Parents whose children were centre of concern in CHI internal review not informed, summary reveals
The revelation emerged in a summary of the findings of an internal CHI report into the handling of extra clinics, paid for by the National Treatment Purchase Fund (NTPF) to reduce waiting lists.
It said the review found that patients seen in the outpatient clinic who required ongoing treatment were placed on an already long inpatient waiting list without consideration of redistribution of patients to colleagues with a shorter waiting list.
'The examination raised the issue as to the possibility that this could have led to any negative outcomes for patients,' it said.
However, the summary, which also includes follow-up actions, said an examination of the relevant inpatient waiting list later took place and patients were re-distributed across the department to ensure equitable access to treatment.
'This action was closed out in September 2022.'
It said 'open disclosure' – informing parents about the concerns raised in the report – was not carried out 'as there is no significant scientific evidence that delaying treatment will equate to patient harm in this patient cohort'.
CHI, which has declined to publish the full report for legal reasons, said it was an internal examination commissioned by the CHI Executive. The hospital involved has been previously identified as Crumlin Hospital by CHI chief Lucy Nugent.
During meetings (2020/2021) between employees in this clinical department and members of the CHI Executive, it became evident that multiple legacy and deep-rooted issues existed that regular meetings could not address, it added.
It became clear that a more robust process was required to identify the issues that needed to be addressed
'In early 2021, an operational lead was assigned to look into these issues. However, it became clear that a more robust process was required to identify the issues that needed to be addressed.'
It led to the examination taking four months.
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It said that a number of issues were raised in relation to an NTPF outpatient waiting list initiative.
The NTPF funds hospitals to carry out extra clinics and procedures.
The examination suggested that based on the documentation review, certain NTPF-funded clinics did not adhere to NTPF standards of chronological scheduling – seeing the longest-waiting patients first.
Data suggested that some of these patients could have been seen by other departmental colleagues within the existing day-to-day service and potentially managed in a more proactive way.
'Patients seen in the outpatient clinic who required ongoing treatment were placed on an already long inpatient waiting list without consideration of redistribution of patients to colleagues with a shorter waiting list. The examination raised the issue as to the possibility that this could have led to any negative outcomes for patients,' it said.
'The above raised concerns relating to the prudent and beneficial management of NTPF funding and lack of oversight of access initiatives.'
It found that interpersonal difficulties among team members led to poor working relationships and a challenging working environment.
There was a high attrition rate among support staff due to bullying issues.
A significant risk was identified where only one employee managed the needs of a complex tertiary speciality. This level of dependency on one individual for a critical service is not in line with best practice and created a vulnerability in this specialty.
The report also sets out a series of actions that were taken on foot of the report.
'A cross-city CHI Central Referral's Office was established. This system manages referrals centrally to ensure equitable distribution. Efficiencies have been gained, and this process is being rolled out across all CHI specialties,' it said.
CHI now has a robust process for NTPF-funded waiting-list initiatives
'CHI now has a robust process for NTPF-funded waiting-list initiatives which requires multiple internal stakeholder approvals both clinical and financial. CHI is regularly audited by the NTPF.'
It added: 'A review of all CHI Hospital sites leadership roles and responsibilities was commenced to provide clarity around delineation of accountability at site and executive level – this work has continued as the transformation programme has evolved in preparation for the move to the new children's hospital.'
The original report stated that a negative culture can impact service delivery, department dynamics and staff experience and has the potential to put patients at risk.
It said that CHI is a learning organisation and service improvements through internal reviews and clinical audits, which are an essential tool to support this, will continue to be a priority.
'CHI recognises the importance of transparency and the interests of the broader public in relation to the issues identified in the report,' it said.
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Irish Times
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Sheridan found the experience so beneficial that she decided to retrain as a counsellor: 'I wrote my thesis about the disenfranchised grief many feel after miscarriage. People don't always recognise the profound loss involved and how women and couples need that loss to be acknowledged.' Acknowledging that loss is what the IFPA's new counselling service plans to do. 'It's difficult to say what the demand will be, but we do know that one in four women experiences miscarriage and our team of eight counsellors will be there to support them,' says O'Brien. 'All of us are accredited by the Irish Association for Counselling and Psychotherapy or the Irish Association for Humanistic and Integrative Psychotherapy and have decades of experience. Women and couples will be able to choose between in-person counselling at six centres throughout Ireland or sessions over the phone or Zoom.' These sessions will aim to validate people's bereavement. 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Click here to read our National Women's Health Survey. The Irish Examiner Women's Health Survey 2025 Ipsos B&A designed and implemented a research project for the Irish Examiner involving a nationally representative sample of n=1,078 women over the age of 16 years. The study was undertaken online with fieldwork conducted between April 30 and May 15, 2025. The sample was quota controlled by age, socio-economic class, region and area of residence to reflect the known profile of women in Ireland based on the census of population and industry agreed guidelines. Ipsos B&A has strict quality control measures in place to ensure robust and reliable findings; results based on the full sample carry a margin of error of +/-2.8%. In other words, if the research was repeated identically results would be expected to lie within this range on 19 occasions out of 20. A variety of aspects were assessed in relation to women's health including fertility, birth, menopause, mental health, health behaviour, and alcohol consumption.
Irish Examiner
2 days ago
- Irish Examiner
Miscarriage: It can be really hard when you don't know what to expect
The vast majority of women who suffer a miscarriage in Ireland feel unsupported by doctors, and have criticised a lack of counselling around such trauma. Only a third of women feel their GPs provide enough support in the aftermath of miscarriage, with family and friends picking up the slack in two thirds of cases. Similarly, just a third believe support from healthcare professionals to be good. The Irish Examiner National Women's Health Survey, conducted by Ipsos B&A, found that one in four women experience miscarriage. Among women who have experienced fertility issues, the figure rises to almost 50%. In the survey of 1,000 women in Ireland, aftercare support receives the loudest criticism. Six in 10 women said the availability of supports such as counselling is lacking. A similar number reports that follow-up from healthcare providers is insufficient. Jennifer Duggan, chairperson of the Miscarriage Association of Ireland, said the findings align with the organisation's experience: 'They, unfortunately, tally with what we hear ourselves from women we speak to." Almost half criticised the quality of information provided by healthcare professionals, citing it as poor or very poor. 'It can be really hard when you don't know what to expect. "You might be told that you may bleed heavily, but you don't know how heavy is too heavy, or how painful is too painful," said Ms Duggan. It can be really scary and frightening to go through that with little to no information. Naomi Collins, 45, from Galway, had her first miscarriage when she was 10 weeks pregnant. At the hospital, she was told that the spotting would progress to miscarriage and that she should go home and wait for it to happen. 'That was the extent of the help I got in the hospital, and nobody checked up on me after that. That was disappointing,' she said. 'The overwhelming feeling was that I felt hollow." Naomi Collins from Corrandulla, Co Galway, miscarried at 10 weeks. Picture: Ray Ryan Given that one in four women miscarry, she said: "There are an awful lot of people who are not aware whatsoever that the woman sitting next to them at work has had a miscarriage, the woman next to you on the bus has had a miscarriage." Some green shoots are emerging in follow-up care. The Irish Family Planning Association (IFPA) announced earlier this month that it is expanding its counselling service to include women and couples who experience recurrent pregnancy loss. The HSE-funded pilot project is available to anyone who has two or more miscarriages in a row, offering up to eight free counselling sessions. "The grief that accompanies miscarriage is real and deeply felt," says the IFPA's counselling director, Clare O'Brien. We don't want anyone to feel isolated and alone. We want them to know they can speak to us about their loss, fear and frustrations without judgment — and with total confidentiality and support. In April, University College Cork's Pregnancy Loss Research Group (PLRG) made a series of resources available to women who experience miscarriage. The resources include accessible booklets that answer questions such as what happens next and what supports are available, and provide details of other women's lived experiences. In response to the survey's findings on miscarriage, Professor Keelin O'Donoghue, PLRG lead and obstetrician at Cork University Maternity Hospital, said: "Pregnancy loss is a common life experience for many women. "Everybody will experience it differently and will have different needs in their care and support after it happens. "The awareness of what is needed and why this is important is improving, but slowly, and there is much more work to be done across society, policy, health services, and communities with regard to pregnancy loss care and supports more generally." Resources are available on the Pregnancy Loss website —
