NMH

NMH | 2024 23 Governance With the usual 'can do' approach, a multidisciplinary team planned and established the service for women in a respectful, compassionate manner. The Covid-19 pandemic in March 2020 was probably one of the most difficult periods we all lived through. Again as a multidisciplinary team we created a plan to provide safe and effective maternity services during the uncertainty of the first year when the virus was new and there was no vaccine available to staff. The Hospital was relying on the staff who continued to show up and care for women with dignity and respect, despite potential risks to their own safety and their families safety. Many other staff were in support functions, also worried for their safety and without the choice to work from home and protect themselves by isolating. All of the team worked with the guidelines, which were changing so often, and managed the service safely, keeping women's needs foremost and facilitating partners to be present as early as possible. Midwifery and nursing staff recruitment and retention have probably been the most important and constant focus of my twenty years in this role. This is because without a stable and committed workforce, the provision of high quality midwifery and nursing care is always going to be more challenging. Turnover rates are 12% annually and continue to be higher in the nursing and midwifery workforce due to the problems of the cost of living in Dublin, particularly the cost of accommodation or rent which is often deemed unaffordable, the cost of crèche and childcare fees. As with every hospital in Ireland we are highly reliant on overseas recruitment, particularly in the specialist areas of operating theatre and neonatology. In partnership with our academic partners, we are constantly exploring ways of increasing the numbers of midwifery and nursing students in our education programmes, in order to improve the stability of the Irish workforce and to reduce this burden of overseas recruitment. Our BSc and Higher Diploma Midwifery programmes continue to attract good numbers and we are delighted when the graduates continue on their journey to become registered midwives and part of our valued workforce. As part of our efforts to improve our workforce planning and to adopt a more strategic approach, we have invested in the Birthrate Plus Acuity App for all maternity inpatient areas, including the Labour and Birthing Unit, Antenatal and Postnatal wards. This has proven to be extremely useful in demonstrating the acuity of the service and the fluctuations in demand due to the unscheduled nature of the maternity service. We are in the process of formally evaluating the data with our UCD colleagues. The Joint Research Network (JRN) between The National Maternity Hospital (NMH) and University College Dublin (UCD) was established in 2007 to develop a research culture for midwives, student midwives and nurses. Each year we have pursued an active research agenda covering a diverse range of topics including bereavement, breastfeeding, care in labour, birth satisfaction, midwifery retention issues. This year a number of midwifery led research projects were undertaken including. • Birth Reflections Service Evaluation • Evaluation of the Midwifery care at the Fetal Medicine & Ultrasound Department • Health and Wellbeing of the Health Workforce Across Maternity Settings (MatWell) Findings from the research have been published in academic journals and presented at National and International conferences. One of the initiatives that I am extremely proud of is the Community Midwifery Service which is now in existence for 25 years. To date, this service has provided midwifery care for over 35,000 women both during pregnancy and post-birth. The Domino and Homebirth Service have cared for over 10,000 women throughout pregnancy, labour and into the postnatal period and over 800 homebirths have been facilitated. In April we welcomed Mrs. Sabina Higgins, wife of the current President of Ireland, Michael D. Higgins and Minister for Health Mr Stephen Donnelly as our special guests of honour, to mark 25 years of the service in Kilruddery House in Co. Wicklow. Representation from the service users and Hospital staff and community partners who have supported the service over the last twenty five years along with current and previous midwives who had worked on the team, celebrated this momentous occasion. In November we had a wonderful celebration of Neonatal World Prematurity Day where our team invited many families of premature babies who received care by our neonatal staff. It was a great celebration for the parents who have had the difficult journey of caring for a premature or sick baby and a joyful occasion for families and staff to celebrate the successes and witness these children growing and thriving. During my years as Director of Midwifery and Nursing, the area of Women's Health has received very significant investment, allowing a great deal of expansion in all the subspecialist areas including Colposcopy, Fertility treatment, Complex Menopause clinic and Gynaecology. In September 2024, following a HSE National Screening Service quality assurance audit, the NMH Colposcopy Service was recognised as one of the largest and highest-performing colposcopy units in Ireland. The team were commended for their strong commitment to audit, quality improvement and education. As with the wider hospital, infrastructural challenges in service delivery and the

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