A new model of care for neonatology will form the foundation upon which all condition-specific pathways, including those for children with hypoxic-ischaemic encephalopathy (HIE), can be delivered effectively, a spokesperson for the HSE told the Medical Independent (MI).
Speaking to MI at the recent IHCA Annual Conference, Dr Rhona Mahony, Consultant Obstetrician and Gynaecologist, said she “would love to see a national clinical pathway” for the care of children with HIE.
Dr Mahony, who was the Chair of the interdepartmental working group on the rising cost of health-related claims, said “it would be brilliant to have a standardised pathway, because… we will develop evidence-based care and we will have easier access for that care”.
She said that, currently, a large proportion of HIE care “is ad-hoc… people are going to private providers… new therapies are coming on board that are super expensive”.
“So, we really need to give people the best possible care and that means growing our experience, evidence, and the multidisciplinary teams that are needed to provide the care.”
A HSE spokesperson told MI it was important to acknowledge that HIE has a profound and often lifelong impact on both babies and their families.
“Admission to neonatal intensive care also places a significant emotional and psychological strain on parents, siblings, and the wider family network,” said the spokesperson.
National reports highlight that while some infants make good recoveries, others may face long-term neurological impairment or, in some cases, death.
“Given these serious and enduring consequences, the HSE recognises that a robust model of care and clearly defined clinical pathways are essential, not only to achieve the best possible medical outcomes, but also to provide comprehensive emotional and practical support for affected families.”
The spokesperson said that as part of the National Clinical Programme for Neonatology, work is currently underway on developing a new overarching model of care for the specialty.
“This model of care will form the structural foundation upon which all condition-specific pathways, including those for HIE, can operate effectively.”
According to the spokesperson, it will define how neonatal services should be organised, staffed, and governed, with a view to ensuring that the necessary expertise, equipment, and referral systems are consistently available across the country.
“For infants with HIE, this includes having appropriately trained neonatal teams, sufficient intensive care capacity, and established transport and referral arrangements to enable timely initiation of therapeutic hypothermia and access to specialist care.”
The model of care will also provide the framework for national governance, data collection, and audit, supporting continuous quality improvement and accountability.
The spokesperson said that, as noted in the Report of the Interdepartmental Working Group on the Rising Cost of Health-Related Claims Implementation Plan, the model of care for neonatology is due to be completed in 2026.
Specific pathways for babies affected by HIE will then be developed with input from relevant policymakers and clinical personnel.
“The overarching ambition is that these pathways will provide a seamless continuum of care, beginning at birth and extending throughout life,” the spokesperson stated.
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