To receive a presentation on the Wiltshire Clinical Commissioning Group Maternity Transformation Project, from Sarah MacLennan, Associate Director, Communications and Engagement, Wiltshire Clinical Commissioning Group.
Minutes:
The Area Board received a presentation from Sarah MccLennan and Lucy Baker, from Wiltshire Clinical Commissioning Group (CCG) about their Transforming Maternity Project. Feedback from service users, together with national guidance such as ‘Better Births’, had led to the development of proposals for future maternity services across the region.
It was noted that the needs of the population were changing, with the average age of a woman giving birth now being 35, with more high risk pregnancies. Many women preferred to give birth at obstetric led units such as the Royal United Hospital and Salisbury District Hospital rather than at Free-standing Midwifery Units.
There were 11,200 births in B&NES, Swindon and Wiltshire in 2017/2018. 85% of these took place at Obstetric Units (65% of these were high risk women), 6% took place at Free-standing Midwifery Units, 7% took place at Alongside Midwifery Units and 2% were home births.
It was stated that the Service had sufficient staff, however it was felt that they could be better deployed to provide an improved service. Often there were staff looking after empty beds which was frustrating for staff and service users. There were several proposals to overcome the issues being faced. These included:
· Continuing to support births in 2, rather than 4 Community hospital units.
· Women would be able to deliver their baby at Chippenham or Frome (detailed analysis was undertaken to support this decision).
· Antenatal and postnatal clinics would continue at Chippenham, Trowbridge, Frome and Paulton.
· Trowbridge and Paulton proposed as pilot sites for our new community hub model of care.
· To create two new Alongside Midwifery Units, one at Salisbury District Hospital and one at Royal United Hospital Bath.
· These would provide more women with the opportunity for midwife-led birth. The two new units would be in addition to the White Horse Alongside Midwifery Unit at Great Western Hospital.
· These alongside units would allow women easy access to an obstetric unit if required, without the need to be ambulanced whilst in labour.
· Improving the range of antenatal and postnatal services, eg more breastfeeding support, to women in their own homes, and to develop community hubs to enhance our antenatal and postnatal care.
· Supporting more women to give birth at home if that was their preferred choice.
· Replacing community postnatal beds at Chippenham and Paulton with support closer to, or in women’s homes.
· Women who need to be admitted for medical treatment after giving birth would continue to be treated at their local obstetric unit at one of the acute hospitals at Bath, Salisbury or Swindon
The benefits of these proposals were said to include:
· Providing more choice for more women across the area about where and how they are supported before, during and after the birth of their child.
· Making better use of their resources and workforce so they can further improve their antenatal and postnatal and birth services.
· Improving continuity of care for women.
· Enhancing and improving their home birth service.
· Freeing up staff, so they are able to maintain their skills, improve their motivation and provide the services they want to women who need them.
The CCG confirmed that they were not planning on reducing spending on maternity services.
They wanted to hear people’s views on maternity services and the proposals suggested. A consultation would be taking place between 12 November and 24 February 2019. Full details and information could be found online at www.transformingmaternity.org.uk.
The CCG responded to a number of questions from the Area Board including:
· There had been no instances of MRSA or Norovirus at the Maternity Unit in the last 5 years, in part to the Unit being separated from the main hospital building, a change in anti-biotic subscribing and more rigorous hospital processes in place.
· Choice of birthing centres at Chippenham, Frome, Salisbury, Swindon or Bath, in addition anti-natal and post-natal care would also be provided at Trowbridge and Paulton.
· The services and support provided by the NCT and pregnant mothers peers.
· Publicity of the CCG proposals through the White Horse News and other local mediums.
· Proposals provided following pregnancy profiling up to 2035. Regular monitoring of the support and services required may would evolve over time, depending on demands.
· Future changes to demand for community led births in Trowbridge and Paulton, could necessitate a further review of services.
The Chairman thanked Sarah MccLennan and Lucy Baker, from Wiltshire Clinical Commissioning Group for their presentation.