Agenda item

To receive a report from UHL on their intention within the STP to consolidate maternity care onto the Leicester Royal Infirmary site with the potential for a midwifery led birthing centre at the Leicester General Hospital, subject to formal public consultation.

Members received a report from UHL on their intention within the STP to consolidate maternity care onto the Leicester Royal Infirmary site, with the potential for a midwifery led birthing centre at the Leicester General Hospital, subject to formal public consultation.

The Chair stated that there would be a further meeting of the Commission on 29 March 2017 to hear submissions from the public and interested organisations on their views of the proposals in the draft STP.    There would also be a further meeting of the Leicestershire, Leicester and Rutland Joint Health Scrutiny Committee to consider the STP once the formal consultation process had started.

Mark Wightman, Director of Communications, University Hospital of Leicester NHS Trust (UHL), Ms Melanie Thwaites, Associate Director, Children and Young People Services, East Leicestershire & Rutland Clinical Commissioning Group, and Ian Scudamore, Clinical Director for Women’s & Children’s Services attended the meeting to present the report and answer Members’ questions.

The details of the proposals were:-

•           Women’s services currently located on the LGH site would be consolidated to the LRI; where a new Women’s Hospital would be developed. The Women’s Hospital would include:

o          Maternity (the proposed Standalone Birth Centre at the LGH would remain when other maternity services are re-located)

o          Neonates – new-born babies needing care

o          Gynaecology

o          Clinical Genetics

·                    Antenatal and postnatal services will continue to be provided in the community, as they always have been

·                     Where clinically appropriate, women will still be able to choose from the following four birth options:

o          Home births

o          Standalone Birth Centre at the LGH (if this is the outcome from consultation)

o          Alongside Birth Centre at the LRI

o          Combined Care Unit at the LRI

The proposals had arisen from the Trust experiencing capacity issues in fully staffing all the existing units over recent years and having to temporality close some units for short periods.   Providing all the maternity services on one site was considered to be safer, more efficient and would provide a sustainable service for women and families; as well as offering a choice of services.

Members, in discussing the proposals, received the following responses to their questions and comments:-

a)         The recent CQC inspection report on Maternity Services would be submitted to the Commission in due course.

b)         The number of births at Melton had been reducing in recent years and now averaged 1 birth every two and half days, which made the unit expensive to run as it was fully staffed by midwives.  There were no specialist obstetricians at Melton in the event of difficulties and many expectant mothers chose to use the existing midwife lead facilities at the General and the Royal Infirmary as a result.  If the midwife lead services were moved to the General Hospital this should increase the choice to use midwife led services as specialist services would be available in the event of difficulties.

c)         The number of home births was declining because more expectant mothers wanted a midwife led service in a safe hospital setting where specialist services were available in case of difficulties.  The option of home births would still be available under the proposals.

d)         There was more choice in Leicester than in the East Midlands for midwifery led services.  UHL had the highest number of access to midwifery services and this was currently 24% of births.

e)         A number of staff were coming up to retirement and part of the workforce plan involved developing new staff and encouraging retired ones to come back.  UHL were confident that they would have the appropriate number of staff to birth ratios for the future.

f)          The proposals to close the Melton unit had been discussed with Melton Borough Council recently and whilst they recognised the loss of the  service they recognised the overall benefit to local people by having more community beds and other diagnostic services as a result of the proposals.

g)         Most ante-natal care would still be provided by GPs in the Melton area and Melton Hospital would still provide ante and post natal services.  Expectant mothers would only need to travel to Leicester for their scan and to give birth.

h)        The critical mass for a birth unit was 500 births a year and the existing midwife led service at the Royal Infirmary already exceeded this.  The proposal to put maternity service at the Royal Infirmary would have the capacity and staff to cope with the expected demand in the future.  The Kingfisher building would be re-developed to accommodate the new unit.

AGREED:-

That the proposals be noted but the Commission has some concerns about the planned building work and how this will be funded.