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Remit of new HSE obstetric incidents team questioned

By Catherine Reilly - 12th Sep 2022

obstetric

Concerns about the role of the HSE’s new obstetric event support team (OEST) have been raised at the Rotunda Hospital’s board, the Medical Independent (MI) has learned. 

At a meeting in May, misgivings were expressed about “management and governance of clinical risk reviews undertaken in voluntary hospitals by an external review team (OEST)”. The issue arose during a discussion on a report from the quality, safety, and risk committee. 

According to minutes, Master Prof Fergal Malone referred to the “potential impact” on the hospital’s current internal clinical risk processes and “external” reporting of reviews shared with the serious incident management forum in RCSI Hospitals. 

“The Rotunda’s own internal robust risk management system was outlined. The board is the named legal entity in any legal issues that arise. Ceding of the hospital’s risk management system to an external agency will erode independence of voluntary hospitals. Prof [Michael] Geary concurred with the Master,” according to meeting minutes seen by MI

The role of the OEST had been raised with the HSE by the joint standing committee of the three Dublin maternity hospitals, it is understood. 

A Rotunda spokesperson said queries regarding the OEST “would be best directed” to the HSE National Women and Infants Health Programme (NWIHP). 

 A HSE spokesperson said the OEST “is a venture by the NWIHP, which looks at adverse events in maternity services with a focus on learning”. The OEST consists of an obstetrician, midwife, and quality and safety manager. 

“By engaging with maternity services immediately following the occurrence of an adverse event, the OEST can offer another set of eyes and make recommendations to the maternity team on areas of focus for the review. Additionally, by engaging with the sites the OEST can offer peer support and counsel to colleagues on the frontline,” stated the spokesperson. 

According to the HSE, the OEST does not commission or undertake any reviews and does not engage with the review team. A key objective of the OEST approach is to “reduce avoidable events by learning from previous reviews with similar causal factors”. 

Currently, the OEST engages with a site when one of four incidents occurs: Maternal death; intrapartum foetal death; early neonatal death; and babies requiring therapeutic hypothermia. 

The latter three incidents apply to term babies with no life-limiting conditions.

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