16.5 Irish Health Policy: Healthy Ireland, HIQA Standards, Your Service Your Say & Community Care
Key Takeaways
- RCSI groups Health, policy and professional matters as references that underpin all the OSCE stations, listing Healthy Ireland, the HIQA National Standards for Safer Better Healthcare, the NMBI Code of February 2025, community care services, the Values of Nursing and Midwifery, reflective writing, Your Service Your Say and the NMBI professional competence scheme.
- The HIQA National Standards for Safer Better Healthcare contain 45 standards across eight themes, and Version 2 came into operation on 26 September 2024 following approval by the Minister for Health in August 2024.
- The four quality and safety themes are person-centred care and support, effective care and support, safe care and support, and better health and wellbeing; the four capacity and capability themes are leadership governance and management, workforce, use of resources and use of information.
- Your Service Your Say is the HSE feedback and complaints process; complaints are normally made within 12 months, acknowledged within 5 working days and investigated within 30 working days, with internal review and then the Ombudsman as further stages.
- Healthy Ireland is the national framework for improved health and wellbeing, with the Strategic Action Plan 2021-2025 setting out its current priorities.
Irish Health Policy: Healthy Ireland, HIQA Standards, Your Service Your Say & Community Care
RCSI groups Health, policy and professional matters with a specific note: the references in this section underpin all the OSCE stations. That is a strong signal. This is not a topic that appears at one station - it is the professional and policy frame that every station is marked inside.
The group contains: Healthy Ireland Strategic Action Plan 2021-2025, the HIQA National Standards for Safer Better Healthcare, the NMBI Code of Professional Conduct and Ethics (February 2025), Community Care Services, the Department of Health's Values of Nursing and Midwifery (June 2016), guidance on reflective writing, HSE Your Service Your Say, and NMBI material on the Code in practice and the professional competence scheme.
Healthy Ireland
Healthy Ireland is the national framework for improving health and wellbeing, led by the Department of Health. Its premise is that health is determined far more by the conditions in which people live, work and age than by healthcare services, so improving it requires action across government - transport, education, housing, food policy, the workplace - not only in hospitals.
Its broad goals are to increase the proportion of people who are healthy at all stages of life, reduce health inequalities, protect the public from threats to health and wellbeing, and create an environment where every individual and sector can play their part. The Strategic Action Plan 2021-2025 sets out the current period's priorities, with associated programmes on tobacco, alcohol, obesity, physical activity, sexual health and positive mental health.
Why it belongs in a nursing exam. Every clinical encounter is an opportunity for health promotion - making every contact count. Brief interventions on smoking, alcohol, physical activity, weight and mental wellbeing, delivered opportunistically during an admission, are part of the nurse's role rather than someone else's. It also connects directly to the food pyramid, the low-risk alcohol guidance and the Chronic Disease Management Programme elsewhere on RCSI's list.
HIQA: National Standards for Safer Better Healthcare
The Health Information and Quality Authority (HIQA) sets standards for the quality and safety of health and social care services under the Health Act 2007. The National Standards for Safer Better Healthcare are the overarching standards for healthcare services in Ireland.
They were first published in June 2012 and took effect under section 8 of the Health Act 2007. Version 2 was approved by the Minister for Health on 27 August 2024 and came into operation on 26 September 2024, extending the standards' application to private hospitals following the widening of HIQA's remit under the Patient Safety (Notifiable Incidents and Open Disclosure) Act 2023.
The standards contain 45 standards organised into eight themes. Four describe the dimensions of quality and safety, and four describe the capacity and capability a service needs to deliver them.
Quality and safety themes
| Theme | What it covers |
|---|---|
| 1. Person-Centred Care and Support | Respect, dignity, privacy, autonomy, information, consent, involvement in decisions, and responding to feedback and complaints |
| 2. Effective Care and Support | Evidence-based care that achieves the best outcomes, continuity, coordination and transitions between services |
| 3. Safe Care and Support | Protecting people from harm: risk management, incident reporting and learning, infection prevention, medication safety, and open disclosure |
| 4. Better Health and Wellbeing | Health promotion, self-management support and improving population health |
Capacity and capability themes
| Theme | What it covers |
|---|---|
| 5. Leadership, Governance and Management | Clear accountability arrangements, corporate and clinical governance, defined responsibility for quality and safety |
| 6. Workforce | Enough staff with the right competence, supported by education, supervision and performance management |
| 7. Use of Resources | Using available resources to deliver the best possible outcomes and value |
| 8. Use of Information | Collecting, using and sharing accurate information to plan, deliver and improve care, with confidentiality protected |
The distinction worth holding: HIQA sets standards for and inspects services; NMBI regulates individual registrants. HIQA can find a hospital non-compliant with a standard; it cannot remove your name from the Register. NMBI can.
HIQA also publishes the National Standards for Adult Safeguarding, which RCSI lists under safeguarding.
Values of Nursing and Midwifery
The Department of Health's Values of Nursing and Midwifery in Ireland (June 2016) sets out three core values with associated behaviours:
- Care - compassionate, person-centred care that responds to the whole person.
- Compassion - recognising and responding to the distress and vulnerability of others.
- Commitment - dedication to delivering high-quality, safe and effective care, to continuous improvement and to the profession.
These sit alongside, rather than instead of, the NMBI Code. A candidate who can name them and, more importantly, demonstrate them at a communication station is meeting Domain 1.
Your Service Your Say
Your Service Your Say is the HSE's feedback and complaints policy, operating under Part 9 of the Health Act 2004. The framing matters: it covers compliments, comments and suggestions as well as complaints, and treats feedback as a source of service improvement rather than a threat.
Who may complain and about what
Any person accessing a service, or someone acting on their behalf with their consent, may complain about any action of the HSE or a funded service that they believe was not fair, not following correct procedure, or not performed properly. Some matters are excluded from the process - for example, matters that are the subject of legal proceedings, clinical judgment issues that fall to other processes, and employment matters.
The stages
| Stage | What happens | Timeframes |
|---|---|---|
| 1. Point of contact resolution | Raise it locally with the staff member or manager; most concerns are resolved immediately and informally | Ideally on the spot, generally within about 2 working days |
| 2. Formal investigation | A complaints officer investigates and issues a written response | Complaints are normally made within 12 months of the event or of becoming aware of it. Written complaints are acknowledged within 5 working days, and the investigation is completed within 30 working days. If that is not possible, the complainant is informed by the due date and updated approximately every 20 working days |
| 3. Internal review | If dissatisfied with the stage 2 outcome, the complainant may request an internal review, normally within 30 days of the response. The review officer acknowledges within 5 working days and normally reports within 20 working days | |
| 4. External review | Referral to the Office of the Ombudsman, or the Ombudsman for Children where the complaint concerns a child |
The Nurse's Role When Someone Complains
A complaint - often delivered as anger at the bedside - is a recognised OSCE scenario. RCSI names safeguarding plus a complaint from a next-of-kin as a current example.
- Listen first, fully, without interrupting or defending.
- Move to a private space, sit down, and give the person your attention.
- Acknowledge the feeling before addressing the facts: "I can hear how worried you are about your mother."
- Apologise for the experience - "I'm sorry this has happened to you" - which is not an admission of liability and is entirely compatible with open disclosure.
- Do not become defensive, do not blame colleagues or other services, and do not speculate.
- Explain what you can do now and what you cannot, and be honest about the limits.
- Explain Your Service Your Say, offer the information leaflet, and tell the person how to raise it formally and that doing so will not affect their care.
- Escalate to the nurse in charge or complaints officer, and involve the Patient Advocacy Service where appropriate for independent support.
- Document the concern, the conversation and the actions taken, factually and without editorialising.
Community Care Services
Citizens Information's guide to Community Care Services is on RCSI's list, and community provision is where most discharges land.
| Service | Role |
|---|---|
| Public health nurse | Nursing care at home - wounds, catheters, monitoring, palliative support, child and maternal health - and the principal community link for discharge |
| Home support service | Personal care at home, assistance with washing, dressing and meals |
| General practitioner and practice nurse | Primary care, chronic disease management, vaccination, screening |
| Primary care team | Multidisciplinary local team: GP, PHN, physiotherapy, occupational therapy, speech and language therapy, social work, dietetics |
| Community intervention team | Nurse-led short-term intensive care at home, often preventing an admission or supporting early discharge, for example intravenous antibiotics at home |
| Day centres and day care | Social engagement, meals, activity, and respite for carers |
| Respite and community nursing units | Short-stay and long-term residential care |
| Meals services and community supports | Practical daily support, often through voluntary organisations |
| Medical card and GP visit card | Eligibility for services free of charge or at reduced cost |
Nurses should be able to name these and know who refers to what, because a discharge plan that cannot be delivered in the community is not a discharge plan.
The NMBI Professional Competence Scheme
Registration is not a one-off event. Under the Nurses and Midwives Act 2011, registered nurses and midwives must maintain their professional competence, and NMBI operates a professional competence scheme to support and evidence that.
In practice this means maintaining and developing knowledge and skills relevant to your scope of practice, engaging in continuing professional development, using reflective practice to learn from experience, and keeping a record of that activity. RCSI lists guidance on reflective writing in this group for exactly that reason, and Domain 6 of the NMBI competencies - developing leadership potential and professional scholarship - is where it sits in the standards.
The practical link for an internationally qualified nurse: maintaining competence, and being able to evidence it, is a continuing condition of registration in Ireland, not something that ends when the aptitude test is passed.
A relative angrily tells a nurse in a busy ward bay that her father has been neglected and that she intends to complain. What is the most appropriate initial response?
Which statement about the HIQA National Standards for Safer Better Healthcare is correct?
A patient submits a written complaint about their care to the HSE. What are the standard timeframes under Your Service Your Say?