'Patient safety risks' at Navan Hospital highlighted in hard-hitting HIQA report

HIQA has warned of patient safety risks at Our Lady's Hospital, Navan due to the lack of acute surgical services on site.

From January to November last year, 258 surgical patients required transfer to other hospitals, according to a report by the Health Information and Quality Authority.

"HIQA found that the risk associated with the hospital not providing acute surgical services on-site remains and continues to be a challenge", the report states.

The report sparked an angry reaction locally amid calls on the government to invest in the hospital.

The report followed HIQA inspections at the hospital in June 2024 and in November last year. It was published last week, along with reports on a number of other hospitals.

The provision of emergency surgery at Navan ceased in 2010 and to support the move, the HSE introduced ambulance bypass protocols for acutely unwell patients to be brought to other hospitals.

If a patient self-presents at Navan with a suspected surgical condition, the hospital has a policy to transfer the patient to an appropriate hospital.

Navan is officially a Model 3 hospital - these hospitals usually provide 24/7 acute surgery and the removal of acute surgery in 2010 caused widespread concern and brought more than 10,000 people onto the streets of Navan in protest.

There has also been widespread concern at proposals to replace the 24 hour Emergency Department in Navan with a 12 hour Minor Injuries Unit.

HIQA says that Navan continues to operate as a model 3 hospital, but does not provide acute surgery on-site and the presentation of acute surgical patients at the hospital persists. The report says that the challenges can not be fully managed until a decision is made about the matter.

The hospital does provide planned surgery and acute medical in-patient care.

The chair of the Save Navan Hospital campaign, Deputy Peadar Toibin said the government had left Navan Hospital in limbo. "There is 100 per cent need for a fully functional A&E in Navan. The population of the county demands it. The overcrowding in neighbouring hospitals demands it. The next question is, how do we make it work successfully and safely. The answer to this is straightforward. We need to provide the necessary consultant support on site in Our Lady’s Hospital in Navan. We need fully functional ICU and CCU in Navan.

"That means there must be investment in consultant cover now. If the government do not provide these upgrades, the Save Navan Hospital Cover will commission a report by an independent Consultant to set out a blue print for the necessary ungraded. Anything less that this necessary upgrade would be catastrophic for the people of Meath and will not be tolerated by the Save Navan Hospital Campaign," he said.

Deputy Johnny Guirke strongly condemned the Government's handling of services at Our Lady's Hospital and said the risks associated with the ongoing lack of acute surgical services was something that Sinn Féin has consistently warned would arise from the Government's decision to downgrade services.

"For years, we have raised concerns about the impact of downgrading services at Navan Hospital and the risks it poses to patient safety. The findings of the HIQA report confirm what we have long known – that the Government's failure to invest in a fully operational Emergency Department is putting lives at risk."

"We must stop the ambulance bypass protocols and ensure that our local hospital has the capacity to handle emergencies effectively," added Deputy Guirke.

He praised the dedication and hard work of the staff at Our Lady's Hospital Navan. "The staff are doing an amazing job under increasingly difficult circumstances. However, without the necessary investment from the Government, they are being placed in an untenable position. We need to see immediate action to upgrade the Emergency Department so that it is fit for purpose and can adequately serve our community."

"The Government must make a decision to protect our hospital's emergency services and ensure that the people of Meath receive the healthcare they deserve," he concluded.

HIQA carried out a two-day unannounced inspection at the hospital in June 2024 to assess compliance with the National Standards for Safer Better Healthcare.

They found the hospital non-compliant with two national standards and partially compliant with six. It was substantially compliant in two standards and compliant in one. Key areas of concern related to governance and management arrangements, risk management, workforce arrangements, audit activity and the physical infrastructure and environment of some of the clinical areas visited. Risks associated with the presentation of undifferentiated surgical patients existed at the hospital.

At the time of the follow-up inspection in November 2025, hospital management reported that decisions regarding the transformation of the hospital at a national level were still outstanding and the hospital continued to operate as a model three hospital without the provision of acute on-site surgical services. Therefore, HIQA found that the patient-safety risks associated with the hospital not providing acute surgical services on-site continued to be a challenge and could not be fully managed until a decision was made relating to this issue.

At this inspection the hospital was found to be partially compliant in eight areas, substantially compliant on one, compliant in one and non compliant in one.

HSE Response

"Our Lady’s Hospital Navan acknowledges the combined findings of the HIQA inspections for June 2024 and November 2025.

"Since the initial inspection, the Hospital has made measurable progress in addressing a number of the areas identified, including enhancements to governance and management arrangements, workforce supports, and improvements to the clinical environment.

"A structured compliance plan was implemented, and the majority of actions have now been progressed.

"At present, patients self-presenting to the Emergency Department are assessed, stabilised, and if necessary transferred to other hospitals within the HSE Dublin and North East network in accordance with dedicated protocols between the National Ambulance Service and Our Lady’s Hospital Navan. Additionally Ambulance Bypass protocols are in place to ensure patients are treated in the appropriate healthcare setting for their needs, under the HSE Dublin and North East Hospital network. Patients classified as Category 1 and Category 2 are not brought to Our Lady’s Hospital Navan by ambulance.

"Our Lady’s Hospital Navan remains fully committed to working closely with HIQA to ensure full compliance with national standards and to deliver safe, high quality care to all patients."