On-call midwife units 'the only option’ for Shropshire

Shropshire’s Clinical Commissioning Group is currently carrying out a review into the county’s midwife-led units in Oswestry, Ludlow and Bridgnorth.

The trust that run’s the county’s two main hospitals have previously said they think the three midwife-led units should be become ‘birthing centres’ – closing at night.

But campaigners have criticised the idea, which they see as a downgrading of services.

But the Shrewsbury and Telford Hospitals NHS Trust, which runs the centres, says that by making the centres on call, it will make sure there is enough staff to allow women to give birth at their chosen hospital.

Recently, high levels of staff sickness has caused centres to close overnight, the most recent closure seeing the suspension of services at Oswestry on Wednesday night.

This week Bridgnorth's MLU also closed for the third time in as many weeks because of staff sickness.

Sarah Jamieson, Head of Midwifery at the trust said: “The long-term provision of midwifery services in Shropshire is under review, and nothing that is currently being discussed would predetermine the findings of that review.

“As we have talked about before, we manage our service as a whole and staff our units based on demand as it’s important to ensure we have enough staff to care for women at the locations where they have chosen to give birth, rather than focusing on staffing buildings which may have little or no birth activity for days or weeks.

"This is in line with national guidance and means our staff are where they are needed, rather than having a number of Midwives and care support workers in one of our Midwife-Led Units (MLUs) where there may be no women being cared for.

“As has been reported, demand has been high at our Consultant-Led Unit in recent weeks and months and, during that time we have needed to enact our escalation procedure on an increasing number of occasions due to a number of factors, including unexpected staff sickness. This has, unfortunately, meant temporarily suspending services at some of our MLUs overnight at short notice.

“We believe this is disruptive for mums-to-be and for our staff and therefore we have been working closely with our colleagues at the Clinical Commissioning Groups (CCGs) and we are exploring the viability of adapting our current model of care to provide an on-call model to staff on demand rather than staffing buildings where there may be no activity.

“If we had an on-call system of midwifery to support births in our units, rather than staffing the units, women’s choice would be maintained at all times and their options for birthing in their local unit or at home would also always be maintained. It is our opinion, and one supported by many, that this option would be preferable to suspending services; however, this is currently our only option in order to ensure safety.

“It is important to stress that no final decision has been taken on this proposal, which would be an interim response to the on-going issues we are facing in terms of demand and staff availability.”

As part of the review, an independent midwife could also be appointed.

At a meeting of the CCG this week, Dr Jessica Sokolov said an option being considered is the appointment of a midwife – independent to Shrewsbury and Telford Hospital Trust and the CCG – to support the service review.