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21 Governance Rep ts NMH Annual Rep t | 2020 A t the beginning of the year, we couldn't possibly have envisaged how significant an impact COVID-19 would have on our world, at a personal and professional level. In early March as part of the NMH COVID-19 taskforce we had to adopt a very proactive approach to ensure the safety of all our patients, women and babies from infection and to ensure the safe delivery of our services. Designated care pathways were essential for women and babies who had been exposed to the virus and also required maternity, gynaecology or neonatal care. We also had and continue to have a duty of care to our staff, to provide a safe working environment and to reduce any unnecessary exposure to COVID-19. Reams of newly updated guidelines on infection control measures were being sent from HSE weekly and treatment algorithms were updated almost daily in the first weeks of the pandemic. The imposition of visitor restrictions in maternity hospitals added to anxiety levels for most women but was crucial in order to limit footfall and reduce any potential spread of infection amongst staff, patients or visitors. However, at all times discretion was exercised when there were particular circumstances for individual cases such as bereavement or fetal anomalies. These limitations were relaxed in June and have been under constant weekly review. Gynaecology services resumed in July, with a multidisciplinary gynae services group reviewing best practice in relation to managing waiting lists and clinic restructuring, setting up a Pre- Assessment Clinic, improving the Operating Theatre infrastructure and ambulatory gynaecology services, with many of these changes being led and implemented by my nursing manager colleagues. Direct of Midwifery and Nursing Rep t Mary Brosnan, Director of Midwifery & Nursing.