CREATING A BETTER FUTURE TOGETHER

1 CREATINGA BETTER FUTURE TOGETHERN ational maternity Strategy2016-2026 CREATINGA BETTER FUTURE TOGETHERN ational maternity Strategy2016-20262 CREATING A BETTER FUTURE TOGETHER : NATIONAL maternity STRATEGY 2016 2026 MINISTER S FOREWORDI fully endorse this Strategy and it was my privilege to present it to Government for approval. The document maps out how we can improve maternity and neonatal care in the years ahead ensuring that it is safe, standardised, of high-quality and offers a BETTER experience and more choice to women, families and fathers. I particularly support the focus on health and wellbeing throughout.

2 As Minister and as a TD, I will advocate for it and will work for its full implementation. In fact, we ve already want to thank all of those who contributed to the Strategy s development, in particular the Chair and members of the Steering VaradkarMinister for Health 3 CHAIR S FOREWORDCHAIR S FOREWORD It is with great pleasure that I present the country s first National maternity Strategy to the Minister for Health, Leo Varadkar TD. The maternity Strategy Steering Group was given the onerous task of designing a new maternity service that facilitates choice, yet has all the necessary safety assurances.

3 The Group worked tirelessly to deliver this Strategy and in so doing have worked TOGETHER to design a model of care based on the principle that childbirth is a natural, physiological process. At the same time, the Strategy recognises that some women have higher care needs and our services must be responsive and capable of ensuring that the increased need is identified quickly and appropriate care provided. One model of care is proposed, with three separate care pathways. Women should be offered choice regarding their preferred pathway of care , in line with their clinical needs and best practice.

4 Insofar as possible, all care pathways should support the normalisation of pregnancy and birth and women should be encouraged, and supported, to make their individual experience as positive as possible. At the centre of this Strategy is the mother. We have therefore avoided, as far as possible, profession-centric terms such as consultant led and midwifery led , as they incorrectly place an emphasis on the profession. In FUTURE , maternity care in Ireland will be provided in an integrated manner, by a multidisciplinary team, with women seeing the most appropriate professional, based on need.

5 As a mother and a grandmother, I feel privileged to have been given the opportunity to chair this Steering Group, and to help shape the FUTURE of our maternity services. On a personal note I want to thank the members of the Steering Group who were so highly motivated and gave unstintingly of their time, their expertise and their experience. My thanks too go to the Secretariat for all their support, dedication and extraordinary hard work over the last few months. Finally, and most particularly, I would like to acknowledge the considerable input to this Strategy of Roisin Molloy and Shauna Keyes, two mothers who have experienced both joy and heartache within our maternity services.

6 Their presence on the Group served to ground us in reality, and I thank them for that. Savita Halappanavar was also ever present with us in our thoughts and we hope that the outcome of our work will be of some comfort to her husband and I present this Strategy, I ask the Government to commit to investing further in maternity services in the coming years; I ask the National Women & Infants Health Programme to implement this Strategy with passion and to reorganise services on the lines proposed as a priority, and lastly I ask the maternity workforce to take ownership of the Strategy and to work TOGETHER , in partnership across professions and with families, to deliver a new, BETTER and safer maternity service.

7 Sylda LangfordChairCREATING A BETTER FUTURE TOGETHER : NATIONAL maternity STRATEGY 2016 20264 EXECUTIVE SUMMARY1. Irish maternity services are good and compare well with those in other countries in terms of safety and patient outcomes. Much has been done to improve services in recent years. We have more consultant obstetricians and staff midwives than ever before and there has been considerable investment in new buildings, equipment and units. This will continue with the Government decision to re-locate the four standalone maternity hospitals in Dublin and Limerick to new state-of-the-art hospitals on the campuses of adult teaching hospitals.

8 The new National Women & Infants Health Programme will provide improved oversight and governance of maternity services, raising quality and standardising In recent years, several reports and reviews have highlighted significant service deficits and failings which have undermined confidence in our maternity services and staff morale. There is a lack of choice for expectant mothers, inadequate emphasis on general health and wellbeing, ageing infrastructure, poor staffing ratios by international standards and geographic variation in The commitment to develop this Strategy arises from the report, Investigation into the safety, quality and standards of services provided by the Health Service Executive to patients, including pregnant women, at risk of clinical deterioration, including those provided in University Hospital Galway, and as reflected in the care and treatment provided to Savita Halappanavar.

9 That report recommended that a strategy be developed to implement standard, consistent models for the delivery of a national maternity service that reflects best available evidence , to ensure that all pregnant women have appropriate and informed choices, and access to the right level of care and This Strategy is intended to provide the framework for a new and BETTER maternity service. The Strategy is focused on, and responsive to, women and their individual needs. It seeks to rebuild and restore confidence in our services by making them as safe as possible. The Strategy, recognising that for all women, the transition to motherhood is an event of a huge social and emotional significance, seeks to create a partnership approach to service delivery.

10 5. This Strategy is informed by a review of national and international literature on models of care across selected jurisdictions and a public consultation. Both reports are being published along with this The vision for maternity services, articulated in this Strategy, is an Ireland where: Women and babies have access to safe, high quality care in a setting that is most appropriate to their needs; women and families are placed at the centre of all services, and are treated with dignity, respect and compassion; parents are supported before, during and after pregnancy to allow them give their child the best possible start in life.