In the June 2021 edition of Clinical Risk Insights, Dr Cathal O'Keeffe, Head of Clinical Risk, reflects on the impact of the IT cyber attack on the delivery of care in Ireland, on opportunities to sustain change in health and social care delivery, and provides a reminder on the reporting of Covid-19 incidents. Read the editorial here.

In recent months, we have once again seen enormous challenges for the delivery of health and social care. We have experienced a third wave of COVID-19 in Ireland - the most deadly - driven by a highly transmissible strain of the virus. Furthermore, the HSE is now facing the additional challenges posed by the cyber-attack on its IT systems last month. In response, we have seen once again health and social care professionals dig deep to find the resilience to face these challenges.

Challenging landscape

The State Claims Agency (SCA) recognises the enormous impact of the recent IT cyber attack on the provision of health and social care services and clinical care within the HSE and the related risks.

We realise that in many situations, health and social care personnel have been providing care in challenging situations, relying on paper-based systems, hand-written results, without access to patients’ and service users’ healthcare records and previous test results, and with limited access to diagnostic tests.

The SCA’s advice in relation to indemnity, incident reporting and risk management in the context of the cyber-attack situation can be viewed here. Health and social care personnel also faced huge challenges earlier this year when the third wave of COVID-19 reached our shores.

However, this wave coincided with the commencement of the COVID-19 vaccination campaign, possibly the biggest public health initiative ever undertaken in Ireland. The benefits of the vaccines were initially apparent in the dramatic reduction in the number of health and social care workers being infected, as well as in the number of outbreaks in hospitals and residential care settings. The more recent significant reduction in the number of COVID-19 deaths is hugely positive.

Minimising litigation risk and incident reporting

Since the COVID-19 vaccines are covered by State indemnity, any clinically significant vaccine incidents must be reported on NIMS, the National Incident Management System. We continue to monitor reported COVID-19 incidents, including COVID-19 vaccine incidents, and to share relevant learning with the HSE and frontline staff. We have liaised with the HSE and Health Products Regulatory Authority (HPRA) to provide guidance on the appropriate reporting of vaccine incidents to all three bodies.

Opportunities to sustain change in health and social care delivery

COVID-19 has both forced and accelerated change in the way health and social care is delivered. Opportunity may lie in the enormous difficulties presented by COVID-19. Irish health and social care services have responded with remarkable agility to the COVID-19 crisis. New ways of working have been developed and implemented. We are exploring some of these new developments, such as telemedicine and integrated care, in our 2021 webinar series and asking have changes come about that have the potential, in the post-COVID-19 world, to provide safer and higher quality care for services users. We hope that many of you will be able to join the final two webinars in the series, which have been postponed until autumn due to the cyber-attack.