Bid to deliver wider choice on child birth

A shake-up of maternity services is meant to give women more choice about where they give birth at no extra cost to the NHS. With staff covering empty wards and increasing numbers of high-risk pregnancies, clinical commissioning groups for Bath and North East Somerset, Swindon and Wiltshire are looking at the best use of their resources. But there is concern about what that will mean at a local level. Debbie Wiltshire, the chief officer at Wiltshire CCG, told Bath and North East Somerset Council’s health and wellbeing select committee: “The Royal United Hospital has the right level of staff - the issue is getting them in the right place at the right time. It’s not a good use of staffing resources. “The RUH has to deploy its workforce across different sites, including community sites where there may be no births. It has to support that arrangement 24 hours a day. “If the obstetrics unit gets busy they may be called in at short notice. That’s difficult for staff, it has an effect on morale. A lot of trained midwives are hardly getting any practice in community settings.” CCG figures from March 7 give a snapshot of staffing levels. At the RUH there were 17 members of staff on hand for five births. There were seven people working at the birth centre in Paulton but no babies were born, although the staff did carry out six clinics and two home visits. The Bath and North East Somerset, Swindon and Wiltshire Local Maternity System proposal is to only continue supporting births at the community hospitals in Chippenham and Frome, while Trowbridge and Paulton are being put forward as “community hubs” - which the meeting heard could include children’s services or advice on housing for “seamless” support. There are also five postnatal beds in Paulton and another four in Chippenham - but they are empty 95 per cent of the time. Ms Forward said that model of care was outdated and there are better ways of providing support for breastfeeding. The CCGS and hospital trusts for B&NES, Swindon and Wiltshire are proposing to replace those beds with support closer to or in women’s homes. They are also looking to support more women to give birth at home - currently only two per cent do. Debbie Forward said: “Women want the home service to be more widely promoted as an offer. It’s difficult when staff are deployed to so many different settings. It’s clear that the service being provided isn’t always what women want.” Rhiannon Hills, the head of children’s and women’s services at the RUH, said: “By rearranging our resources, we can free midwives up to give more support. We want to support more women to give birth at home. We aren’t looking to reduce the number of staff. We aren’t closing any buildings.” Labour group leader Councillor Robin Moss said: “There are concerns in the community in Paulton because of this proposal.” In response to Cllr Moss’ concerns, a CCG spokesperson said in a statement: “We will not make any plans for the space where the birthing unit at Paulton Hospital is based until after the public consultation has finished.”