Report finds cavan maternity services effective
The RCSI Hospital Group has welcomed a new independent report into Cavan General Hospital maternity services which has found the hospital to have systems and processes for the assurance of quality, risk, and patient safety that are well established and effective.
The report, ‘A Review Of The Governance Of Maternity Services At Cavan Monaghan Hospital’, was done by the UK’s distinguished former CEO of the NHS Trust Development Authority, Mr David Flory. He found that the hospital had a fit-for-purpose infrastructure and a strong Executive Team and General Manager that operate within a governance system that is well designed and embedded. There is also very strong staff commitment in Cavan General Hospital and the perinatal mortality rate is below the Ireland average and lower than most other units with a similar number of births, according to the report.
The review found too that the hospital had a stretched management structure in some key functional areas, with the hospital’s biggest challenges including staff shortages in critical areas such as obstetrics and midwifery, as well as a committed level of expenditure in excess of available funding. The report also stated that there should be better coordination between the Midwife Led Unit and the Consultant Led Unit in the hospital to facilitate more effective multi-disciplinary working. The positive findings of the report have been welcomed and its other observations have all been accepted and are being implemented.
Ms Margaret Swords, Group Chief Operations Officer, said: 'The very positive comments in the report regarding governance structures and staff commitment in Cavan are welcomed by the RCSI Hospitals Group. Issues identified like investment, multi-disciplinary working and staffing in Cavan General Hospital are challenges that are being faced both locally and nationally. It is particularly pleasing to see the report’s comments regarding the importance of the new Clinical Directorate model across the Group and how these networks are the single most important factor in building greater resilience in the smaller maternity units like Cavan. With the support of the National Acute Hospitals Division, the RCSI Group intends to tackle the issues identified in this report and progress them as a priority as part of the broader National Maternity Strategy being developed by the Department of Health.”
There is a need, according to the report, to ensure the resilience of the maternity services provided while at the same time planning for the medium and long-term sustainability of Cavan within the RCSI Group. Smaller hospitals like Cavan General Hospital need to be part of a more formal, stronger network that can improve the breadth and depth of services provided and facilitate better use of funds, the report said.
Professor Fergal Malone, Clinical Director for Women and Children at the RCSI Hospital Group and incoming Master of the Rotunda Hospital, said: “Mr Flory’s report very much highlights the positive work being done in Cavan but also the potential benefits to service users in ensuring the new RCSI Group structure develops a single maternity network. Better aligning maternity services from smaller hospitals like Cavan with larger units like the Rotunda has the potential to build a resilient, sustainable maternity services configuration that results in better patient outcomes in the long-term across the Group. This is a priority for the RCSI Group.”
Dr Alan Finan, Clinical Director for Women and Children at Cavan General Hospital thanked Mr Flory for his work and said: “This review provides a valuable framework for considering governance of quality, safety and risk. It is positive that Mr Flory finds systems and processes in Cavan to be effective in this respect. The report points to areas where decisive action is required, particularly in the area of midwifery and obstetric staffing. The report also emphasises the need for more progress in the development of our RCSI Hospital Group Maternity Network. The key findings in this report and the key actions identified will be implemented.”
Dr Finan, while welcoming the Report's positive comments, also noted that: 'The management team are very conscious that there are a small number of families who have not had a positive experience of the maternity service in Cavan and this report will not alter in any way our determination to ensure that all cases currently under review are processed as quickly as possible and any consequent recommendations are implemented.'
The review was commissioned by the HSE earlier this year following the publication of the ‘Report of the investigation into the safety, quality and standards of services provided by the Health Service Executive to patients in the Midland Regional Hospital, Portlaoise ’ by HIQA in May 2015. In the aftermath of this HIQA report, the HSE instigated a quality, risk and patient safety review, undertaken by Mr Flory, which focused on Cavan General Hospital and South Tipperary General Hospital. These two hospitals were selected as a sample of the country’s maternity units to facilitate providing a useful framework for considering governance of quality, safety and risk and not due to any specific clinical or safety concerns.
The report’s author, David Flory, is an expert in hospital governance and was previously chief executive of the NHS Trust Development Authority.
RCSI Hospitals includes Beaumont Hospital, Our Lady of Lourdes Hospital Drogheda, Connolly Hospital, Cavan General Hospital, Rotunda Hospital, Louth County Hospital and Monaghan Hospital. The academic partner of RCSI Hospitals is the Royal College of Surgeons in Ireland (RCSI).