28 June 2017

Proposals to suspend services at Midwife-Led Units (MLUs) in Bridgnorth, Ludlow and Oswestry for between three and six months will be considered tomorrow (Thursday 29 June 2017).

The Shrewsbury and Telford Hospital NHS Trust (SaTH) has faced a combination of short-term and long-term sickness in recent months, as well as a significant fall in the number of midwives prepared to work overtime or temporary bank shifts to cover shifts at times of sickness. This has led to some significant challenges in our ability to fully staff teams at all our maternity sites, all of the time.

The number of births at the Consultant-Led Maternity Unit in Telford has also risen from 3,795 in 2014-15 to 4,194 in 2016/17.

These factors have meant we have had to deploy our existing staff in different ways to make sure we have safe staffing levels in our units and sufficient staff where they are needed most.  As a result, and due to our need to move staff between our different units to get the right cover in place, there has been an increase recently in the number of times that services have had to be temporarily suspended at our MLUs at short notice

Tomorrow’s SaTH’s Board will receive a report explaining that action needs to be taken to make sure we can sustainably provide the right complement of staff to safely look after the women using the service at our Consultant-Led Unit.  These recommendations will remove uncertainty about whether an MLU will be closed at short notice.

The Board will be asked to approve a report which recommends suspending services at Bridgnorth, Ludlow and Oswestry MLUs for between three and six months from 1 July 2017. The Board will be asked to decide the exact length of time services will be suspended for, if they agree with the proposal.

The proposals are being put forward on safety grounds to ensure safe staffing levels.  This is not about the competence of our staff but our ability to ensure safe numbers of staff.  The proposals do not pre-empt the outcome of the Midwife-Led Unit review that our clinical commissioners are carrying out. In the meantime, the Trust will also continue its efforts to recruit more Midwives.

If the plan is approved, women who have chosen to give birth at the MLUs during this period will be able to access their midwife as usual and be offered a birth at an alternative MLU location, such as Shrewsbury or Wrekin MLU, or they can choose the Consultant-Led Unit at the Princess Royal Hospital in Telford or a home birth if appropriate. Midwives will remain available for advice 24-hours-a-day, seven-days-a-week.

Deirdre Fowler, Director of Nursing, Midwifery and Quality at SaTH, said: “The safety of mothers and babies using our service is our number one priority and this proposal, albeit difficult, is something we have given careful consideration.

“An increasing number of women are choosing to give birth at our Consultant-Led Unit in Telford, rather than at our MLUs. In 2008/2009 MLU births, including home births, accounted for 26% of our activity but in 2016/17 this figure has fallen to 13.1%, with just 3.4% of this activity taking place at Ludlow (0.7%), Oswestry (1.1%) and Bridgnorth (1.6%) MLUs.

“This means we have seen a high level of demand on our Consultant-Led Unit (85% of local women are giving birth here). At the same time we have faced a combination of short-term and long-term sickness, as well as a significant fall in the number of midwives prepared to work overtime or temporary bank shifts to cover shifts at times of sickness. This has meant that at times we have had to temporarily suspend services at our MLUs due to staffing shortages.

“We appreciate that such temporary suspensions of service are disruptive for mothers-to-be, their families and our staff and create uncertainty for women about whether an MLU will be open or not when they go into labour.

“As a result, we are proposing temporarily suspending services at our MLUs in Bridgnorth, Ludlow and Oswestry for between three and six months in a measured and planned way, rather than having to suspend some services temporarily at short notice to ensure we continue to provide a safe overall service.

“We recognise the significant impact that this may have on some of the women we care for about their planned place of birth and we are sorry for this. We have taken into account the many comments received regarding short-notice closures and recognise that the women we care for need assurance about their place of birth. For this reason, we are proposing the most difficult decision to suspend some services for a defined period of time whilst we work up alternative longer-term sustainable options. If the decision is approved tomorrow, I would encourage any woman using our service who has concerns or questions about how this will affect them to discuss their birth options with their midwife.”

SaTH will be working with service users and stakeholders to ensure they are fully engaged in the process to shape the service. Head of Midwifery Sarah Jamieson is keen to hear your views. If you would like to be involved please contact her via her PA Nick Robinson by calling 01952 565996 or email nick.robinson@sath.nhs.uk

Regular meetings are planned to consider options and future models but this work will not pre-empt the outcome of the Midwife-Led Unit review that our clinical commissioners are carrying out.

  • Trust Board papers for tomorrow’s meeting can be found here