Proposals to suspend services at Shropshire’s Midwife-Led Units for up to six months to be considered

Proposals to suspend services at Midwife-Led Units (MLUs) in Bridgnorth, Ludlow and Oswestry for between three and six months will be considered tomorrow.

The Shrewsbury and Telford Hospital NHS Trust (SaTH) has faced a combination of short-term and long-term sickness in recent months, as well as a significant fall in the number of midwives prepared to work overtime or temporary bank shifts to cover shifts at times of sickness. It has resulted in services having to be temporarily suspended at MLUs at short notice.

Tomorrow’s SaTH’s Board will receive a report explaining that action needs to be taken to make sure the Trust can sustainably provide the right complement of staff to safely look after the women using the service at the Consultant-Led Unit. The recommendations will remove uncertainty about whether an MLU will be closed at short notice.

The Board will be asked to approve a report which recommends suspending services at Bridgnorth, Ludlow and Oswestry MLUs for between three and six months from 1 July 2017. The Board will also decide the exact length of time services will be suspended for, if they agree with the proposal.

The proposals are being put forward on safety grounds to ensure safe staffing levels. The Trust says it is not about the competence of staff but the ability to ensure safe numbers of staff.

If the plan is approved, women who have chosen to give birth at the MLUs during this period will be able to access their midwife as usual and be offered a birth at an alternative MLU location, such as Shrewsbury or Wrekin MLU, or they can choose the Consultant-Led Unit at the Princess Royal Hospital in Telford or a home birth if appropriate. Midwives will remain available for advice 24-hours-a-day, seven-days-a-week.

Deirdre Fowler, Director of Nursing, Midwifery and Quality at SaTH, said: “The safety of mothers and babies using our service is our number one priority and this proposal, albeit difficult, is something we have given careful consideration.

“An increasing number of women are choosing to give birth at our Consultant-Led Unit in Telford, rather than at our MLUs. In 2008/2009 MLU births, including home births, accounted for 26% of our activity but in 2016/17 this figure has fallen to 13.1%, with just 3.4% of this activity taking place at Ludlow (0.7%), Oswestry (1.1%) and Bridgnorth (1.6%) MLUs.

“This means we have seen a high level of demand on our Consultant-Led Unit (85% of local women are giving birth here). At the same time we have faced a combination of short-term and long-term sickness, as well as a significant fall in the number of midwives prepared to work overtime or temporary bank shifts to cover shifts at times of sickness. This has meant that at times we have had to temporarily suspend services at our MLUs due to staffing shortages.

“We appreciate that such temporary suspensions of service are disruptive for mothers-to-be, their families and our staff and create uncertainty for women about whether an MLU will be open or not when they go into labour.

“As a result, we are proposing temporarily suspending services at our MLUs in Bridgnorth, Ludlow and Oswestry for between three and six months in a measured and planned way, rather than having to suspend some services temporarily at short notice to ensure we continue to provide a safe overall service.

“We recognise the significant impact that this may have on some of the women we care for about their planned place of birth and we are sorry for this. We have taken into account the many comments received regarding short-notice closures and recognise that the women we care for need assurance about their place of birth. For this reason, we are proposing the most difficult decision to suspend some services for a defined period of time whilst we work up alternative longer-term sustainable options. If the decision is approved tomorrow, I would encourage any woman using our service who has concerns or questions about how this will affect them to discuss their birth options with their midwife.”

The proposals do not pre-empt the outcome of the Midwife-Led Unit review that clinical commissioners are currently carrying out. The Trust says it will also continue its efforts to recruit more Midwives.