Agenda item

Councillor Liz Hardman made a statement to the Panel on the subject of the Maternity Services Transformation Consultation. A copy of the statement can be found on the Panel’s Minute Book or as an online appendix to these minutes, a summary is set out below.

This consultation is about reducing the choices facing women in our area. Maternity services will be concentrated in large district hospitals such as the RUH, Great Western Hospital, Swindon and Salisbury District Hospital.

Two of the led Birthing Units at Trowbridge and Paulton will be closed. This means women won’t have a choice as to where to have their babies in the Paulton and Trowbridge areas. It will have to be the RUH.

So you can imagine how congested parking in the RUH is going to be not to mention pollution levels in Bath, with increased numbers of heavily pregnant women now travelling by car or ambulance to the RUH to give birth and to have post-natal care.

We have been told that Maternity Units like Paulton and Trowbridge are underused. Bed usage has been calculated unfairly by breaking it down to each bed. So, if only one of the 5 beds is being used this will give them a calculation of 80% of how often the beds are empty, rather than assessing how often women are staying at the centre. At least one woman is using a post-natal bed 75% of the time.

The consultation suggests that in place of these postnatal beds, midwives will be able to provide more support closer to home. This doesn’t make sense in terms of staff usage, as at present there is one midwife and one midwife Care Assistant working over a night shift in Paulton Hospital, caring for up to 5 families. To replace this with staff doing home visits overnight is unsafe, worrying and inefficient.

I’m afraid to say that the whole transformation Maternity process looks to be

an elaborate cover up to conceal the endemic staff shortages in the RUH and to siphon off midwives from our Community Maternity Units to our larger hospitals. In August 2018, the RUH had a shortage of midwives of 14.4%. This was the greatest shortfall since 2015.

Local midwives have told us they like working near their homes and don’t want the expense of travelling to Bath and parking fees.

Promoting births and after care at the RUH will increase traffic congestion and parking problems in the Bath area. Community birthing units at Paulton and Trowbridge run effectively are cheaper and more cost effective than expensive Hospital Birthing Suites.

We need to consider the needs of our communities before making decisions on the outcomes of this consultation.

Councillor Lin Patterson said that she had attended a briefing day and was impressed with the presentation plans for the changes proposed and that the staff present appeared to be in approval. She asked if there was time for the proposals to be re-examined.

Councillor Hardman replied that in general she believed that the public briefings were not attended well, although locally in Paulton it was advertised well and around 50 people attended. She added that there is a survey to be completed as part of the consultation, but that the language within it and the consultation itself was difficult to understand in places.

She said that she believed that a decision was due to be taken in September and that therefore a rethink was possible.

Dr Ian Orpen said that he was not able to respond in detail to all the points raised in the statement as he had no prior warning of it, but confirmed that the consultation was still ongoing and that the proposals were not a done deal. He stated that it was also in no way a cover up of the staff shortfall at the RUH but rather it was based on national best practice and the Better Births (national maternity review).

He added that there have been around 1,700 responses to the consultation online with the bulk of those coming from within B&NES. He said that face to face conversations with members of the public have also taken place.

Councillor Hardman stated that an online petition has been signed by 4,000 people to urge a rethink for proposals relating to Paulton. She asked that this be considered as part of the decision making process.

Dr Orpen replied that it would.

+ Having shared the draft minutes with officers from the CCG they have requested the following response be included to address the points raised by Councillor Hardman.

We thank everyone who took part in the Transforming Maternity Services Together consultation which closed on 24 February 2019. There were 1800 survey responses and more than 600 face to face discussions – and all views will be considered.

The proposal put forward by the Bath and North East Somerset, Swindon and Wiltshire Local Maternity System would continue to provide women with the choice of giving birth at home, in a Freestanding Midwifery Unit or in an Obstetric Unit, with the additional choice of giving birth in an Alongside Midwifery Unit. 

We are not proposing to reduce how much we spend on maternity services, nor are we proposing to reduce the amount of staff we have or to close any buildings.  Under the proposal antenatal and post-natal care would continue at all four Freestanding Midwifery Units (Paulton, Chippenham, Frome and Trowbridge).

With regard to post-natal bed usage in Freestanding Midwifery Units, the standard NHS definition of bed occupancy has been used – that is the proportion of available (open and staffed) beds occupied at midnight on a bedded ward. For example, as Paulton has five post-natal community beds, if just one bed is occupied at midnight that would equate to a 20% occupancy rate for that day.

Across our LMS there are currently nine community post-natal beds, four in Chippenham and five in Paulton. Usage in 2017 equates to 5.2%.

In 2017/18 14% of births supported by the RUH took place at a Freestanding Midwifery Unit. We would like to reassure people that there is no shortage of midwives at the RUH. We believe we have the right number and mix of staff, for the number of babies born in our area, but they may not be based in the right locations to deliver the kind of care women and families want to receive, and our staff want to provide.