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Minister for Health publishes the National Women and Infants Health Programme’s Annual Report for 2022

Minister for Health Stephen Donnelly has published the National Women and Infants Health Programme’s (NWIHP) Annual Report for 2022.

The NWIHP’s role in the Health Service Executive (HSE) is to lead the management, organisation and delivery of maternity, gynaecology and neonatal services, strengthening these services by bringing together work that is currently undertaken across primary, community and acute care.

Minister Donnelly said:

"As Minister for Health, improving women’s health is one of my priorities, and implementing the National Maternity Strategy continues to be an important part of the broader health agenda under the Programme for Government. Building on the substantial investment in 2021, I am pleased to see this Report clearly demonstrate that the increased investment in 2022, including almost €8.7 million for the National Maternity Strategy, is having a positive impact on women’s healthcare.

"The focus we have placed on women’s health is making a difference, and the targeted investment is translating into improvements for patients. For example, over 100 full-time staff were funded for our maternity services in 2022, allowing us to increase choice of care even further by ensuring that all 19 units now have an advanced midwifery practitioner to implement the supported care pathway. We have also added clinical midwifery specialists in areas such as diabetes, parentcraft and high-risk pregnancy, and we have funded and advanced the development of postnatal care hubs. The Ambulatory Gynaecology Model of Care continued to be rolled out, with a total of 12 clinics operational by the end of 2022. There was also significant development in the areas of menopause, endometriosis, and fertility, with new services delivered and progressed throughout the year. I look forward to seeing continued progress in these developments, leading to improved supports and better outcomes for women."

The NWIHP was established to drive the implementation of the National Maternity Strategy and, in that regard, the Programme has overseen significant improvements in our maternity services over the last six years as well as driving more recent reforms to our gynaecology services.

Minister Donnelly concluded:

"The NWIHP has contributed enormously to the development of our maternity services, and more recently to other areas of women’s health such as reforming our gynaecology services. The Programme’s Annual Report shows that efforts to provide quality and timely health care to women in Ireland continued in earnest across 2022 and I would like to commend NWIHP for the progress they have made."

Bernard Gloster, CEO of the HSE, stated:

"I welcome the publication of the National Women and Infants Health Programme’s Annual Report for 2022. This is such an important aspect of healthcare and ensuring the safety and health of women and babies is a central element of what we do.

"The remit of NWIHP has expanded significantly since its establishment and has seen very substantial reforms of gynaecology services and women’s health. The continued investment in these services in 2022 has facilitated this change and the excellent progress in implementing the National Maternity Strategy."

Notes

As recommended by the National Maternity Strategy, the National Women and Infants Health Programme (NWIHP) has submitted its 2022 Report to the Minister for Health. The Report sets out the progress achieved on the work streams under NWIHP’s remit, with a particular focus on the implementation of the National Maternity Strategy and developments in our maternity services more broadly. The Report also outlines progress across other areas of NWIHP’s work, including ongoing reform of gynaecology services and a range of women’s health developments.

Developments in Maternity Services in 2022

NWIHP’s 2022 Report sets out a number of important developments and achievements, including:

  • funding for the recruitment of an additional 175 whole time equivalents (WTEs), including ten Obstetricians & Gynaecologists, 54 additional midwives and 23 Health and Social Care Professionals
  • continued focus on increasing the consultant Obstetrician/Gynaecologist workforce to reach a minimum of six for each regional hospital
  • a framework for postnatal hubs was developed which will provide postnatal care within the community in line with the findings from the National Maternity Experience Survey and Sláintecare objectives. The first five Hub sites have been identified and staff recruitment is underway
  • a framework for the establishment of a National Perinatal Genetics Service was developed which will focus on the evaluation, diagnosis, management, and treatment of anomalies before birth
  • in conjunction with the Irish College of General Practitioners (ICGP), the first GP Lead in women’s health was appointed to NWIHP, an integral role in achieving Sláintecare objectives.12 new clinical guidelines in Obstetrics and Gynaecology were developed over the course of 2022. These guidelines were launched in January 2023
  • investment was prioritised in specialist services, including gestational diabetes, with Clinical Midwife Specialists appointed to all services
  • an Integrated Epilepsy and Maternity Model of Care was developed in collaboration with the National Epilepsy Clinical Care Programme
  • a review of perinatal pathology services was carried out, and a network for this critical service developed across three of the maternity networks
  • the first National Maternity Bereavement Experience Survey was undertaken in September and October 2022. The survey offered women and their partners the opportunity to share their experiences of Ireland’s maternity bereavement care services
  • the roll-out of Phase Two of the Obstetric Events Support Team (OEST), enhancing learning from adverse events
  • in the context of ensuring a safe, high-quality, standardised service, NWIHP continued to place a strong focus on staff education and training. For example, in 2022, NWIHP appointed a Project Co-ordinator for the development and implementation of an antenatal education programme
  • a baseline review of Obstetric Emergency Training was completed
  • the first Annual Midwifery Conference was held on 5 May 2022. This event was a wonderful celebration of the role and importance of midwives in maternity care

Ambulatory Gynaecology Model of Care

  • in an effort to improve access to services and ensure a more sustainable gynaecology service, we are developing a network of one-stop, “see and treat” ambulatory gynaecology clinics. It is estimated that approximately 70% of general gynaecology referrals are suitable for management in the ambulatory setting
  • significant progress was made with regards to the roll-out of this Ambulatory Gynaecology Model of Care, which began in 2020. By the end of 2022, 12 ambulatory gynaecology clinics were operational
  • the thirteenth clinic opened in Kilkenny in May 2023 and development of further clinics is ongoing with the aim of having a network of 20 clinics nationally

Menopause

  • in 2022, four more specialist menopause clinics were established - in Nenagh, the Coombe, the Rotunda and Galway. These clinics deal with more complex cases that require specialist medical expertise in menopause, which cannot be dealt with at the primary care level
  • five of these clinics now in place, including the first one in the National Maternity Hospital (NMH), which opened in 2021
  • the last clinic is due to open in Cork soon, which will result in a specialist menopause clinic in each of the six maternity networks

Endometriosis

  • in 2022, NWIHP commenced the development of a National Framework for the Management of Endometriosis in Ireland, which will be rolled out in a phased basis and will be published in 2023
  • this Framework will identify how care for women in this area needs to be delivered, with this care spanning primary care to local hospital care to specialist complex care
  • investment in this area commenced over the course of 2021 and 2022 with two supra-regional complex endometriosis services in the process of being established in Tallaght and Cork. The Framework envisions the development of five endometriosis hub services, supporting these two complex endometriosis services

Model of Care for Infertility

As part of Phase One of the roll-out of the Model of Care for Infertility, 2022 saw the establishment of a fifth Regional Fertility Hub in University Hospital Galway. The sixth and final Hub will be located at Nenagh General Hospital and is due to become operational in 2023.

National Women and Infants Health Programme: Annual Report 2022

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