Wednesday 28 September 2016

Maternity safety data 'may lead to adverse publicity' - masters

EilishO'Regan

Published 17/02/2016 | 00:00

A spokeswoman for the HSE said yesterday that all 19 units will publish maternity safety statements before the end of the month and there will be no exceptions. Stock image
A spokeswoman for the HSE said yesterday that all 19 units will publish maternity safety statements before the end of the month and there will be no exceptions. Stock image

The masters of the three main Dublin maternity hospitals lodged strong objections to plans by the HSE to publish monthly information on the safety of their services, the Irish Independent has learned.

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From the end of this month, the public will, for the first time, get statistics on areas such as newborn baby deaths and Caesarean section rates in each of the country's 19 maternity units.

These include the busiest hospitals - the National Maternity Hospital (Holles Street), the Rotunda and the Coombe in Dublin.

However, the masters of the three main hospitals, including Dr Rhona Mahony, Dr Sharon Sheehan and Dr Sam Coulter-Smith, who has since finished his tenure, wrote a firm letter to the HSE in September warning about the move. They said the kind of information to be included in the monthly statements would leave the hospitals at risk of "adverse publicity and media scrutiny".

They also warned about the risks to "patient confidentiality" if hospitals are to report their data monthly and make it publicly available.

"Where the number of events reported is small, the patient may be easily recognisable," the letter stated. "The risk of data misinterpretation is also of significant concern.

"As tertiary-referral centres, the complexity of the patient cohort, of both mothers and babies, is far greater than other smaller units."

Complexity

They insisted that while there is merit in comparing units of similar size and complexity, there is little value in making comparisons with other units that do not look after complex mothers or babies, or transfer them to larger units.

The letter said the "rates of stillbirth, early neonatal deaths and late neonatal deaths will be higher in these tertiary-referral centres, as the rates of congenital anomaly, prematurity and other complications will be far greater."

The doctors stressed that "reporting bias" must therefore be considered and that they already report their data to several bodies, including the State Claims Agency.

They also produce their own individual annual reports relating to patient safety and quality of care.

One of the knock-on effects of this type of scrutiny could be an under-reporting of some negative outcomes, they said.

The doctors sought a meeting with Liam Woods, the interim national director of the HSE's acute hospitals division.

A spokeswoman for the HSE said yesterday that all 19 units would publish maternity safety statements before the end of the month and there would be no exceptions.

She said the aim was to publish the data every month.

The statement would include information on hospital activity, as well as the total number of clinical incidents reported per month.

The need for this kind of information to be made public was recommended by the Health Information and Quality Authority (Hiqa) following its investigation of Portlaoise Hospital, where a number of babies died over several years in similar circumstances.

Health Minister Leo Varadkar has already voiced his support for the monthly statements, which will also include general hospitals over time, with different sets of data.

Earlier this week, health watchdog Hiqa found patient welfare was at "high risk" in Holles Street because of poor hygiene controls and overcrowding. Vulnerable newborns in the intensive care unit are in danger of infection, Hiqa said.

The newly opened unit was designed to accommodate 36 babies, but on the day of the inspection, 46 babies were there.

Holles Street master, Dr Rhona Mahony, admitted the busiest maternity hospital in the country, with 9,000 births annually, is "not fit for purpose".

Inspectors acknowledged the hospital was built in the 19th Century and faces infrastructural problems while coping with a high number of births.

Irish Independent

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