Care of high-risk pregnancies to be moved from Portiuncula

The care of an increased number of high-risk pregnancies are to be moved out of Portiuncula Hospital in Ballinasloe, it has emerged.

This is one of the steps being taken on foot of a series of clinical reviews into maternity services at the hospital.

The HSE said that since a previous report into maternity services at the hospital, there is a "well-established pathway" in place for the transfer of high-risk pregnancies to Galway University Hospital (GUH).

It said this would now be expanded to other groups of higher-risk women whose care will be transferred to GUH or the hospital of their choice, in the coming months.

These could include those with a 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.

The move comes on foot of the completion of five external reviews into the care provided to women and their babies at the hospital.

The HSE today said these had been shared with the families and it would now offer to meet individually with them to discuss the findings, answer any questions and lay out the next steps.

A further seven reviews are underway or due to commence.

In a statement this lunchtime, the HSE accepted that although changes had been made on foot of the Walker report in 2018, similar issues had been identified by the 2024 review process as had been identified in that previous review of maternity care.

It said it was “committed to implementing the 34 recommendations contained in these five reviews”.

Last January, external experts were appointed to oversee maternity services at the hospital and the HSE announced individual external reviews were underway into the maternity care provided to nine women who gave birth there since late 2023.

It said, since the start of 2024, seven babies were born with hypoxic ischaemic encephalopathy (HIE) (the reduction in the supply of blood or oxygen to a baby’s brain before, during, or after birth).

Six of those babies were referred for neonatal hypothermic treatment, also referred to as neonatal cooling.

At the time, the HSE said the incidence of HIE, resulting in referral for neonatal cooling treatment, was “significantly higher than that observed nationally or internationally for a similar time frame.”

Reviews are also taking place into the care provided in the cases of two stillbirths which occurred at the hospital in 2023.

Today the HSE said work on implementing the recommendations of the five reviews was already well advanced.

“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.”

It said this work had aligned the service more closely with national and regional standards. In addition, the external team oversees all consultant and registrar rotas in Obstetrics and Paediatrics, the statement added.

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.

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.