Changes on way for Shropshire maternity services

The news of the plans, which are subject to consultation, has angered campaigners who want to see births return to the midwife led units at Ludlow, Bridgnorth and Oswestry.

They are currently closed to births because of a shortage of midwives.

The plan is for the three rural midwife led units to resume inpatient services on January 1, however they remain open for antenatal services and postnatal outpatient services.

Currently, the midwife-led unit at Royal Shrewsbury Hospital has also had to close until next month due to snow damage.

However, health bosses have now suggested creating a number of maternity hubs across the county which would support women before and after birth.

They would offer a broad range of services from antenatal and postnatal care from a midwife, scanning, foetal monitoring as well as support with emotional wellbeing and healthy lifestyle services.

Under the plans drawn up by Shropshire and Telford and Wrekin clinical commissioning groups, mothers would only be able to give birth at the Princess Royal Hospital in Telford, Royal Shrewsbury Hospital or at home.

They would no longer be able to give birth at the three rural midwife-led units.

Community hubs would be open for 12 hours a day with doctors and obstetric services carrying out outpatient appointments as part of the changes.

The plans will need to be approved for public consultation by Telford and Wrekin CCG next month before the public can have a say.

But they have already received criticism from health campaigners including Gill George, who chairs Shropshire Defend Our NHS. Responding to the plans, she said: “They’re playing games with the lives of women and babies. They have been told by hundreds and hundreds of women in our rural communities to keep births and postnatal care in our local areas, and to keep our midwife-led units open.”

The CCGs say the new model would continue to offer a full range of birth options within the county.

They say this is good practice and currently only happens in 22 per cent of health trusts and health boards across England, Wales and Scotland.

It is proposed that midwives and women’s support assistants will also be available 24/7 for advice and support either over the phone, in person, or through video call.

The CCGs say the way each midwife led unit has developed over time means they all have a different service offer for women.

Women accessing one midwife led unit may have access to scanning but those accessing another may not.

The planned new model aims to change this so that women using any of the maternity hubs have access to the same type of services closer to home.

Health bosses say the range of services on offer through the maternity hubs will be much broader than the service currently available through midwife led units.

The maternity hubs would also offer support with feeding, emotional wellbeing and practical baby care, along with information on pregnancy, parenthood and birth options.

Dr Jess Sokolov, Shropshire CCG’s clinical lead for the midwife led services review speaking on behalf of both Shropshire and Telford & Wrekin CCGs, said: “Under the current system there is a risk that mums-to-be will not get one-to-one care through their labour and that a midwife led unit may potentially have to close again in the future due to staff shortages.

“This new proposal puts midwives in the places where they are needed most.

“At Oswestry there is around one birth a week, but a midwife is on site 24/7 compared to the consultant led unit where 85 per cent of locally registered pregnant women give birth and midwives are so stretched they cannot guarantee one-to-one care.

“The majority of women travel in their labour and this proposal will bring a whole range of pre and post-natal services together in community hubs, closer to women’s homes.

“Therefore throughout their pregnancy and after the baby is born women will be travelling less as they will be able to get all their pre and post-natal checks done at their community hubs, along with a whole range of services and support.”

System has to change

Dr Sokolov said: “The current system cannot remain as it is because the midwives are not based in the places where they are actually needed. “This means that one-to-one support cannot be guaranteed for women in the consultant led unit.

“There are also inconsistencies in which services are offered and where, as well as access issues for women across the county.I understand people may have concerns about change but this proposal is a change for the better where services are actually being enhanced to offer more support for more women close to home.

“Whilst the proposed new model will continue to offer a full range of birthing options, it also introduces a new concept of maternity hubs across the county to bring together a whole range of maternity related services.

“We listened to mums who said the current focus was too much on just giving birth so we have worked with them to help devise a whole range of specialist antenatal and postnatal support and services.

“It has been developed with an expert midwife and also meets national guidelines and practices.”

As part of the CCG review, interviews were carried out with staff and pregnant women and new mothers.