Trust Board Febuary 2010 - Sandwell & West Birmingham Hospitals

SWBTB (2/10) 045 (a)
• Two obstetric (consultant) led Delivery Suites with associated inpatient beds and Antenatal Day
Assessment Units, one at Sandwell Hospital and one at City Hospital, that primarily provide a
medical model of care.
• Consultant led antenatal clinics are also held on both sites.
• The Trust delivers around 6100 babies a year with 3500 deliveries at City Hospital and 2600
deliveries at Sandwell Hospital (see table 1 below). During 2007/08 the Trust supported 27 home
births.
• There is a Level 2 Neonatal Unit at City Hospital that admits babies delivered from 26 weeks
gestation requiring intensive or special care.
• There is a Level 1 Neonatal Unit at Sandwell Hospital that admits babies from 34 weeks
gestation requiring special care. As a result women presenting at Sandwell Hospital in labour
between 26 and 34 weeks gestation are transferred to City Hospital for delivery (or if there is no
capacity at City another Hospital with an onsite Level 2 Neonatal Unit). It is estimated that up to
about 200 women a year presenting at Sandwell will require this type of transfer.
• Women presenting at Sandwell or City Hospital in labour under 26 weeks gestation are
transferred to a Hospital with an onsite Level 3 Neonatal Unit (locally these are the Birmingham
Women’s Hospital and Heartlands Hospital).
• In order to offer women with low risk pregnancies the advantages of more choice, a less
technical and clinical environment and a midwifery led model of care with less likelihood of
medical interventions, the Trust is developing a Midwifery Led Birth Centre at City Hospital, colocated
to the main Delivery Suite. This will open at the end of March 2010 and it is anticipated
that once it is fully established, 30% of women delivering at City Hospital will be eligible to deliver
in the Centre.
Table 1: SWBH Births by Hospital Site
2007/08 2008/09 2009/10
Forecast based
on Month 9 actual
activity
Estimate
for 2010/11
(Based on RCRH
Activity Model V5)
Estimate
For 2011/12
(Based on RCRH
Activity Model V5)
Site Swell City Swell City Swell City Swell City Swell City
Number
of Births
2 628 3 607 2 611 3 508 2 670 3 649 2 645 3 752 2 692 3 924
Trust
Total
6 235 6 119 6 318 6 397 6 616
The Trust’s maternity services sit in the context of over 10 000 births a year to women resident in the
local health economy of which 4 300 take place in other hospitals - primarily Dudley Group of Hospitals,
Walsall Manor Hospital, Birmingham Women’s Hospital and Heartlands Hospital. The Trust provides
community midwifery services to a total of 8 200 women per year.
2.4 The Clinical Case for Change
In addition to the internal focus described above the Trust has also undertaken some work in
conjunction with external bodies in order to address specific local issues so as to ensure the
maintenance of a safe and effective maternity service that is also in line with national Policy Imperatives.
These external bodies include the Healthcare Commission, West Midlands Strategic Health Authority,
Sandwell and Heart of Birmingham Primary Care Trusts, the Royal College of Obstetricians and
Gynaecologists (RCOG), and the Local Supervisor of Midwives (who has carried out regular
independent supervisory reviews). The input of these external bodies has been invaluable, particularly
in providing an independent perspective, in benchmarking the Trust’s performance against its peers and
in making clear recommendations for areas of further action.
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