[toggle title=” Why can’t we continue as we are?“]
Over the last few years, the Department of Health has produced a series of policy documents seeking to improve both safety of mother and child and maternal experience of maternity care. These have both responded to, and been supplemented by, professional guidance aimed at raising standards of safety and professional practice published by different interested professional bodies.
There are two specific standards where Solihull Hospital’s current maternity service does not meet best practice:
- Access to advanced paediatric resuscitation within 10 minutes
- Paediatric Medical consultation available to baby within 30 minutes
[toggle title=”When will the consultation process take place?“]
The consultation will be led by the commissioners of the service (NHS Birmingham East and North PCT and Solihull Care Trust). This is a legal requirement and it cannot be led by Heart of England Foundation Trust. The Commissioners will confirm the exact timeline once the date of the election is known. It is likely to take place after the election to ensure that a full and open dialogue can take place with the residents of Solihull and Birmingham. HEFT will support this consultation to the fullest extent.
[toggle title=”Why is this not sustainable until the outcome of the consultation is known?“]
The date of the public consultation on the long term future of the service is not known and was originally proposed for October 2009. This presents safety concerns beyond April 2010.
The primary reasons for this are:
- overall non-sustainability of current model from a patient safety perspective
- interim measures with on site paediatric cover overnight are agreed only to April 2010, and is only at 90% coverage in any event
- interim measures with continued ARNB midwives is agreed only to April 2010
[toggle title=”Why are we making these changes if there have been no issues or incidents with regards to the safety of the service?“]
In December 2007 the Coroner asked the Trust to review the safety of Solihull maternity services under a Rule 43 letter following the death of an infant delivered at Solihull. At the same time recommendations for resuscitation of a neonate were changed, such recommendations constitute best practice for neonatal resuscitation, against which practice will be measured. This change recommended umbilical vein catheterisation (UVC) for the administration of adrenaline as part of “normal” resuscitation skills required in a resuscitation team.
[toggle title=” Is this a cost-saving measure by the Trust?“]
No. The temporary changes have had to be made because the clinical staff (midwives, nurses, paediatricians, obstetricians, anaesthetists and neonatologists) are concerned about the sustainability of the support for newborns that has been provided over recent years. The small changes to the unit in Solihull are being kept to a minimum so that, depending on the results of the formal consultation, this can be removed or further developed.
In addition, a series of independent, professional reviews have raised similar concerns.