SaHF DMBC Volume 1 Edition 1.1.pdf - Shaping a healthier future

7.44 Implementation Issues to be addressed
The implementation of all of the recommendations must be made in a safe and step wise
way, ensuring that services are properly maintained and improved:
1. Six maternity units are proposed. To enable this each unit should have a planned
capacity of at least delivering a minimum of 5000 deliveries. All six Obstetric units will
have alongside midwifery led units. These obstetric units may vary in the complexity
of care offered and specialist services provided. There may be facilities or estate
adaptation required to achieve this agreed model in some units. These are being
addressed by the Business and Financial Planning work stream. For implementation,
the Maternity Network will ensure that it is consulted on any changes and, where
necessary will seek to approve the scheduling and implementation of such changes
2. The neonatal support required is as outlined in the Paediatric CIG Report. The
Paediatric and Maternity CIGs have worked together to ensure the correct provision
taking into account maternity, neonatology and paediatric factors. There would
be five paediatric units (all incorporating ED, inpatients and short stay /ambulatory
facilities and co-located neonatal unit), all co-located with the proposed Major
Hospitals. There would be an additional "stand alone" neonatal unit (NNU) supporting
Queen Charlotte's Maternity Unit
The Maternity Network will work closely with paediatric colleagues to implement this
model. To do this there will need to be consideration of the workforce requirements
needed to support complex maternity cases as well as the number of deliveries and
the activity of the wider acute paediatrics service
3. The CIG recommends that NWL should adopt and aim to achieve the London Health
Programme Maternity Service Clinical Quality Standards during implementation of
the programme (i.e. within three years).For these standards to be implemented fully
the Maternity Network will work closely with commissioners and providers during
implementation to ensure that the standards are implemented in a way that mothers
and their families continue to have comprehensive and appropriate access to
services across north west London
4. The proposal is for a sector wide collaboration to increase staff and develop a
homebirth service in NWL in line with the national evidence. The national evidence
demonstrates that Homebirth is safe and recommended practice. Other regions of
London demonstrate much more success in homebirth midwifery led births. The NWL
maternity Network will ensure it is a true option for women (see issue 5 below)
5. The Maternity CIG has considered the issue of standalone birthing and midwife led
units. They agree that these can be important elements of maternity provision.
However, for Shaping a Healthier Future, since they are proposing six maternity units
with alongside midwife led units, they do not at this stage consider, there would be
sufficient demand for a standalone or birthing centre for the population of North West
London. The Maternity CIG will ensure that there is a Midwifery led homebirth
community facility for all women in NWL. However as SaHF is implemented, the
requirements of pregnant women and mothers will remain at the heart of their
approach and should the need for such a unit arise they will ensure it is properly
considered. To implement this approach the NWL Maternity Network will work with
the commissioners and providers, as well as the communities themselves to enable a
comprehensive homebirth service is across North West London
7d. Work of the Maternity CIG 210