Work ongoing to return Portiuncula maternity unit to local management

Work is underway on a handover plan that would see responsibility for the maternity services at Portiuncula University Hospital (PUH) returned to local management.

Since January 2025, an external management team (EMT) has been responsible for managing maternity, gynaecology and neonatal services at the Ballinasloe hospital.

However, in a statement to the Westmeath Independent last week, the HSE West and North West confirmed that a handover plan was now being drawn up.

The statement said this plan involves “review of all responsibilities held by the EMT, including governance meetings, and assigning responsibility back to the PUH maternity and hospital management team.”

The external management team was put in place due to what the HSE described at the time as “concerns in relation to the provision of maternity services in PUH”.

It related to what the HSE said was an incidence of hypoxic ischaemic encephalopathy (HIE) (the reduction in the supply of blood or oxygen to a baby’s brain before, during, or after birth) and the referral for neonatal cooling treatment being “significantly higher than that observed nationally or internationally for a similar time frame”.

The HSE said last week that the external management team continues to work with the PUH team on improvements.

“The External General Manager and External Clinical Director remain in place in PUH on a full-time basis,” it said. However, since the beginning of March, the external Director of Midwivery has maintained “a one day per week on-site presence”.

“The team will remain in place in PUH until the completion of all external reviews,” the HSE said.

“When the term of the external management team concludes close monitoring will continue via the Women’s and Children’s Network of Care and the Regional Implementation Team.”

Reviews into the maternity care provided to seven women were completed in 2025 and a summary document of recommendations relating to five of these cases, was published in June. On foot of the reviews, the HSE moved to relocate all high-risk pregnancies from Portiuncula.

The move sparked fears of downgrade of the hospital, with some 25% of births, or up to 350 deliveries a year, relocated from the hospital.

The move resulted in a major demonstration taking place in Portiuncula and prompted the establishment of a campaign group, Portiuncula Maternity Alliance.

At the time, it emerged that reviews into the care provided to mothers and babies in five further cases were underway.

Asked as to the status of those later reviews, the HSE said last week that one review was now fully completed and the final report had been shared with the family with an offer to meet.

“The External Management Team are working with PUH on the quality improvement plans to address the recommendations made. This remains a work in progress, however a large proportion of the recommendations made have been addressed through the work of the external management team over the past 16 months,” the statement added.

Two further reviews were said to be “going through the final stages”. “The final reports will then be sent to the families in early June with an offer to meet with the Women’s and Children’s Network to discuss the report. Recommendations made in this review were shared at the Women’s and Children’s Network Incident Management Team meeting on 27 May 2026.

The External Management Team are working with PUH on the quality improvement plans to address the recommendations made.

“The remaining two reviews are in progress with a timeline of completion early Q3 2026,” it said.

The HSE said these five reviews were “individual to the care delivered to the women and their babies” and it does not publish individual review reports “as doing so might reveal information in relation to identifiable individuals, breaching the ethical requirement on us to observe our duty of confidentiality”.

However, it said that general themes from the recent external reviews include documentation, training and education, communication and team-working. “Many of the recommendations made have been addressed through the work of the external management team and the quality improvement plans to address recommendations from the initial seven completed reviews,” it added.

Referring to the earlier seven reviews, it said “one external review team provided an overarching summary report of the findings” from five of those reviews. That summary concluded that "the current situation does not meet the expectations of parents, increases clinical risk, and is no longer sustainable."

On foot of the reviews, the HSE moved to transfer high-risk pregnancies from Portiuncula, sparking fears that maternity services at the hospital, the main location for women in the wider Athlone region, are being downgraded.

It's understood the cohort of expectant mothers being transferred annually could total up to 350 and represent up to 25% of the annual number of births at the hospital.

In its statement to the Westmeath Independent last week, the HSE said quality improvement plans relating to the initial seven reviews of maternity care at Portiuncula University Hospital (PUH) are now at 99% status of completion.

“Through a system of audit and monitoring there is evidence that all improvements made are being sustained,” it said.

“Considerable improvements have been made in governance structures, care pathways, workforce, communication and education and training,” it said.

It also cited a number of infrastructural developments including a Maternity Day Assessment Unit, enhancements to the Early Pregnancy Unit and labour ward and environmental upgrades in inpatient areas.

“In January maternity outpatients was relocated from the main PUH Out Patients Department to a dedicated facility on the grounds of the hospital.

The facility includes nine clinical rooms, including a dedicated phlebotomy service to help make clinic visits more efficient and convenient for women.

The new facility supports both consultant-led and midwife-led clinics with dedicated car parking available directly outside, ensuring ease of access for women attending appointments,” it added.

“A new emergency bleep system has been introduced, improving the process of direct communication to staff when obstetric emergencies arise.

It said other improvements in progress include a dedicated theatre for emergency caesarean sections and boosting of Wifi and mobile phone coverage across the site.

The HSE said it is “aiming to have a Design Team appointed in the coming weeks to progress with the works to enhance the Wifi coverage and mobile phone connectivity within the hospital with particular focus on the priority areas such as the maternity department”

In January this year, the HSE Chief Executive Bernard Gloster declined to give a timeline for the full restoration of maternity services at Portiuncula.He told an Oireachtas Committee on Health in December 2025: “I would hate to meet a woman on the streets of Ballinasloe in two years' time who would say to me 'You said',” he said, adding that restoration of services depends on assurances by The National Women and Infants Health Programme that the level of clinical service available, the sustainability of that and the implementation of the key recommendations of the various reports in a sustainable way are all present to reconsider the booking profile in Portiuncula.”