The HSE needs to establish a formal framework to respond to disclaimer forms in relation to identified risk to patient care, the Letterkenny Branch demanded.

Proposing the motion, Mary Gallagher from the Letterkenny Branch said when nurses or midwives submit disclaimer forms they are frequently lost or not accepted by management. A disclaimer form is required to legally protect staff where they have identified failings in the system, whether due to lack of staff, poor skill mix on the ward etc.

While agreeing with the sentiment that ‘we will collectively do better every day’ in the letter from Tony O’Brien, HSE director general, to all staff after the investigation into deaths at Portlaoise Hospital, Ms Gallagher said she wished to respond to the implication that staff were not doing their best and that we can do better with less.

“It is simply not possible to provide better care, better outcomes, with less and less staffing resources and at its crux there is a failure by the HSE to acknowledge this,” she said. “We are calling on the HSE to establish a framework for dealing with these forms when they are submitted. They may then finally recognise the extent of the staffing resource issue and that only when these are addressed can our capacity to do better everyday become a reality.”

Supporting the motion, Joe Hoolan from the Laois Branch said: “The letter from Tony O’Brien was another kick in the teeth to everyone in Portlaoise Hospital. The phrase that ‘we will collectively do better everyday’ jumped out at us because there is no midwife in the hospital that does not go into work to do better every single day.

“When the report was then issued by the chief medical officer commenting on the practice of midwives, no midwife had been interviewed – not one. But yet he felt he was able to make comment about their practice.

“We send in our disclaimer forms and adverse incident forms, but there is a definite lack of action when they are submitted. Remember that the paper trail is key. When this episode happened in our maternity unit, the staff could turn around and say ‘We told you so’,” said Mr Hoolan.

Geraldine Talty, Executive Council and Offaly Branch, urged delegates to use the HSE tools that are available, and to communicate their views back to Tony O’Brien as he requested in his letter. This would include things like delayed medication, delays in recording the vital signs, delayed recognition of deterioration of patients, inadequate time for assessing and planning care, and inadequate time to discharge patients.

“If the HSE put the patient first, it would provide adequate numbers of nurses and midwives so that we can do the same,” said Ms Talty.

When put to the f loor, the motion was passed unanimously.

ADC - Call to deal with disclaimer forms falling on deaf ears