Update on Maternity Services in Portiuncula University Hospital

HSE West and North West has appointed a highly experienced management team to oversee and manage maternity services in Portiuncula University Hospital (PUH) over the coming months.

This management team, is led by an external consultant obstetrician Dr Mark Skehan and includes a director of midwifery and a senior manager. They will work on site from today, Monday January 27th. The team will report directly to the HSE West and North West regional management and will be fully responsible for managing and supporting all aspects of maternity/gynaecology and neonatal services at PUH. 

These steps are part of a number of changes that we are taking as a result of concerns in relation to the provision of maternity services in PUH.

Dr Pat Nash, Regional Clinical Director HSE West and North West said:

“I want to firstly apologise to all those women and families for whom this news will be worrying or upsetting. We are making these changes now to ensure that the maternity service at Portiuncula is as safe as possible for mothers and their babies.

External reviews are currently underway into the delivery of nine babies in PUH. Since 2024, seven babies had hypoxic ischaemic encephalopathy (HIE), resulting in six of those babies being referred for neonatal hypothermic treatment, also referred to as neonatal cooling. In 2023, two stillbirths occurred at the hospital and the care provided in relation to these two deliveries is also currently being reviewed externally.

This incidence of HIE, resulting in referral for neonatal cooling treatment, is significantly higher than that observed nationally or internationally for a similar time frame.

HIE has many causes and is essentially the reduction in the supply of blood or oxygen to a baby’s brain before, during, or even after birth. Therapeutic Hypothermia is now considered the standard treatment for term infants with moderate to severe HIE. This treatment involves cooling a baby quickly after birth and keeping them cool for several days. It slows the brain’s metabolism and can prevent further damage. The sooner body cooling starts, the better the outcomes for the baby.”

Tony Canavan, Regional Executive Officer HSE West and North West said:

“Our biggest concern is for the women who have had, and will have, their babies in PUH, and for their children. From today, we have appointed a highly experienced team, led by an external consultant obstetrician to manage and lead the maternity service at Portiuncula University Hospital to ensure as safe and high quality services as possible, while we await the outcome of the reviews currently underway.  

We are concerned by these cases and we believe it is important that we review the care provided. The purpose of the reviews currently underway is to examine all of the clinical findings and care provided to our patients. We know this is a distressing time for women whose care is under review and we apologise for any added distress that this news brings. We are providing support to the families involved.

Each of these reviews are independent and external to PUH and the West North West region. Once completed, we will meet with each family to share the review finding with them.”

Commenting Dr Cliona Murphy, Clinical Director HSE National Women and Infants Health Programme said:

“We have been working closely with the team in HSE West and North West and at Portiuncula University Hospital to put in place more measures to improve safety for women delivering their babies at this unit. We await the outcome of the reviews into the care provided to nine women since late 2023 which are currently underway. We will continue to provide the necessary support to the unit and will work closely with the new management team there, led by an external consultant obstetrician. During this time all services will continue to operate as normal. Women with appointments should attend as normal and those with understandable concerns should discuss them with their obstetrician or midwife.

The findings of these reviews will be considered alongside previous reviews conducted at the unit. Between 2019 and 2023 a further eight reviews took place into cases that gave rise for concern. Seven of these eight cases were babies with hypoxic ischaemic encephalopathy (HIE), six of whom received neonatal cooling. We met with each of these families at that time and shared their review findings with them. A series of service improvement plans and other measures were implemented at the unit following these reviews.

It is important to note that all services at the maternity unit will continue to operate as normal, including outpatient appointments. This team is an additional measure to make the maternity service at PUH as safe as possible.

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.”