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

2. National Maternity Strategy
HSE | NWIHP
National Maternity Strategy

3. 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

4. NWIHP Update HSE | NWIHP Appointments were slow to start
Kilian McGrane
Dr Peter McKenna
Angela Dunne
Responsibility for;
Maternity services
Neonatology
Benign Gynaecology

5. 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

6. 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

7. 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.

8. Maternity Networks Establishing maternity networks Clinical Leads
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

9. Priorities Focus in 2017 was on maternity services
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 €4.55m to implementation the Strategy in 2018
Building on €9.8m invested in recent years

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

11. 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

12. Model Of Care Currently only 7 hospitals/units providing 100% access
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

13. 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

14. 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

15. 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

16. Other Elements in Implementation Plan
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

17. Other Elements in Implementation Plan
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.

18. Other Elements in Implementation Plan
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

19. Other Elements in Implementation Plan
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

20. Investment 2018 Recruitment of
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 €75m investment over 10 years

21. 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