Filenews 19 February 2026 - by Marilena Panayi
Telediagnosis from Greece without an institutional framework, ex post opinions, waiting up to 11 hours in the A&E departments, admissions of patients with forms that do not bear the signature of specialist doctors and disagreements between clinics and departments, are demonstrated by the findings of the Audit Office, as recorded in a special report for the State Health Services Organization.
The surprise visits of officials of the Audit Office to the Accident and Emergency Departments in the early hours of October 1, 2025, led to findings that are rather of particular concern with the relevant Report referring to "structural, procedural, interpersonal and labour issues, which cannot be an excuse to extend the time of stay of patients in the A&E and the Service pointing out the the need to strengthen internal control and oversight mechanisms to ensure continued compliance with procedures."
It is recalled that the specific midnight visits of the officials of the Audit Office to the A&E departments of the two state hospitals (Nicosia and Limassol) had raised a storm of reactions on the part of doctors, but also other professionals and were the subject of intense public discussions and disagreements.
Retrospective opinions and the issue of radiological examinations
The Audit Office makes a special reference to the ex post opinions of doctors, some of which were even made after the patients were discharged.
"The medical opinions concerning 14 cases of X-rays performed on 30.9.2025 at the Nicosia hospital during the night shift, were prepared by a radiologist of the hospital on 2.10.2025, while the patients had already been discharged from the A&E", the Report states with the Audit Service pointing out that: "The delay in the preparation of the opinions increases the risk of non-timely recognition of pathological findings and may lead to affect patient safety." (It is noted that after the audit, instructions were given to terminate the above practice).
Untapped equipment and purchase of telediagnostic services from Greece
There is extensive reference to the Expox and the market of telediagnostic services from Greece.
The Audit Office refers in its report to the damage that the CT scanner presented during the audit at the Nicosia General Hospital, as a result of which the patients were transferred to a private hospital of the GHS for CT scan through the purchase of services.
"The agreement with the private hospital, which was concluded on the same day of the damage (30.9.2025) exclusively provides for the conduct of examinations only, without the provision of a medical opinion by radiologists."
The medical opinions, the Report states, "were carried out through telediagnosis by a specific company in Greece, despite the presence of a radiologist on duty at the Nicosia General Hospital, since the hospital's radiologists refused to provide services citing practical and medical reasons".
"It is noteworthy that, in all districts, full (24-hour) coverage agreements had already been secured by the Administration of OKYPY, with the exception of the province of Nicosia, where coverage is limited to the normal working hours of the contractors. In addition to the above, it is worth noting that the CT scanner showed two consecutive failures in a short period of time, which raises questions as to its maintenance."
During the audit, it was found "the absence of a legislative framework in the provision of telediagnostic services that ensures the quality of the provision of these services".
On the occasion of the agreement to purchase telediagnostic services from a specific company in Greece, the Audit Office, as stated, "requested in a letter to the Ministry of Health and the National eHealth Authority to clarify whether telediagnostic services are currently covered by an existing legal framework and whether the necessary safeguarding and supervision mechanisms existthe quality, safety and adequacy of the services provided to patients
In a response letter, "the National eHealth Authority informed us that the implementation of telediagnostics in Cyprus is carried out without a special, comprehensive and independent legislative framework". Furthermore, it was mentioned that there are no specific adequate mechanisms to fully ensure the quality and safety of these services, as well as the absence of a specific legal framework regarding the distribution of legal responsibility among those involved."
(It is reported that remote radiology services are largely implemented in Cyprus and by the private sector, inside and outside the GHS).
Waiting for a specialist doctor and disagreements between clinics
Particularly important, although not new, are the findings concerning the length of stay of patients in the A&E Departments.
According to the Report, "in five cases, patients who visited the A&E between the hours of 11:44 on 30.9.2025 and 00:55 of the next day, at 07:30 their examination by on-call specialists was still pending. It is noted that at 14:30, one of the specific patients was still waiting for an examination by a neurologist."
"During the inspection carried out at the Limassol A&E Department, an incident was found in which the patient needed an opinion from a doctor specializing in neurosurgery, this was requested via fax from the Nicosia General Hospital and was received with a delay, while the patient had already been transferred for treatment to an OKYPY hospital in the Nicosia district.
"Our Service, on the occasion of the above incident, expressed its concern about the practice applied by OKYPY, in cases where it does not have a critical specialty in hospitals in its network," the report states.
In addition, during this audit, it was found "that the average time spent in the A&E was five hours and 15 minutes at the Nicosia General Hospital and two hours and 49 minutes at the Limassol General Hospital, while the maximum stay time of patients at the A&E was 11 hours and 28 minutes in Nicosia and 6 hours in Limassol".
The report even refers to disagreements between nurses' clinics.
Some cases, the Report states, "are delayed only because there is a disagreement between the directors of clinics (specialties) as to the decision to which specialty the case belongs. The disagreements of the responsible beds should in no way cause a delay in the management of incidents."
Admissions with the signature of trainees
Issues of medical responsibility and risks that patients may face are raised by the Audit Office, referring to patient admissions that are made with the signature of residents and not specialist doctors.
"The non-implementation of the Organization's procedures by specialists and resident doctors may endanger the health of patients, as well as create issues of accountability and legal responsibility," the Audit Office states, noting that in Nicosia, only 1 out of 15 admission forms was signed by a specialist doctor on duty, while 13 were signed by residents.
It is noted that, "while during the unannounced inspection at the Nicosia hospital, the physical presence of a cardiology specialist was confirmed, two of the above cases of signing the admission forms by a resident doctor concern the specialty of cardiology".
In addition, "two cases of ultrasound were found, in which the medical opinion was drawn up and signed by a resident radiologist, even though the radiologist on duty was present and the physical presence was confirmed. The above practice poses serious risks, as it undermines the quality and safety of the services provided."
Regarding the recommendation, the Service calls on the Organization to ensure the implementation of the prescribed procedures for imports, so that the forms are signed by the specialist doctor on duty, as provided.
