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Maternity review reports that local services are safe

An independent external review of maternity services across Leicester, Leicestershire and Rutland has found them to be safe and providing good standards of care for mums-to-be, while also recommending a number of areas for further improvement.

The review was commissioned by the three local Clinical Commissioning Groups – Leicester City CCG, East Leicestershire and Rutland CCG and West Leicestershire CCG – to make sure Leicester’s Hospitals are providing high standards of care for pregnant women, new mums and their babies.

Led by a midwife and obstetrician from outside Leicestershire and Rutland, the review included analysing the results of previous reviews, visiting local hospitals to see services first hand and talking to patients and staff about their own experiences.

A report into the findings of the review is to be presented to the governing bodies of the three CCGs on Tuesday June 11, and concludes that services provided by Leicester’s Hospitals, including the St Mary’s Birthing Unit in Melton Mowbray, are safe and that the team of midwives and support staff are well-trained and well-motivated.

However, the review also found that despite the hospital redeploying staff and transferring activity when needed, services at the Leicester Royal Infirmary and Leicester General Hospital can become over-stretched during busy periods and recommends reviewing the numbers of midwives, doctors, support staff and bed capacity.

Dr Avi Prasad, co-chair of Leicester City CCG and chair of the task and finish group set up to oversee the independent review, said: “We want all mothers and their families to be confident they will receive high quality care when they need it most. We are pleased with the overall findings but know there is still more to do. We will be working with the hospitals to make whatever improvements are needed.”

In total the review identified 49 recommendations, most of which relate to operational issues to be addressed by Leicester’s Hospitals. But the report also sets out four key priority recommendations that will need the hospitals and CCGs to work together. These include increasing the number of midwives, improving training and support for the obstetrics team, looking in more detail at how services are delivered in the Melton Mowbray area and the role of St Mary’s Birthing Unit, and revisiting plans for a new single-site maternity hospital.

The report has suggested a further review of maternity services at St Mary’s after highlighting the low number of births which happen there and the distance to the nearest acute services. It also said that the services which are offered at the centre are the same as those which could be provided in the homes of women who are low risk and ask for midwifery-led care.

Dr Dave Briggs, managing director of East Leicestershire and Rutland CCG, which covers the Melton area, said: “We know that the women who use the birthing unit really value it. Our next steps are to explore the issues which have been raised in the report and no changes will be considered until we have done this.

“If, in the future, changes to maternity services in Melton are proposed, we would of course take into account the views of patients and the public and we would carry out a full public consultation to make sure people are able to have their say on the plans.”

Another of the priority recommendations is for work to continue to increase the number of midwives in Leicester, Leicestershire and Rutland to a maximum of one to every 28 births, and for more improvements to be made to the training and support given to the obstetrics team.

Dr Nick Pulman, chair of West Leicestershire CCG and clinical lead for the UHL contract, said: “Understanding patient needs is a vital part of what CCGs are about. We know how important the relationship between midwife and new mum is. Over the last three years investment has been increased to try and get more midwives in place. CCGs are key to monitoring quality of services and we will work with the obstetrics team to make sure maternity services across Leicester, Leicestershire and Rutland are amongst the best in the country.”

The review also asks the CCGs to ensure that plans for a new single-site maternity hospital are revisited in the future. Previous plans for a single-site solution were shelved by the previous Primary Care Trust in 2010 on the grounds of affordability, with extra money instead being spent on increasing the number of maternity and delivery rooms, expanding neonatal care and taking on more midwives.

Dr Prasad added: “The financial challenges facing the NHS have not changed since 2010 and the money simply doesn’t exist for us to invest in a new maternity hospital. We feel the extra money invested since 2010 has had a positive impact and we need to continue on with that journey. This is very much a long-term solution that won’t be delivered in the foreseeable future but we’ve agreed to keep it on the agenda.”

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