Suggested plans to shake-up Nottingham's 'failing' maternity services before a long-awaited review by Donna Ockenden has been concluded have been criticised by councillors. The 'rebuilding' of the city's hospitals is being discussed and as part of this the consolidation of 'inadequate' maternity services has been proposed.
The shake-up comes as part of the 'Tomorrow's NUH' programme, a multi-million pound upgrade plan of Nottingham University Hospitals' (NUH) services. The trust, which runs the Queen's Medical Centre (QMC) and City Hospital, will be one of 40 acute trusts to receive funding to rebuild and improve its operations.
As well as proposed improvements to emergency care and elective care, the plan outlines maternity services could be merged with neonatal services. A new "state-of-the-art" women's and children's hospital could also be set up at the QMC and further include the merging of fertility and gynaecology departments.
Mark Wightman, the director of reconfiguration for reshaping services at the Nottingham and Nottinghamshire CCG, says there are roughly 4,500 births at each unit at City Hospital and QMC every year. It is, as such, "one of the biggest in the country" he says, meaning it is "difficult to run effectively" in its current state.
"I am talking process, I'm not going to get into maternity review because I don't know enough about it, but from a process point of view it is very difficult to run effective, efficient, quality, safe, humane maternity services when you are constantly struggling with staffing across two big sites like that," he said during a Nottinghamshire County Council health scrutiny committee meeting on June 14.
"So the plan is to pull those together and create a new, state of the art women's and children's hospital called a family care hospital, with maternity and children's services, including neonatal on site. That would be at the QMC."
He added it was "about time" and says out of approximately 160 acute hospital trusts, all of them would have wanted to get onto the funding list, as has NUH. Serious concerns have however been raised over the plans, particularly ahead of the looming review into the inadequate maternity services at NUH.
Earlier this month it was announced the experienced midwife Donna Ockenden would lead her own review into maternity services at the trust. It was a long-pushed for victory for the many families who have told their 'appalling' stories of baby loss while under the care of the trust's maternity services.
Labour councillor Michelle Welsh, who sits on the committee, also feared the merging of the fertility and maternity services could present a serious problem. She said: "I have grave concerns about fertility and gynaecology being in with maternity services.
"As part of the women's group I am involved with, I did mention this to them and a lot of them have been through fertility treatment and a lot of gynaecological appointments where they have been told the chance of them having children are very slim, or they have come out and they have had another failed fertility attempt, and then to walk out to see a lot of people with babies, they are not jealous, it is just about preserving those feelings and being respectful to those women and those partners.
"And I think that is something in the current climate that NUH needs to be very, very wary of."
Councillor Welsh further raised issue over the overall lack of adequate plans for maternity services which have "been failing for a number of years" and recommended health bosses put the brakes on this until the Ockenden review. She says bosses should not be jumping the gun and it is "going to take some convincing" for parents who have had "appalling" care recently or historically.
Alex Ball, for the Nottingham and Nottinghamshire CCG responded to say "We haven't quite got that right" in regards to combining maternity with other departments and offered to connect with those concerned.
But he added: "There won't be any diminishing of the type of birth that women can access. You will still be able to have a midwife-led birth, an obstetric-led birth, a home birth, but the location could be different and that is no small thing so again we have got to work that through and help explain to people why we believe that is the right thing.
"I'm going to reserve judgement on the comments on the input of the new nationally-led review by Donna Ockenden. We don't quite know what that is going to look like yet. I'm fairly sure we will want to dovetail our timings on that. Whether we would want to pause our work to wait for that I don't know."
The scrutiny has somewhat ceased its in-depth discussions over maternity in Nottingham until Mrs Ockenden has finished her review "We will virtually leave this vital review to her", chairwoman councillor Sue Saddington added.
It was also argued families involved would need better emotional and psychological support. Sarah Collis, for Healthwatch, said it had been "woefully lacking".
she added: "One of the key things we feel really concerned about with any review that comes up is the welfare of the families that are involved in that review. One of the key things we discovered talking to NUH yesterday was that trauma support is something that is not readily available.
"We at Healthwatch will be writing to the CCG, NUH and we will be writing to Donna Ockenden to ask for reassurance about the emotional and psychological support for families."
