An inspection of Our Lady's Hospital Navan by HIQA said patient safety risks, associated with the hospital not providing acute surgical services on-site, persist and remain to be fully addressed by the HSE.
The inspection was conducted in November 2025 and is published today, 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.
Also, 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 which usually provide 24/7 acute surgery and the issue has been a source of controversy in the region with some concerned the hospital's emergency department may be at risk of closure.
HIQA says that Navan continues to operate as a model 3 hospital, but does not provide acute surgery on-site. It does provide planned surgery and acute medical in-patient care.
HIQA has expressed concern that the presentation of acute surgical patients at the hospital persists.
In particular, it relates to patients who go to the hospital for the first time for care and have not been assessed by a GP and may present with a wide variety medical or surgical issues.
The hospital told HIQA that the presentation of surgical patients at Navan was being closely monitored.
From January 2025 to 5 November 2025, 258 surgical patients required transfer to other hospitals, equating to 1.5 patients a day.
Navan is the last of nine hospitals identified under the Smaller Hospitals Framework (2013) to transition from a model 3 to a model 2 hospital, which would mean it no longer having a 24 hour emergency department.
But no government decision has been made on this and concerns have been regularly voiced locally in the community, by doctors and politicians about such a move.
The HIQA report says that the challenges can not be fully managed until a decision is made about the matter.
HIQA said that since its previous inspection in June 2024, it was aware of engagement with the hospital and senior HSE management in the Dublin North East region.
It was informed that recommendations from a specially convened Task Force aimed at determining the best way to address the risks were under consideration by senior HSE management.
At the time of the November 2025 follow-up inspection, HIQA noted that the recommendations awaited full implementation.
"Therefore, HIQA found that the risk associated with the hospital not providing acute surgical services on-site remains and continues to be a challenge", its latest report says.
