HIQA makes recommendations to ensure sustainability of Ireland’s maternity services

Date of publication:

HIQA has published an overview of its inspections of Ireland’s 19 maternity units and hospitals.

While HIQA found good practice in how maternity services detect and respond to obstetric emergencies, it also identified opportunities for improvement to ensure that maternity services remain safe and effective into the future.  

The report notes the overall level of professionalism, teamwork and commitment displayed by staff providing maternity care across the country — in what is a highly pressurised and demanding environment.

Mary Dunnion, HIQA’s Director of Regulation, said: “Overall, our findings provide assurance that improvements have been made in maternity services since HIQA’s investigation into maternal care in Portlaoise Hospital. However, we found a lack of clarity and national leadership within the HSE regarding the responsibility for implementing the National Maternity Strategy. This Strategy provides a framework for a new and better maternity service that improves choice for women, and ensures that smaller maternity units, in particular, are better supported to provide sustainably high-quality and safe care.

“It was of concern to HIQA that the HSE had made only limited progress in advancing this Strategy since it was approved by Government in 2016, and a more comprehensive, time-bound and costed implementation plan is required. While more formalised governance structures were introduced by the HSE at the end of 2019 to improve national leadership in this area, the HSE must now implement the Strategy and establish maternity networks to ensure that pregnant women, mothers and newborns across the country have access to the same level of care and support regardless of where they live.”

Sean Egan, HIQA’s Head of Healthcare, said: “Our inspections showed that services around the country were reliant on front-line medical staff working onerous rosters — some on call every three nights — and midwifery staff working overtime to address staffing deficits and maintain service levels.

“In addition, the poor infrastructure and physical environment across maternity services significantly impacts on a woman’s comfort, dignity and privacy, and increases the potential risk of cross infection for women and babies. Addressing the ageing infrastructure across many maternity services will require significant funding.”

HIQA has made eight recommendations to the HSE to improve the quality and safety of maternity services into the future, including the development of a comprehensive plan to fully implement both the National Standards for Safer Better Maternity Services and the National Maternity Strategy.

Ms Dunnion added: “It is imperative that the HSE acts on HIQA’s eight recommendations in a timely manner to ensure that Irish maternity services are enhanced and placed on a more sustainable and equitable footing for women and their babies.”

Read the Overview report of HIQA’s monitoring programme against the National Standards for Safer Better Maternity Services, with a focus on obstetric emergencies, and all 19 inspection reports, from the link at the bottom of the page.

Further Information:
Clare O’Byrne, Acting Media and Stakeholder Relations Manager, HIQA
01 8286712 / 085 8030846, cobyrne@hiqa.ie  

Notes to the editor:

  • In 2015, following its investigation into the quality and safety of maternity services in Midland Regional Hospital Portlaoise, HIQA developed specific standards for maternity services to drive improvements in the standard of care. The National Standards for Safer Better Maternity Services were approved by the Minister for Health and published in December 2016.
  • This monitoring programme inspected all maternity hospitals and units in Ireland, for the first time, against these National Standards.
  • In January 2016, the Minister for Health launched the Creating a Better Future Together: National Maternity Strategy 2016–2026 which sets out a significant restructuring and reform programme of maternity and neonatal services over a 10-year period.
  •  Inspections of maternity services began in mid-2018 and were completed in late-2019. The monitoring programme focused in particular on how each maternity unit or hospital ensured that measures were in place to detect and respond to potentially life-threatening obstetric emergency situations. As the programme included inspections of all maternity services in Ireland, it also allowed HIQA to observe the level of progress achieved by the HSE in implementing the National Maternity Strategy.
  • HIQA carried out follow-up inspections in two maternity units with poor levels of non-compliance — University Hospital Kerry and St Luke’s General Hospital, Kilkenny. Re-inspection identified improvements in both hospitals.
  • Watch HIQA Regional Manager Joan Heffernan explain the findings of this report in this short video
  • The National Maternity Experience Survey — the first ever national survey asking women about their experiences of maternity care in Ireland — is currently underway. Find out more at www.yourexperience.ie