Future of Cavan Midwifery Led Unit Secure

New operational protocol on transferring expectant mothers

The Maternity Led Unit (MLU) at Cavan General is to be retained and even extended into the future, as per recommendations contained in recent review of maternity services at the local hospital.

A new operational protocol, which requires signining-off before an expectant mother can be transferred out of the MLU in future for non-emergency reasons, is also set to be implemented.

Delivery of the three-page seven-point report, committed to by then minister for health Simon Harris in June last year, was overseen by CEO of the RCSI Hospital Group, Ian Carter, and chaired by Fergal Malone, Master at the Rotunda Hospital, and RCSI Group Clinical Director for Women and Infants.

It was completed with insight from other working group members including an Obstetrician at CGH and midwives internal and external to the MLU.

An “initial assessment” signed off towards the end of last year recommended the MLU service be expanded, and even bolstered with additional expertise.

That has now happened, following the appointment of Dr Seán Daly, former Master of the Coombe Hospital in Dublin. A specialist in foetal medicine, he has taken up the role of Associate Clinical Director at two half-days per week, and will oversee the transition to a more encompassing MLU strategy.

The position is in addition to the National Women and Infants Health Programme's funded Advanced Midwifery Practitioner.

The MLU in Cavan is one of only two in the country- alongside Drogheda. The recommendations in the report its hoped will bring the service in line with its more successful sister facility in Louth.

The changes arise out of the suprise announcement less than 12-months ago that MLU services at CGH would be subsumed under a new consultant-led model of care.

The decision to merge services was initially recommended from within the RCSI Group.

No new cases were to be admitted from June 1. But within days, following public outcry, the proposal was halted, and a committment given to review maternity services at CGH in line with the National Maternity Strategy (NMS).

Key findings of that review include the MLU at CGH will remain fully operational, with no restriction on eligible women accessing the service.

GP's have now been contacted to outline clearly the pathway's for referral, including in the event of transfer or evaluation with a Consultant being required.

Going forward a joint care pathway for entry will be reviewed by Our Lady of Lourdes in Drogheda and CGH, under the leadership of both Directors of Midwifery.

A joint MLU meeting forum will re-establish, to discuss care pathways between both MLUs, and community midwifery pathways at the Rotunda, while a new operational protocol will be implemented.

This will require discussion between the lead midwife and either the local lead obstetrician or the Associate Clinical Director for Maternity and Newborn services before any non-emergency transfer is actioned.

A virtual meeting took place last week between all revelant parties including MLU and consulants at CGH, as well as hospital and RSCI management.

The INMO welcomed the publication of the recommendations, but stated implementation must be carried out within a planned timeframe.

The union is now requesting an urgent meeting with the RCSI hospital group to progress the plan. Funding of €12 million has been allocated this years, and INMO Industrial Relations Executive in the North East region, Karen Clarke said: “We welcome the assurances around the future of the unit at CGH, and the recommendations to develop the service.

“Maintaining and expanding midwifery led services is not only a pillar of the National Maternity Strategy, it is key to ensuring quality care and true choice for women.”

Fianna Fail's Niamh Smyth meanwhile stated that the MLU plays a vital role in the lives of expectant mothers across the region. “Having the Unit based at Cavan General saves so many women from travelling long distances over the course of their pregnancy,” she said.

The commitment to retaining the MLU was also welcomed by her party colleague Brendan Smith.

A spokesperson for the Department for Health commented that the report from the RCSI Hospital Group in relation to the MLU at CGH is “currently being examined”.

They added: “It is noted that the report confirms that the Unit remains fully operational and there is no restriction on eligible women accessing the service.”