Angela Dunne Director of Midwifery The Institute of

Angela Dunne, Director of Midwifery The Institute of Community Health Nursing Annual Conference 23 rd May 2018

HSE | NWIHP National Maternity Strategy

HSE | NWIHP Introduction I am delighted to be here this morning to give you an overview of the National Women & Infants Health Programme. The NWIHP was established in January 2017 to oversee the Implementation of the Maternity Strategy

HSE | NWIHP Update Appointments were slow to start • Kilian Mc. Grane • Dr Peter Mc. Kenna • Angela Dunne Responsibility for; • Maternity services • Neonatology • Benign Gynaecology

HSE | NWIHP Maternity Networks • Central to the NMS is the establishment of maternity networks • Six Hospital Groups will have a maternity network • While similar in role and function, the networks will reflect the difference in each hospital group

HSE | NWIHP Maternity Networks Governance model for the maternity networks in consultation with the Acute Hospital Division, Primary Care and the Department of Health. The agreed model will ensure responsibility for women and infants services are clearly defined at hospital/unit level, maternity network level and nationally

HSE | NWIHP Maternity Networks Establish a working group reflecting public health nursing, primary care and midwifery to ensure a coordinated approach to postnatal care. This approach will build on the experience of previous and existing collaborative arrangements for such care and will recognise regional variations.

HSE | NWIHP Maternity Networks • Establishing maternity networks – Clinical Leads – Midwifery Lead – Quality and Safety – Data Analysis • A number of the hospital groups have the process well established

HSE | NWIHP Priorities • • Focus in 2017 was on maternity services Visiting sites and developing our networks Building organisational capacity Commenced engagement with neonatal clinical care programme, and are now developing an agreed work plan • Commenced process of developing benign gynaecology • Delighted in the context of the current budget challenges, that we received € 4. 55 m to implementation the Strategy in 2018 • Building on € 9. 8 m invested in recent years

HSE | NWIHP Priorities Implementation Plan launched October 2017 All actions are important, but NWIHP 2018 priorities are: 1. Anomaly scanning 2. Model of Care 3. Quality and Safety

HSE | NWIHP Anomaly Scanning • Currently only 7 hospitals/units providing 100% access • Dedicated funding provided in 2018 budget • Plan is to add significant number of sonographers during 2018, to enable all 19 maternity hospitals/units to offer 100% of women an anomaly scan • 28 additional sonographers approved • We have engaged with UCD re training • Challenge with recruitment and training

HSE | NWIHP Model Of Care • Currently only 7 hospitals/units providing 100% access • Dedicated funding provided in 2018 budget • Plan is to add significant number of sonographers during 2018, to enable all 19 maternity hospitals/units to offer 100% of women an anomaly scan • 28 additional sonographers approved • We have engaged with UCD re training • Challenge with recruitment and training

HSE | NWIHP Model Of Care • Assisted and specialised pathways are well established. Focus is on midwifery led supported pathway. • Establish an MDT steering group to develop the model • The Group will be informed by the models currently in operation around the country • Identify sites who are ready to go • Define the resource requirement for each location • How many outreach units will each maternity hospital/unit have

HSE | NWIHP Model Of Care • The new model of care will required clinical guidelines, and these are in development. • The expected completion date for the guidelines is end 2018 • In advance of the completion of the guidelines, a set of principles will be developed to underpin the model • The 2018 investment will support an additional 52 midwives to commence the rollout of the supported care pathway

HSE | NWIHP Quality & Safety • • Need to build trust and confidence in maternity services Model of Care and confidence are related Q&S priorities Maternity SIMF for each maternity network focusing on all adverse maternity events • NWIHP focusing on the most extreme adverse event: – Maternal deaths – Neonatal deaths – IPDs – HIE • Similar approach to Each Baby Counts

HSE | NWIHP Other Elements in Implementation Plan • Three other big priorities for 2018 are: – Breast feeding – Perinatal mental health – Voice of women – Health and Wellbeing – Capital priorities for all 19 units, including alongside birthing centres

HSE | NWIHP Other Elements in Implementation Plan Engage with Primary Care to see how the MECC training programme can be provided to GPs and PHNs with a view to ensuring consistency of approach across the shared model of care.

HSE | NWIHP Other Elements in Implementation Plan • NWIHP and Nurture will develop an antenatal education programme, in consultation with ONMSD and service users, that provides easy to understand information. • NWIHP will work with Primary Care to ensure that the education programme is provided to women throughout the appropriate primary care settings

HSE | NWIHP Other Elements in Implementation Plan • Antenatal care encompasses a holistic approach to the woman’s needs including her physical, social, lifestyle and mental health needs. • Postnatal care promotes health and wellbeing for the new mother and baby, supports breastfeeding and identifies and supports at risk with a particular emphasis on mental health

HSE | NWIHP Investment 2018 • Recruitment of – 9 OBGYN consultants, 3 perinatal pathologists, 2 anaesthetists – 52 Midwives, 15 CMS, AMPs (approximately 80 additional posts) – Q&S resource – Social Work – Dietetics – Supporting maternity networks • Focus at Group level initially. • Plan envisages € 75 m investment over 10 years

HSE | NWIHP Summary • Policy platform is in place for maternity services: NMS, Bereavement, HIQA, Implementation Plan • Funding now available • Challenge is to demonstrate to government our effective use of that funding, and to show the return on that investment