Trust Board Febuary 2010 - Sandwell & West Birmingham Hospitals

SWBTB (2/10) 045 (a)
1. INTRODUCTION
In September 2009 the Trust Board agreed a short list of three options for changes to the way maternity
services, in relation to intra-partum (labour and birth) and Consultant led care (ante-natal care, and care
during and immediately after birth) are provided at Sandwell and West Birmingham Hospitals NHS Trust
for the time period up to the opening of the new Acute Hospital in 2015/16. The need to undertake a
formal public consultation on these options was also agreed. Sandwell Primary Care Trust, as lead
commissioner and lead organisation for the medium term review of maternity services gave final
approval to proceed with the public consultation at its Board meeting in September 2009 having sought
the agreement of the Trust Board and the Heart of Birmingham teaching Primary Care Trust (HoBtPCT)
Board.
Public consultation on ‘Improving Services for Giving Birth,’ took place between 12 th October 2009 and
18 th January 2010. The outcome has been reviewed by an independent organisation, Merida Associates
and their report is also being presented to the Board at its meeting in February 2010.
During the public consultation period the Project Steering Group leading the medium term review of
maternity services, undertook more detailed work on the short listed options in relation to activity,
capacity, finance, staffing, risks, feasibility, timescale for implementation and equality impact
assessment. The Project Steering Group also considered responses to the consultation document.
The purpose of this report is to:
• Present the Project Steering Group’s response to the issues raised by the consultation.
• Present the Project Steering Group’s recommended option and related service changes.
• Set out the business case for change.
• Seek Trust Board approval of the recommended option and related service changes.
• Seek Trust Board approval for the required capital investment and the Income and Expenditure
Analysis for the recommended option.
2. STRATEGIC CONTEXT
2.1 Long Term Vision for Maternity Care
The expected standards for maternity care within England have been defined by the Department of
Health (DoH) in the Maternity Standard within the National Service Framework for Children, Young
People and Maternity Services (DoH, 2004). The Maternity Standard identifies safety, normality,
women’s choice and involvement, and a focus on wide accessibility as key elements of a high-quality
service which for low risk pregnancies should be community and midwifery based. The Department of
Health publication Maternity Matters: Choice, access and continuity of care in a safe service (DoH,
2007) confirms the importance of these factors and sets out, from a national perspective, expectations
relating to the delivery of these.
The service provided and the models of care delivered should encompass the central role of midwives
as autonomous practitioners of normal labour and birth, together with their role as partners with
obstetricians, anaesthetists and paediatricians, in the care of women with complex and complicated
labours.
The Right Care Right Here Programme through the Strategic Model of Care Group (SMOC) for
Maternity, Neonatal and Newborn services has set out a vision and service model for maternity and
associated services for the local health economy. The SMOC group advocates, ‘…the normalising of
pregnancy and birthing experience through a midwifery-led approach, based in local communities and
integrated with primary care’ ( RCRH Maternity and Newborn SMOC, 2009, page 3). In developing its
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