In January 2017, the National Women and Infants Health Programme (NWIHP) was established in the HSE to lead the management, organisation and delivery of maternity, gynaecology and neonatal services, strengthening such services by bringing together work that was being undertaken across primary, community and acute care. In addition, the Programme was mandated to drive and lead the implementation of the National Maternity Strategy.
The NWIHP therefore provides strategic direction and leadership, drives improvement, and fosters a learning culture in maternity, neonatal and gynaecological services. The Programme also aims to ensure that learning from adverse incidents is disseminated and applied in a comprehensive and consistent manner, promoting a national approach to consistent, evidenced-based practice in maternity care. The Programme has identified the development of key performance indicators in the areas of maternity and gynaecology services as a priority for 2021.
The Programme is intended to act as the single central authority on maternity care and as a reference point and resource for women’s health issues within the HSE. The Programme is also tasked with the appropriate allocation and effective, specific targeting of all new development funding for maternity, neonatal and gynaecological services.
In relation to the actions being taken regarding maternal mental health, the Specialist Perinatal Mental Health Service Model of Care was launched by the HSE in November 2017 and is currently being implemented. The new model of care addresses the seven key actions identified in the National Maternity Strategy, including developing and delivering access to appropriate care, early identification and a multidisciplinary approach by skilled professionals, including standardised access to perinatal psychiatry and psychology.
Specialist Perinatal Mental Health Services are aligned to the six maternity networks and, in that context, are being developed in a hub and spoke model. Funding of some €3.6m was provided in recent years for the six Specialist Perinatal Mental Health hub teams at the Rotunda Hospital; National Maternity Hospital; Coombe Women & Infants University Hospital; Cork University Maternity Hospital; University of Limerick Maternity Hospital; and University Hospital Galway. While some gaps in staffing remain, all of the hub sites are now in operation. On average, eight to nine multidisciplinary staff provide services at each site.
Along with six hub teams, there are 13 spoke sites in the other maternity units. An integral component of the Specialist Perinatal Mental Health Service Model of Care is the deployment of a mental health midwife to each of the 13 maternity spoke sites. The mental health midwife augments the liaison psychiatry services and their focus is on women with mild to moderate mental health problems throughout the perinatal period. An equally important aspect is to educate all midwives, public health and practice nurses on the need to ask women about their mental, as well as their physical health. 11 of the 13 spoke mental health midwives are now in place and the recruitment process is in train for the two remaining sites.