The Health Information and Quality Authority (HIQA) has today published an inspection report on St Luke’s General Hospital, Kilkenny. 

During an unannounced follow-up inspection of the maternity service at St Luke’s General Hospital on the 16 February 2022, inspectors focused on assessing compliance with six national standards from the National Standards for Safer Better Maternity Services. The service was found to be compliant or substantially compliant with the standards assessed on the day of inspection. 

Since HIQA’s last inspection of the service in 2019, the hospital had improved arrangements in place to ensure maternity care was planned and delivered to meet the initial and ongoing assessed needs of women attending the maternity service at St Luke’s General Hospital. Women were risk assessed and assigned to the most appropriate care pathway based on their risk profile, with care provided by the most appropriate person. Communication and team working among consultant obstetricians in the hospital had also improved since the previous inspection. 

Some areas for improvement were noted by inspectors:

• Although the hospital had structures and processes in place to monitor and improve the quality and safety of the maternity service — and a number of quality improvement initiatives had been introduced to improve the safety of the service — greater clinical auditing and oversight of audit activity for the maternity service is needed to provide hospital management with an ongoing assurance on the quality and safety of the maternity service.
• The hospital was part of the Ireland East Hospital Group maternity network. However, the maternity network was still evolving and was not operating as described in the National Maternity Strategy. 
• The supervision, mentoring and training of non-consultant hospital doctors in obstetrics at the hospital had also improved. However, it was clear to inspectors that the COVID-19 pandemic had affected the delivery and uptake of training in the management of obstetric emergencies and basic life support at the hospital. While there was an improvement in the uptake of multi-professional training in the management of obstetric emergencies for obstetric medical staff since 2019, the uptake of this training for midwives and training in basic life support for all staff had decreased. The hospital had plans to provide mandatory training in the management of obstetric emergencies for all staff, which should have a positive impact on the number of staff up to date with this training.
• While there was evidence of a positive culture of reporting patient safety incidents at the hospital, the sharing of learning from incidents could be improved. This is important if the risk of recurrence and prevent avoidable harm to women attending the maternity service is to be minimised. 

Overall, notwithstanding the areas identified for improvement, inspectors were assured that there was an increased focus on the quality and safety of outcomes for women using the maternity service at St Luke’s General Hospital. This resulted in significant improvements in compliance since the previous inspections of the maternity service in 2018 and 2019.

Notes to Editors

• Ireland’s first National Maternity Strategy, Creating A Better Future Together, 2016 – 2026 was launched by the Minister for Health on 27 January 2016. The Strategy sets out a plan for maternity and neonatal care in Ireland, to ensure that it will be safe, standardised, of high-quality and offer a better experience and more choice to women and their families.
• The National Standards for Safer Better Maternity Services was published by HIQA in 2016. These national standards support the implementation of the National Maternity Strategy. The standards aim to drive and promote improvements in quality and safety across the maternity services.
• In 2018 and 2019, HIQA’s monitored compliance with the National Standards for Safer Better Healthcare Services, with an emphasis on obstetric emergencies across all 19 maternity hospitals and units. HIQA focused on obstetric emergencies to ensure that structures, systems, processes and outcomes were aligned to national guidelines and standards.
• HIQA conducted a two-day unannounced inspection of the maternity service in St Luke’s General Hospital in November 2018. Findings from that inspection identified a high level of non-compliance with a number of the national standards from the National Standards for Safer Better Maternity Services. A one-day follow-up announced inspection in September 2019 identified evidence of improved compliance and areas where further work was required to further improve compliance with the National Standards for Safer Better Maternity Services.