Latest news with #neonatalcare
Irish Times
09-07-2025
- Health
- Irish Times
Portiuncula review: How can the same issues occur at the same hospital again?
In 2018, a publication, known as the Walker report, highlighted significant issues with maternity services at Portiuncula hospital – particularly around governance, communication, the presence of consultants and training and reliance on locum consultants. Seven years later, the public would be forgiven for wondering if this is Groundhog Day, as another review at the Ballinasloe hospital highlights strikingly familiar concerns. 'Unfortunately, although changes were made following the 2018 review, many of the same scenarios have been identified by this 2024 review process,' a review summary noted. On Wednesday, the Health Service Executive published a summary report of five external reviews into the care provided to women and their babies at the Ballinasloe hospital. READ MORE The reviews were commissioned after five cases of neonatal encephalopathy (NE) requiring therapeutic hypothermia (known as neonatal cooling) were identified in a close time period. NE is an impairment of neurological function. [ Maternity services across Ireland should be reviewed, expert group urges following Portiuncula report Opens in new window ] Adding to this, a further five reviews are under way, while two more reviews are due to begin imminently. In the summary, the review team laid out four common themes of concern: communication, governance, clinical care, leadership and clinical governance and infrastructure. For anyone who consistently follows health news, the terms will be familiar. Time and time again, they are touted as the reason why things go wrong in our health service. But how can the same issues occur at the same hospital again? Steps were taken to improve things. One of the recommendations in the 2018 report was to improve clinical governance. Consequently, the responsibility for maternity services was given to a new clinical director from the hospital group. Wednesday's report notes, however, that while this might have seemed a 'positive move', the position has no executive oversight, no regulatory or budgetary control and their role is 'purely oversight and advisory'. 'There have been a number of changes in recent years to the governance structures of HSE hospitals from health boards to hospital groups to regional groups,' the report said. 'The further the distance between the key decision makers and the clinical coalface, the more likely it is that decisions will be significantly delayed and based more on financial merit than clinical need.' As such, the review team has recommended that clinicians take up leadership roles, and reliance on locum consultants is reduced. The review team also noted the two communication systems in place, which they said should be simplified to make it more efficient and to reduce the 'clinical risks'. Furthermore, the report said there were situations in which staff were unable to contact the consultant on call due to mobile phone coverage problems. 'This is not a safe or satisfactory arrangement and needs to be resolved as a matter of urgency,' the report added. [ What is HIE? The condition affecting newborns has led to reviews in Portiuncula hospital Opens in new window ] The hospital's maternity unit is small, delivering 1,400 babies annually. Consequently, the review team cited difficulty in its ability to provide the 'full range' of maternity and newborn services and to attract permanent staff members. 'It is operationally challenging and there are significant clinical risks in providing maternity services in this way,' it said. In conclusion, it found 'the current situation does not meet the expectations of parents, increases clinical risk, and is no longer sustainable'. That statement is stark, but the more alarming finding is the review team stating the issues arising in the report are ones that 'could plausibly arise in other similar sized maternity units'. As such, the team 'strongly recommends' that there is an opportunity to review the way maternity services are delivered across the State. Such a finding will do little to reassure expectant parents of the safety of the maternity system. If anything, it will leave them with more questions than they had before.
Irish Times
09-07-2025
- Health
- Irish Times
‘Higher risk' pregnancy antenatal care to be moved from Portiuncula hospital
Expectant mothers whose pregnancies are defined as being 'higher risk' are to have their antenatal care moved from Portiuncula University Hospital to other locations. Earlier this year, the HSE announced 10 reviews were taking place into the care given to women and babies at the hospital in Ballinasloe, Co Galway. The investigations were initiated after six babies delivered in 2024 and one in 2025 had hypoxic-ischemic encephalopathy (HIE) – a reduction in the supply of blood or oxygen to a baby's brain before, during or after birth. Six of these babies were referred for neonatal therapeutic hypothermia known as neonatal cooling. READ MORE In addition, two stillbirths occurred at the hospital in 2023 and the circumstances were also being reviewed externally. In light of the concerns highlighted in the review, it is understood pregnant woman who are deemed to be 'higher risk' will have their care moved elsewhere. The definition of a high-risk pregnancy is not clear cut, but often includes mothers who are older, have gestational diabetes, those with a high BMI and women who had caesarians in previous pregnancies. However, this will be subject to a decision by treating clinicians. It is understood a summary of the reviews carried out at the hospital this year will be published imminently. A previous inquiry into maternity services at the hospital was established in early 2015 with James Walker, professor of obstetrics at the University of Leeds, appointed to head it. The findings of the Walker report, published in May 2018, identified multiple serious failures including staffing issues, a lack of training and poor communication among maternity staff, which contributed to the death of three babies. Of the 18 births examined, six involved either still births or the death of the baby shortly after delivery.
BBC News
07-07-2025
- Health
- BBC News
Baby simulator is a 'gamechanger' for Norfolk hospital training
A manikin of a new-born baby is helping hospital staff prepare for a wide range of medical the SimBaby, it is in use at the Queen Elizabeth Hospital (QEH) in King's Lynn, in the maternity, neonatal and paediatric departments will use the doll to practise life-saving procedures in a realistic £60,000 manikin, which can simulate a range of medical conditions, has been paid for by the hospital's charity. Helen Muncey, head of education at the QEH, said it would help provide safer care for the hospital's "tiniest patients"."This generous investment from the QEH Charity is a gamechanger for our neonatal and paediatric training," she said."This simulation manikin will allow us to deliver cutting-edge, hands-on education that mirrors real-life clinical situations."Until now, the hospital's simulation school has been largely focused on the treatment of adult patients. Pippa Street, chief nurse at the QEH, said: "The neonatal and paediatric stages in life are critical and vulnerable times for babies and their families. "These simulators allow our teams to refine their skills and work collaboratively in high-pressure scenarios – ultimately helping to save lives and improve outcomes." Follow Norfolk news on BBC Sounds, Facebook, Instagram and X.
BBC News
06-07-2025
- Health
- BBC News
Yr Wyddfa hike raises £21k for Worcestershire hospital trust charity
More than £21,000 has been raised for a hospital trust thanks to a charity hike in what organisers described as tough challenge saw 58 people climb to the summit of Yr Wyddfa, Wales' tallest mountain, in the dark - facing torrential rain and 50mph raised will go to the Worcestershire Acute Hospitals Charity, towards improving care and experiences for patients in the area."My beautiful boy came into the world tiny and fragile," said Paige Cheshire, who climbed with her family to give back to the neonatal unit at Worcestershire Royal hospital, after her son was born at 30 weeks. "What followed was an emotional 47-day stay in the neonatal unit – intubation, sepsis and a cerebral palsy diagnosis."But throughout it all, the neonatal team stood by us with expertise, compassion, and unwavering support - they saved my boy and held me up when I needed strength the most." Husband and wife, Andy and Heather Asbury, climbed in the June trek to raise money for one of the charity's specialist funds - The Children of Worcestershire and Herefordshire Cancer is a cause close to their home because they said the group supported their son Josh during his walked along with Dawn Forbes, a children's cancer specialist nurse with the NHS trust."Without the support of Dawn and the charity, Josh's hospital journey would have been very different," said Mr Asbury."From little things like fresh fruit vouchers for the fruit stall outside the hospital to bigger things like Halloween parties, they helped us to make memories and to feel more comfortable during our hospital stays. "Even now, they're still there for us after Josh rang his end-of-treatment bell." Members of the trust's children's emergency department team also made the climb, raising money to buy toys and therapeutic resources - with the aim of helping young patients feel more at ease during visits."This support reduces anxiety and helps both children and their families feel more relaxed during their time with us," said Natalya Moore, from the trust. Follow BBC Hereford & Worcester on BBC Sounds, Facebook, X and Instagram.
Irish Times
02-07-2025
- Health
- Irish Times
Court hears nurse raised concerns that flow of oxygen at low level for first 11 minutes of baby's life
A nurse who was involved in the resuscitation of a baby who died five days later has said she was 'extremely concerned' after finding that oxygen flow through respiratory equipment used was initially at a low level. A sitting of Dublin District Coroner's Court heard on Wednesday that nurse Elaine Sheehy raised concerns that the flow of oxygen was at a low level for the first 11 minutes of Aaron Cullen's life. Ms Sheehy, who resigned from her post at the Midland Regional Hospital Portlaoise in October 2016 and took up a post elsewhere, was on duty at the Special Care Baby Unit when she was asked to urgently attend resuscitation efforts. Aaron had been born by emergency Caesarean section on May 4th, 2016, at 35 weeks gestation. The inquest heard he was 'extraordinarily' unwell after his birth and was 'gasping' for breath, witnesses said. READ MORE He suffered from severe persistent pulmonary hypertension, a condition in which a baby fails to transition from antenatal circulation. Two attempts to intubate him after birth by a paediatric registrar were unsuccessful. Between attempts, a Neopuff resuscitator was used in an effort to pump his lungs. Aaron was 11 minutes old by the time Ms Sheehy arrived, she said, recalling the mask being used to ventilate him being too large, as it was for full-term babies. It was then switched to a preterm mask, which was readily available in the room, to ensure an airtight seal so no gas could escape. Ms Sheehy further recalled being 'extremely upset and concerned' at the fact that she had to increase the oxygen flow of the Neopuff used during resuscitation. Although she could not be certain, she said she either had to turn on the flow of gas providing oxygen entirely or she at least needed to it turn up to recommended levels. Ms Sheehy, who became visibly upset while giving evidence, said she found the fact that she had to adjust the flow 'very upsetting'. While Prof Colm O'Donnell, a consultant neonatologist and expert witness who reviewed the case for the coroner, said he could not definitively say whether or not the Neopuff gas flow was turned on, it was his opinion that it was. He cited several staff being in attendance before Ms Sheehy arrived, saying they reported checking the equipment before Aaron's delivery. He also noted that although Aaron did not breathe spontaneously, his heart rate increased from less than 60bpm to over 100bpm, which indicated the machine had some effect. Prof O'Donnell said Aaron's lungs were 'very poorly compliant', adding that it would have been 'extremely difficult' to aerate his lungs during mask ventilation as opposed to intubation, which the inquest heard was not achieved until 21 minutes after his birth. While sooner intubation would have allowed for an immediate and better supply of oxygen, he did not believe this, or a proper fitting mask from the beginning, would have changed the outcome. Ms Sheehy disclosed concerns to the hospital's interim director of midwifery, Maureen Revilles, after learning of Aaron's death, which took place at the Coombe hospital on May 9th. Ms Revilles, who said she expected Ms Sheehy to be a witness at Aaron's initial inquest due to the disclosure, insisted that she said she had to turn on the machine. This was later 'revised' to her having to turn up the flow, she said. Evidence concerning Ms Sheehy's concerns was not made available to coroner Dr Myra Cullinane at the time of the original inquest, which returned a narrative verdict. The evidence was secured by his mother, Claire Cullen, through Freedom of Information requests, prompting a fresh inquiry. An inquest verdict is due to be returned on Thursday.
