The ban on staff recruitment in the HSE west region is having a bigger impact on frontline nursing services than on management posts, according to the findings of an internal review by the HSE.

It said that 9% of nursing and midwifery posts are vacant in the HSE West and concludes that there is a direct impact on patient care across hospital and community services.

The review said that 67% of all nursing and midwifery vacancies are in frontline positions.

The highest percentage of vacancies are in mental health, where 20% of nursing posts are vacant and waiting lists have increased.It warns that in maternity services, low staffing levels pose an increased risk to mothers and babies.

In the Clare Mental Health services, 32% of posts are vacant.

The review said that services previously provided are not being made available.

In public health nursing, it said problems go unidentified and referrals for speech therapy and psychological assessment are not being made.

Some areas have no public health nursing service.

It said that the ability to comply with HIQA infection control standards is 'seriously curtailed'.