Update on Maternity Services in Portiuncula University Hospita

FIVE external reviews into the care provided to women and their babies at Portiuncula University Hospital (PUH) have been completed and shared with the families. The Women’s and Children’s Network, HSE West and North West will now offer to meet individually with the families to discuss the findings, answer any questions and lay out our next steps.

These reviews are part of a number undertaken into maternity services at the hospital. A further seven reviews are underway or due to commence.

While each of these five reviews is individual, the review team also prepared an overarching summary document. In this summary the review team laid out four common themes of concern:

• Communication.
• Governance.
• Clinical care, Leadership and Clinical Governance.
• Infrastructure.

A previous review of maternity care in PUH took place in 2018 (Walker report 2018) which highlighted similar concerns around governance, training and consultant presence. The Walker report also highlighted concerns in relation to reliance on locum consultants, communication and timely recognition of deteriorating clinical situations.

Although changes were made following the 2018 review, similar issues have been identified by the 2024 review process.

We are committed to implementing the 34 recommendations contained in these five reviews.

Much of this work is already well advanced through the external team which was put in place in January to oversee all aspects of maternity and neonatal care.

Working closely with the Women’s & Children’s Network and the hospital, the external team has made significant improvements in clinical governance, operational processes, patient care pathways, and multidisciplinary team collaboration.

This work has enhanced structures for quality and patient safety oversight, training and education, mandatory training compliance and clinical performance monitoring. This has aligned the service more closely with national and regional standards. In addition, the external team oversee all consultant and registrar rotas in Obstetrics and Paediatrics.

An implementation team with key stakeholders is now being set up to further progress the recommendations and any further changes required over the coming months.

While well-established pathways are already in place for the transfer of care for women with high-risk pregnancies to GUH, considering the safety issues highlighted in these reviews, this implementation team will expand this to other groups of higher-risk women whose care will be transferred to GUH or the hospital of their choice.

Factors which contribute to higher risk pregnancies include previous loss of a baby, history of significant medical disease, history of massive obstetric haemorrhage, obesity and maternal age. Women considered likely to deliver their baby before 35 weeks pregnancy will also have their care moved.

Dr Pat Nash, Regional Clinical Director, HSE West and North West said: “We are fully committed to implementing the recommendations laid out in the five reviews and will take all steps necessary to ensure we are providing the best care possible to the women and babies receiving care at our hospital. Much of this work is well advanced through the work of the external management team and Women’s & Children’s Network.”

Tony Canavan, Regional Executive Officer, HSE West and North West, said; “The management team appointed in January to oversee and manage maternity services in Portiuncula University Hospital (PUH) remains in place and are working on a programme of improvements, many of which relate to the recommendations. Our focus remains on ensuring the safety and wellbeing of women and their babies,” he added.

Dr Cliona Murphy, National Women’s and Infants Programme added: “The National Women and Infants Health Programme welcome the publication of the five reviews today. We note that some of the commentary in the summary Report relates to the challenges that are faced by the regional maternity services. Currently all maternity services are managed through maternity networks, and the specific issues raised in the summary of the five reviews will form part of the considerations for the successor to the National Maternity Strategy, which is set out in the Programme for Government.”

If women who are attending the unit have questions, they can contact the HSE on 1800 807 008 and arrangements will be made for them to receive a follow-up call from the maternity service.

Full Report Summary can be accessed here:  

Full List of Recommendations can be accessed here: