort must be made to ensure error rates in pathology are kept within accepted international standards and that appropriate quality assurance and management systems exist.
In its findings, the HIQA investigation team found that in Ms. A’s case, two errors were made in the examination and interpretation of Ms A’s pathology specimens by two individual pathologists working at Galway University Hospital. These were compounded by a failure to hold a fully functioning multidisciplinary team meeting where the principle of triple assessment could be applied.
The Faculty of Pathology supports the report’s recommendations relating to functioning multidisciplinary teams and the effective management and review of patients. Since his appointment in January 2008, the Faculty has worked with Prof Tom Keane of the National Cancer Control Strategy on a range of significant initiatives designed to monitor and improve quality assurance of pathology services in Ireland. These include external quality assurance; dissemination of guidelines for internal and external quality assurance; competence assurance systems for pathologists; and the establishment of expert pathology panels in a range of cancer areas.
Following the initial HIQA report (April 2008), the Faculty of Pathology, RCPI asked an established subcommittee of the Faculty (Histopathology Subgroup) to review these recommendations and make proposals as to how the Faculty might best respond to this and other reports dealing with pathology services. The Histopathology Subgroup recommended the implementation of the Faculty Guidelines on Quality Assurance in Histopathology as soon as possible. To that end, a Forum on Quality Assurance took place on Tuesday 17th June 2008. The Forum was attended by representatives of all histopathology laboratories in the country. Representatives of hospital management also attended.
While significant challenges were identified to the implementation of the programme, particularly in respect to IT, the process of a national QA programme in Histopathology (including Cytopathology) is now underway.
Faculty Involvement in the Investigation
The Faculty of Pathology of the Royal College of Physicians of Ireland (RCPI) as an authoritative body consulted by national, international and government agencies has an important role in safeguarding the quality of pathology services in Ireland. The Faculty was requested by the HSE to undertake an independent review of specimens, identified by Galway University Hospital. In light of the fact that the Health Information Quality Authority was undertaking a full investigation into the care of Ms A, it was agreed between the Faculty and HIQA that this pathology review would be undertaken as part of the Authority’s investigation. The Authority engaged the Faculty, which developed a series of protocols in order to assess the pathology standards and capability of the systems in place at Galway University Hospital. These protocols were informed by national and international best practice.
For further information, contact the Faculty of Pathology at pathology@rcpi.ie