Today, the Shrewsbury and Telford Hospital NHS Trust (SaTH) issued a press release about the plan to convert midwifery-led maternity units (MLUs) in Ludlow, Oswestry and Bridgnorth to on-call services. This means that mums-to-be must ring to arrange for a midwife to come to unlock the maternity unit before care can be provided for the mother and child. This could possibly work if births came according to a prearranged schedule but that’s not the way that pregnancies run. SaTH says this will “maintain choice for mums-to-be”. I can’t see that being the case.
If you don’t use a health facility, it will be closed. The mums-to-be I have spoken to are clear that they need certainty. They fear they will call a midwife when in labour and none will be available outside Telford. They need a clear pathway at an uncertain time of life. This panic plan will not deliver that. What it will deliver a few months from now is the permanent closure of rural midwifery units.
The SaTH press release is reproduced in full below.
Maintaining choice for mums-to-be
8 June 2017
There have been reports in the news and on social media today following a report which went before yesterday’s meeting of Shropshire Clinical Commissioning Group (CCG) about the future of Midwife-Led Units (MLUs) in the county. Below is a statement from Sarah Jamieson, Head of Midwifery, setting out the facts:
“The long-term provision of midwifery services in Shropshire is under review, and nothing that is currently being discussed would predetermine the findings of that review.
“As we have talked about before, we manage our service as a whole and staff our units based on demand as it’s important to ensure we have enough staff to care for women at the locations where they have chosen to give birth, rather than focusing on staffing buildings which may have little or no birth activity for days or weeks. This is in line with national guidance and means our staff are where they are needed, rather than having a number of Midwives and care support workers in one of our Midwife-Led Units (MLUs) where there may be no women being cared for.
“As has been reported, demand has been high at our Consultant-Led Unit in recent weeks and months and, during that time, we have needed to enact our escalation procedure on an increasing number of occasions due to a number of factors, including unexpected staff sickness. This has, unfortunately, meant temporarily suspending services at some of our MLUs overnight at short notice.
“We believe this is disruptive for mums-to-be and for our staff and therefore we have been working closely with our colleagues at the Clinical Commissioning Groups (CCGs) and we are exploring the viability of adapting our current model of care to provide an on-call model to staff on demand rather than staffing buildings where there may be no activity.
“If we had an on-call system of midwifery to support births in our units, rather than staffing the units, women’s choice would be maintained at all times and their options for birthing in their local unit or at home would also always be maintained. It is our opinion, and one supported by many, that this option would be preferable to suspending services; however, this is currently our only option in order to ensure safety.
“It is important to stress that no final decision has been taken on this proposal, which would be an interim response to the on-going issues we are facing in terms of demand and staff availability.”
The report which went before the CCG can be found here: http://www.shropshireccg.nhs.uk/governing-board-meetings-2017