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No decision yet made on return of freestanding midwifery birthing units in Staffordshire

Community leaders have been told that no decisions have been made on the return of midwife-led birth services in Stafford and Lichfield.

County Hospital in Stafford. Photo: Google

The Freestanding Midwifery Birthing Units (FMBUs) at County Hospital and Samuel Johnson Community Hospital were available for mothers considered low-risk to give birth in – but these services were suspended at the start of the Covid pandemic in 2020.

Almost four years on the future of the units is being considered, members of Staffordshire County Council’s Health and Care Overview and Scrutiny Committee heard on Monday.

Antenatal and post-natal care continue to be provided at the sites, a report to the committee said, but births take place at Royal Stoke University Hospital or Queens Hospital Burton.

Stafford councillor Ann Edgeller asked health service bosses: “Knowing the growing population within the Staffordshire area, especially in Stafford and Lichfield, how do you see the Samuel Johnson and County Hospital moving forward with maternity services?”

Helen Slater, associate director of transformation at Staffordshire and Stoke-on-Trent Integrated Care Board (ICB), replied: “There’s been no decision made, so we’re not able to tell you the long-term model at this stage.

“We recognise it has been a number of years since the temporary units closed, initially due to the Covid response. Over the last 12 months the challenge has been around the workforce; we’ve seen both of the organisations have more positive recruitment campaigns and being able to recruit more midwives.

“Some of those are more junior midwives, some are overseas and there is a programme of work to get those midwives up to be able to support both the community services and the hospital-based services. The challenge at the moment is we’re still not up to those full workforce numbers, so we are undertaking a process where we are looking at all different proposals.

“When we came out of Covid in 2021 we looked at, rather than a 24/7 staffed model at the free-standing midwife-led units, an on-demand model where the midwives would meet the ladies at the birthing unit. That was the model we were hoping to move forward with but we have been unable to progress with that model.

“The process we are undertaking at the moment is to go back and look at all the different models, taking information from national best practice, looking at the complexity of the women who are presenting now to the units, looking at the eligibility of the type of women that would be suitable for birthing in those units – they were for low-risk women – and being able to look at what the clinical model needs to be and also what the workforce model needs to be. That process is up and running and we are looking to hold patient, public and stakeholder meetings so we can talk through those and look at the impacts in terms of the women and families that would be potentially using those services and the impact of any changes we would put forward.”

Councillor Edgeller welcomed the news that public meetings would be taking place. And Councillor Janice Silvester-Hall, whose Lichfield division includes Samuel Johnson Community Hospital asked for further details of the public events.

She said: “Is it a case of sharing the information? Are we sending out information or gathering information from those – there would be an appetite for that in Lichfield City North in particular.

“Is it complexities which mean some mothers aren’t necessarily appropriate to birth at those units? Or is it the amount going through those particular areas?

Ms Slater said: “The numbers going through those units prior to them temporarily closing was low. They were lower at County Hospital than at Samuel Johnson, probably because of the geographical area, and we recognise there were women from outside Staffordshire utilising Samuel Johnson, so we are working with Derby and Derbyshire ICB as well.

“The review that both the providers have undertaken demonstrates that the complexity of women presenting, in terms of being able to monitor women, has risen quite a lot since before Covid. That’s where the workforce numbers need to reflect the type of women who are medium and high-risk and have the services in place for them.

“We recognise at the moment we have got a temporary pause on the home-birthing service as well. Both of the organisations are looking to reinstate the home-birthing service so we can offer that choice as well for low-risk women.

“The deliberative event will talk through the proposals we have looked at across the organisations and within the ICB. We will ask for alternative proposals to come forward if people have got those, we will look for the impacts in terms of each of those different proposals so we can then take that away and look to build that into a business case as we have done with other service change processes.

“We will share the information that we have to date, but are happy to take feedback from patients, public and stakeholders at those sessions. We have set up a patient panel that people can register for and we’ve circulated information through the maternity units and through community sites so that people can come forward and share their views with us as we go through this process.”

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