This page contains FAQs relating to the changes to the Women's Services at The Shrewsbury and Telford Hospital NHS Trust.
Please also refer to the latest designs of the new Women and Children's unit and the Looking to the Future Newsletters including Looking to the Future Special Issue Women's Services - January 2012.
You can view the initial designs for what the new Women and Children's Unit might look like here
What women’s services will be provided in Shrewsbury?
We propose that a wide range of services will continue to be provided in Shrewsbury. This includes:
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Midwife-led delivery unit
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Consultant and midwifery antenatal care
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Gynaecology outpatients and daycase surgery
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Scanning services
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Early pregnancy assessment
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Antenatal day assessment
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Consultant opinions on patients already in hospital.
What women’s services will be provided in Telford?
We will provide an inpatient women’s unit in Telford. This includes:
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Midwife-led delivery unit
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Consultant obstetric maternity unit and neonatal care
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Consultant and midwifery antenatal care
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Gynaecology outpatients and daycase surgery
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Scanning services
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Early pregnancy assessment
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Antenatal day assessment
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Consultant opinions on patients already in hospital.
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How much space will the new Women’s and Children’s Unit at PRH need?
We have done some initial modeling that suggests that a Women and Children’s Unit should be established at PRH, along with the other work needed as part of these proposals, for £26m to £28m.
Following the consultation we have worked this up into more detail, building on the feedback we had received from patients and carers to design the services.
A first look at the new Women and Children's Unit at PRH can be found via the Looking to the Future Newsletters including Looking to the Future Newsletter Issue 3 - Janaury 2012.
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How do the costs compare between providing a new maternity unit at RSH and at PRH?
We estimate that it will cost around £60m to create a new women and children’s unit at RSH. This is because the current building only has a working life as a clinical environment for a further five to ten years and we need to plan to move services from this building in the near future. In the Developing Health and Health Care work in 2008/09 we were also proposing to move from this building as part of the longer term 2020 options.
It will cost in the region of £26m to £28m to create a women and children’s unit at PRH, as well as the other changes needed as part of these proposals. The newer estate at PRH, as well as options for using existing space, means that there are more options for creating this facility at PRH.
There is a very big difference in cost which we have to take into consideration when deciding how to solve the dilemmas facing local NHS services.
We have to borrow money to develop our buildings. The more money we borrow the more we have to pay back with interest taking money away from delivering care, not only to women and children but all the patients entering our doors.
It is also very doubtful that anyone would lend us the sum of money required for a totally new building in Shrewsbury and it would be very difficult to pay this back.
The costings have been developed in accordance with the NHS Estates Healthcare Capital Investment Manual based on providing services to modern healthcare buildings and space standards (rather than simply reproviding the current standards of service). The costs include appropriate contingencies for factors such as site condition, infrastructure costs, on-costs and other contingencies.
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What will happen to the women and children’s building at RSH when the changes go ahead?
Options for what will happen to the maternity building at RSH are also being explored. Even though the building will not be fit for inpatient clinical care in the near future, there may be other support services that could be accommodated in the building in the medium term and so free up space within the main hospital buildings. We will have to make sure that the asbestos in the roof of the building remains safe.
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What will the facilities be like in the new Women and Children's Unit at PRH?
There will be 11 new delivery suites, the majority of which will have en-suite facilities. We will also have separate ante-natal and post-natal wards, a separate adjacent neonatology unit,dedicated maternity theatres, gynaecology assessment services and inpatient services.
There will also be a children’s assessment unit (PAU), children’s cancer unit, children’s inpatient and children’s outpatient services. At the PRH site there will also be gynaecology outpatients, colposcopy, gynaecology and paediatric day surgery, gynaecology theatre,
antenatal services and the midwifery unit.
Why do we have to change our maternity services?
Women and children's services in Shropshire currently face real problems that require a sustainable solution.
The first driver for this change is that our children's doctors believe that the best way to achieve high quality services for children is to have one single inpatient paediatric unit for the
county. This concept is supported by outside agencies.
Women’s and Children’s inpatient services physically sit together as new born babies sometimes require the support of neonatologists and paediatricians.
The second driver is that our current building at RSH is a real live problem. We cannot continue to provide maternity services from the existing maternity building as it is in a poor state of repair, has significant internal functional and structural problems and is not designed for the delivery of 21st century care.
For further information about the problems we face and how these problems are being solved please refer to the FAQ homepage.
Why are you moving maternity services to Telford? I thought the proposal in 2009 suggested they should stay in Shrewsbury?
In 2009 we were looking at a set of options and these did not get to the stage of public consultation. One of these options – which would have seen women and children’s services based in Shrewsbury in the short term – attracted a lot of media attention before any consultation was underway.
The option of women’s and children’s services being based in Shrewsbury was one of four options that was being considered as a short term change from 2012/13 to 2020. In some options, obstetric maternity services were based in Shrewsbury. In others they were based in Telford.
As mentioned these options were intended as a short term change from 2012/13 until 2020. The NHS was looking at options for moving major health services to a single site by 2020. These options included major redevelopment of RSH as the main acute site (including obstetrics and inpatient children's services), major redevelopment of PRH as the main acute site (including obstetrics and inpatient children's services) or creating a new acute hospital site between Shrewsbury and Telford (including obstetrics and inpatient children's services). All of these options included moving from the deteriorating women and children’s building at RSH.
More information about the options discussed in 2009 is available from the Archive section.
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Can consultant-led maternity services and inpatient children’s services be provided on separate sites?
We cannot provide these services on separate sites.
Firstly, neonatal services must be on the same site as consultant maternity services.
Secondly, we have strong clinical links between neonatal services and children’s services, including doctor’s rotas, skills and training. We would find it very difficult to provide the same level of neonatal services if these were not working in partnership with on-site inpatient children’s services.
What is the profile of maternity beds now? What is the planned profile of maternity beds and births when these proposals are implemented?
An indicative profile of the beds and services in The Shrewsbury and Telford Hospital NHS Trust can be found in the Data Pack developed for the Clinical Problem Solving Workshop in August 2010. This is available from the Event and Assurance Reports page.
The profile of beds and births are currently being developed. Planning for implementation will take place between April 2011 and April 2012 and this will be included as part of the Full Business Case.
Also available to download is a profile of births from Shropshire, Telford & Wrekin and mid Wales in NHS services in England between April 2008 and March 2010 showing location (RSH, PRH, other MLU, other English NHS Trust) and GP practice.
What is the profile of ill baby, neonatal and special care baby services now? What is the planned profile of these services if these proposals are implemented?
An indicative profile of the beds and services in the The Shrewsbury and Telford Hospital NHS Trust can be found in the Data Pack developed for the Clinical Problem Solving Workshop in August 2010. This is available from the Event and Assurance Reports page.
The profile of ill baby, neonatal and special care baby services will be developed based on the outcome of consultation. After consultation, planning for implementation would take place between April 2011 and April 2012 and this will be included as part of the Full Business Case.
Who will be able to have their baby at the Royal Shrewsbury Hospital?
If the consultant obstetric unit moves to Telford there would still be a midwife-led unit in Shrewsbury. Any woman who is at low risk of complications would be able to choose to have her baby in the RSH Midwifery Led Unit, the PRH Midwifery Led Unit, at home, at one of our community midwifery led units in Bridgnorth, Oswestry and Ludlow or at one of the midwifery led units run by Powys Health Board.
As part of these proposals an improved midwife-led unit would be created at the Royal Shrewsbury Hospital.
Part of this work includes making sure that maternity services have access to the range of support services they need, particularly in an emergency - such as surgical support and blood transfusions.
Draft models of care were presented to the Local Assurance Panel on 28 February 2011.
Who will go to the Princess Royal Hospital to have their baby?
Any woman who needs a consultant-led delivery would give birth at the PRH. Women at high risk include those expecting twins, women with diabetes, women who have had previous caesareans, women whose babies are in the breech position or women whose babies are premature.
Will I be able to choose to give birth at the new women and children's unit?
Yes, any woman can choose to give birth at the new women and children’s unit. There will be slightly more delivery rooms with much better specifications than in the existing unit.
Will my partner be able to stay with me in the new unit?
There are different circumstances when a partner may wish to stay with you. This can be when you are in labour, if you are waiting for the successful induction of labour, if a baby or child is on the neonatal or paediatric unit or purely because of distance. We are working with both the architects and builders to offer a number of different solutions depending on your needs and circumstances.
If a woman develops complications during labour, how will you make sure that there is enough time to safely transport mother and baby to PRH?
This is a real and natural worry and it exists now with home births and within our midwifery-led units. Delivering a safe maternity service with our geography and distant maternity units
is a high priority. We do this now and will do it in the future by:
- asessing and talking to women to help decide whether they are wise to give birth at home or in one of our midwifery led units so the likelihood of significant problems is low
- taining our midwives in the midwife-led units and conducting home confinements to identify problems so we can ensure the safe and early transfer to the consultant-led unit
- taining our midwives in dealing with unpredicted emergencies, either with mum or the newly born baby
- having an effective and rapid transfer policy in place in partnership with the ambulance services.
As a result of these measures, risks are reduced to the minimum. However, risk can never be removed completely whatever the care setting. Our maternity services in Shropshire
have been developed over many years to support our geography and the desires of mums and families to stay close to home if possible, but to access higher levels of care when
necessary.
What will happen to the maternity units in Bridgnorth, Ludlow and Oswestry?
The midwifery led units in Bridgnorth, Ludlow and Oswestry will continue to provide services to women as now. In fact, it is hoped that by continuing to raise awareness of the excellent service women, their babies and their families receive, more women would choose to have their babies in one of our midwifery-led units. Women will also still be able to choose to have their baby at home.
How will the new arrangements actually work?
We have set up clinical working groups to develop the models of care in detail.
These groups include consultants, GPs, nurses, therapists, ambulance and other staff who work directly or indirectly in surgery and women’s and children’s services. We are also testing the ideas developed by these groups with patient representatives.
Part of this work includes making sure that maternity services have access to the range of support services they need, particularly in an emergency - such as surgical support and blood transfusions.
Draft models of care were presented to the Local Assurance Panel on 28 February 2011.
Why is a second theatre needed for maternity? How often is it needed? When will a second theatre be put into place?
Because of the number of births we see in our obstetric unit, we should have a second theatre. This is so that we can handle obstetric emergencies when planned operations (e.g. planned caesareans) are taking place. At present there are rare occasions where we need to make emergency arrangements because there is an obstetric emergency when a planned operation is underway.
This is a significant risk on the Hospital Trust's risk register. We are looking at ways of putting a second theatre in place as an interim arrangement, before any changes are made as a result of the "Keeping It In The County" consultation. But, this would be an interim arrangement at RSH as the maternity building is already cramped and the building is deteriorating and does not have a long term future. It will be important to plan for a second theatre as part of the future shape of services.
Will I still be able to see my gynaecologist at RSH?
Yes. The vast majority of gynaecology appointments and day case procedures will continue to be provided where they are now. There will also be an Early Pregnancy Assessment
Service (EPAS) and an ante-natal assessment service at RSH. You will only need to go to PRH if you are having a procedure that requires an overnight stay.
What will the new facilities be like for gynaecology patients at PRH?
The new unit will have dedicated gynaecology inpatient beds, an assessment area for patients who have become unwell with a gynaecological problem and an Early Pregnancy Assessment Service (EPAS) with ultrasound scanning facilities. Outpatient services, colposcopy, theatres, day surgery and ambulatory care will also be provided at PRH.
How can I get involved in the changes to the Women and Children's services?
We would be very interested to hear from you if you would like to get involved in shaping our new Women and Children’s Unit. Over the next 12 months we will be looking to you to help us decide everything from the colour of the walls to the furniture and children’s play equipment. One way you can get involved is by taking part in one of our focus groups.
If you run or attend a group which you would like us to visit or you would like to take part in the focus groups , please email the project team via future@sath.nhs.uk.