Implementing A Framework for Maternity ... - Scottish Government

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Miss Eleanor Stenhouse Senior Midwife, Queen Mother’s Hospital, Yorkhill NHS Trust, Glasgow Dr Graham Stewart Clinical Director and Consultant Paediatrician, Royal Alexandria Hospital, Paisley Dr Tom Turner Consultant Paediatrician, Queen Mother Hospital, Yorkhill NHS Trust, Glasgow Dr Ian Lowles Consultant Obstetrician/Gynaecologist, Borders General Hospital Dr John H McClure Consultant Anaesthetist, New Royal Infirmary of Edinburgh Robert Colburn Head of Accident and Emergency Services, Scottish Ambulance Service page 31
Appendix 2 Risk Assessment Exit and entry examples to levels of maternity care Section V explained the rationale for the identified entry and exclusion criteria to the different levels of maternity care. The attached tables provide examples of morbidities and co-morbidities which would not be suitable for delivery in the specified units, but this requires local and regional agreement and the development of guidelines and explicit networks. This list is not all-inclusive, and examples are given for clarity. The identification criteria may be for referral at any level of care, for advice regarding management, or transfer to a higher level of care, depending on local agreements. It must be stressed that any woman with significant morbidity is not suitable for delivery in Level Ia-d. It is crucial that appropriate referral pathways are used for any mother and baby who give cause for concern. Level IIa exit criteria, especially for maternal reasons, will require consultant obstetrician involvement and care will depend on the available level of service, local facilities and emergency support. Level IIc units should be able to care for the majority of pregnancies. Though the document has concentrated on exclusion criteria, the following table identifies the women who are suitable to Level Ia-d of maternity care. Exit examples for Level Ia-d care Age Primigravida of >16 Primigravida of
Page 1 and 2: Implementing A Framework for Matern
Page 3 and 4: Foreword Our National Health Servic
Page 6 and 7: Contents Key Messages from the Expe
Page 8 and 9: 8. There is no such thing as ‘zer
Page 10 and 11: Introduction 1. Scotland’s mix of
Page 12 and 13: 10. The report shows that in 2002,
Page 14 and 15: Principles 1.1 Acute maternity serv
Page 16 and 17: Assessing and Managing Risk 1. Risk
Page 18 and 19: Risk assessment and management 6. T
Page 20 and 21: Table 1 Levels of intrapartum care
Page 22 and 23: Education, Training and Workforce I
Page 24 and 25: Principles 3.7 A national, post-reg
Page 26 and 27: Developing the maternity workforce
Page 28 and 29: Stakeholder Engagement 1. The Scott
Page 30 and 31: Information Management and Technolo
Page 32 and 33: Transport in Acute Maternity Servic
Page 34 and 35: Appendix 1 Membership of Short Life
Page 38 and 39: Exit examples for Level Ia-d: mater
Page 40 and 41: Exit examples Level Ia-d: present p
Page 42 and 43: Exit examples Level IIa: past histo
Page 44 and 45: Exit examples Level IIa: intrapartu
Page 46 and 47: Exit examples for Level IIb: presen
Page 48 and 49: Entry examples for Level III Matern
Page 50 and 51: Clinical judgement and decision-mak
Page 52 and 53: Additional competency which will be
Page 54 and 55: Glossary Accredited Certified as be
Page 56 and 57: Named Midwife A named, qualified mi
Page 58: Further copies are available from T

Implementing A Framework for Maternity ... - Scottish Government

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