NMH

NMH | 2024 20 Governance D uring 2024, apart from continuing to develop our core activities in maternity, gynaecology and neonatology, we continued to grow additional women's health services introduced in the past few years and also to continually strive to offer new services, all within the context of our existing site with its known infrastructural limitations. Many of our new services have been introduced with the support of National Women and Infant's Health Programme (NWIHP) and also the Dublin South East Hospital Group (DSE) and often involve additional resources, primarily staffing. In certain instances the NMH, with the support of our Executive Committee, has been the innovator in providing and investing in a new service (genetics/fetal MRI) with other Hospitals and NWIHP then recognising the need and the benefits and subsequently providing additional support. While core maternity numbers have continued a moderate decline in recent years, the cohort of patients has shown an increase in complexity due to many factors and, as in other Hospitals, there continues to be a rise in caesarean section rates. New and developing services such as fetal MRI, genetics, menopause, placenta accreta, mesh and fertility all have seen growth in numbers since their introduction. Existing departments such as dietetics, perinatal mental health and medical social work have expanded their services to offer additional supports to our patients and also see increasing referrals due to increasing complexity in the patient cohort. In 2024, there was continued expansion and investment in public fertility and very significantly, a respiratory syncytial virus (RSV) immunisation program for newborns was introduced in August and this should yield significant health benefits to these babies. The co-location to Elm Park continued to be a major focus of the Executive Management Team (EMT) and the Executive Committee. Enabling works on the site continued with further contractors appointed in 2024 for additional enabling projects to ensure the site would be "de-risked" for the main contract works. The major focus of the Project Board was the main contract tender and the re-engineering of the governance preparation for the build and commissioning phases of the project. The Design Team were focussed on preparing the full range of tender documents and these issued to the market during the summer. Tenders for main contractors were received back by year end and the sub specialist contract tenders are due back early 2025. These tenders will be evaluated by the Design Team with a report expected mid-2025.The tender evaluation and revised Business Case then go through approvals processes in the HSE and Department of Health for final approval by Government and hopefully award of contract around end of 2025. A significant development during the year was the HSE purchase of a number of buildings on the Elm Park site which will greatly assist in the decanting of some St Vincent's University Hospital (SVUH) departments to progress site works for the project. In addition, this space in Elm Park has the potential to allow NMH some additional space to deal with capacity issues in the intervening years until the new hospital is completed. Over the coming 12 months we will be liaising with DSE to determine what services might be able to utilise the space available and to determine design and fit-out. Dealing with the aging infrastructure on the Holles Street site continues to be challenging, and during 2024 significant works continued on main electrical infrastructure including new generators. This was supported by IEHG and HSE capital funding. As noted in previous years various aspects of the building continue to be problematic including lifts, heating and water systems, windows and downpipes and the lack Secretary/General Manager's Report of adequate bathroom facilities. A project for a new patient transport lift was pursued with the assistance of the Ireland East Hospital Group (now DSE) and planning permission was granted after year end. Similarly, the ambulatory gynae project (approved during 2023) finally commenced post year-end. Other significant issues to be considered in the lifetime of the current site continue to be the central decontamination unit and perinatal pathology/bereavement which had been highlighted as concerns for over four years. The continued introduction of new services and the expansion of both new and existing services continues to exacerbate the urgent demand for additional space. It is hoped that the potential use of some of the buildings on the Elm Park site might address some of these needs during the years before the new hospital is completed. Extended service periods have been introduced in a number of areas with new rosters including longer days and Saturdays which provides an overall better access to services for patients and other Hospital Departments. Virtual consultations continue to be an option offered by many Hospital Departments where appropriate. Our ICT, both infrastructure and systems, continues to be an area requiring constant updating. During 2024 the phone systems upgrade was substantially completed and work continued across our ICT and network infrastructure. This work is overall important in the context of ongoing cybersecurity and there are a number of further initiatives in development to enhance our cybersecurity and compliance when Network and Information Security 2 (NIS2), a European directive is enacted. A number of major software upgrades were initiated, including the upgrade of the Winpath lab system, radiology system, single sign-on and viewpoint.

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