The Shrewsbury and Telford Hospital NHS Trust is planning to convert the midwifery-led maternity units (MLUs) at Ludlow, Bridgnorth and Oswestry to “birthing centres”. This means that the MLUs will not be staffed overnight. Women in labour will instead must call the units to arrange for them to open.
Tracey Huffer, Shropshire Councillor for Ludlow East and a practising nurse, is very concerned about the plans.
“This is madness. It is impossible to predict the onset of labour and the need for midwifery services. Midwives may have to travel up 30 miles to open Ludlow Maternity Unit (LMU) in the middle of the night. Women about to give birth will probably instead call an emergency ambulance to get taken to Shrewsbury, Telford or Hereford hospitals.
“What happens to the women who have given birth? Many need a rest and help with how best to cope with their babies. They need support in initial breastfeeding. With these plans, it looks like mothers will be thrown out of hospital pretty quickly rather than given the care and advice they need.
“We have seen this before in rural areas. It happened in Knighton, Powys where the maternity unit was gradually downgraded and women found they had to go elsewhere to give birth. Knighton is now just a birthing centre and the few births there are by appointment.
“I really fear that this is the first step in making Shropshire’s three MLUs an appointment only service all day long. I worry that the changes will threaten antenatal and postnatal services in Ludlow.
“Our young mothers deserve better than this. We need maternity services close to home. We need services that support young women and help them care for their new-born babies. SaTH should recognise rural maternity services are essential to the health and wellbeing of young women and their babies.
“It needs to save money but the £95,000 it is trying to save from the maternity units is money that is currently well spent.”
SaTH is planning to close the MLUs at Ludlow, Oswestry and Bridgnorth overnight. The maternity units will instead operate an “on-call service”.
The plan to close the maternity unit at Ludlow is buried in the Financial Recovery Plan, a document agreed by the SaTH board yesterday afternoon. The board reviewed more than 60 schemes to save money. The need for SaTH to cut its budget is urgent. It is heading for a deficit of more than £12.3 million by the end of March 2017. This is more than £6 million above its agreed overdraft with NHS England.
SaTH wants to save £4 million from staff budgets by the end of the financial year, mostly through cutting back agency staff. The remaining £2 million will come from service delivery. Cutting the hours of the MLUs will make a £95,000 contribution towards this (1.5% of the overall savings).
Savings item 60, in a list of 64 potential cuts, reads: “Midwifery Convert 3 x MLUs to birthing centres.”
What’s the difference between MLUs and birthing centres? We asked SaTH to clarify. Sarah Bloomfield, the Director of Nursing and Quality at SaTH, told us:
Birthing centres maintain the full range of services offered by Midwife-Led Units but do not remain open overnight; instead operating through an on-call system. Therefore women can still chose to give birth locally and are met at the Birthing Centre by the midwifery team where they are supported to give birth and then return home after their immediate postnatal care is complete and when it is safe to do so.
An MLU provides the following;
Community Midwifery hub
Home birth service
Birth service and postnatal care