Pan‐Essex Maternity Capacity Plan November 2012
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Contents
Purpose 4
Background 4
Birthrate Plus 5
Current Service Provision 6
Princess Alexandra Hospital NHS 6 Trust
Mid Essex Hospital Services NHS 6 Trust
Colchester Hospital University NHS 7 Foundation Trust
Southend University Hospital NHS 7 Foundation Trust
Barking, Havering & Redbridge 8 University Hospitals NHS Trust
Basildon & Thurrock University 8 Hospitals NHS Trust
Steady State Capacity 9
Princess Alexandra Hospital NHS 9 Trust
Mid Essex Hospital Services NHS 9 Trust
Colchester Hospital University NHS 9 Foundation Trust
Southend University Hospital NHS 9 Foundation Trust
Barking, Havering & Redbridge 10 University Hospitals NHS Trust
Basildon & Thurrock University 10 Hospitals NHS Trust
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Anticipated Increase in 10 Service Growth
Princess Alexandra Hospital NHS 10 Trust
Mid Essex Hospital Services NHS 11 Trust
Colchester Hospital University NHS 11 Foundation Trust
Southend University Hospital NHS 11 Foundation Trust
Barking, Havering & Redbridge 11 University Hospitals NHS Trust
Basildon & Thurrock University 12 Hospitals NHS Trust
Impact of Capacity 12 Expansion on Current Service & Other Providers
Princess Alexandra Hospital NHS 12 Trust
Mid Essex Hospital Services NHS 12 Trust
Colchester Hospital University NHS 12 Foundation Trust
Southend University Hospital NHS 13 Foundation Trust
Barking, Havering & Redbridge 13 University Hospitals NHS Trust
Basildon & Thurrock University 13 Hospitals NHS Trust
Summary of Essex‐wide 14 position and overarching future projects / Next Steps
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Glossary 17
APPENDIX 1‐Maternity Capacity Escalation Flow Chart
Purpose
The purpose of this document is to provide an overview of and inform on the current capacity of the acute maternity service providers pan‐Essex, future projections on increased demand and anticipated subsequent pressure on these services and any plans in place with each provider to expand current capacity to meet this demand.
Given that there has not previously been a collective overview of the maternity capacity pan Essex and the key associated risks, a Steering Group was convened comprising representation from acute maternity service providers and commissioners pan‐Essex to explore and address the issues of maternity capacity in the region. This document has arisen as a result of the discussions that took place during these meetings. The plan will ensure that the appropriate action plans and risk mitigation strategies are in place and that all acute providers are aware of the appropriate escalation processes required in relation to demand exceeding capacity within their area.
A pan‐Essex whole system approach has been taken with the additional involvement and input from Barking, Havering and Redbridge given current patient flows, to ensure inclusivity and to identify potential solutions to these shared issues.
A maternity capacity escalation flow chart (Appendix 1) has also been incorporated to provide a succinct working document that provides guidance on the required channels of communication to take in the event of maternity capacity being exceeded in any one of the acute Trusts.
It is anticipated that the steering group will continue to meet quarterly to ensure that this document is updated in a timely manner and that any real or potential issues are addressed promptly and resolutions found.
Background
In common with the rest of the NHS, maternity services face some significant challenges over the next few years.
Changing demographics and rising birth rates come at a time of increasing financial constraint and insufficient staffing levels.
The driving principle for NHS maternity care continues to be the requirement to deliver high quality safe and accessible services designed around the needs of women and their families. One of the main aims of national policy is to offer a choice of type and place of maternity care and birth.
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There has been a general increased demand for maternity services across Essex in recent months due to an underlying increase in the birth rate. Significantly however, a report published in October 2011 regarding maternity services at Queen’s Hospital, Romford resulted in a cap being introduced to limit the number of deliveries that could take place there, having the direct effect of displacing activity across Essex. This resulted in some acute providers experiencing a significantly increased demand on their resources.
Maternity capacity however cannot be viewed in isolation and simply from a “bricks and mortar” perspective. The maternity staffing complement required to support this increased demand is crucial to address concurrently. There are already pressures on midwives due to the rising birth rate and high levels of retirement from the profession and many have called for increased staffing levels. There is most certainly a need for minimum levels of staffing in maternity services.
Birthrate Plus
The DH iand the Royal College of Midwivesii endorse the ‘Birthrate Plus’iii Midwifery Workforce Planning System. This is based upon the principle of providing one‐to‐one care during labour and delivery to all women with additional midwife hours for women in the higher clinical need categories. There are not only increasing numbers of deliveries, but an increasing complexity of cases and increased cross‐border activities which all make a significant contribution.
The current national average suggests a ratio of 1 wte midwife to 28 births in hospital, 1 wte midwife to 35 home births with the same in midwife led birthing units and caseload midwifery practice, plus an additional 5% specialist staff.
NHS Midlands and East, for ease of standardisation, has recommended that all units work towards a ratio of 1:30. NHS London also recommends a ration of 1:30
Pan‐Essex, all acute Trusts have undertaken their own Birthrate Plus staffing assessments. This will describe detailed information as to current and future staffing requirements to demonstrate safe midwifery service provision.
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Current Service Provision (number and types of units etc.)
Princess Alexandra Hospital NHS Trust (PAH)
Approximately 4300 deliveries in 2011/12 Care is provided on one site at Princess Alexandra Hospital, Harlow 11 Antenatal Beds plus one bereavement room Consultant‐led unit with 9 Delivery Rooms and 3 Midwifery Led Beds on Birthing Unit (co‐ located) 22 Post Natal Beds plus 8 Post Natal Beds in birthing unit which can be increased to 12 Community Midwives provide an integrated service with dedicated team for Teenage pregnancy and vulnerable women. Level 2 Neonatal Unit with 16 Cots No Maternity High Dependency Unit (HDU) 60 hours/week Consultant presence on Labour Ward Midwife to Birth Ratio 1:34 aiming to achieve 1:30 by quarter 4 2012/13 Home Birth rate 2%
Mid Essex Hospital Services NHS Trust (MEHT)
Approximately 4800 deliveries in 2011/12 Care is provided across three sites within Mid Essex:‐
Chelmsford ‐ Broomfield Hospital: ‐ Consultant led unit with 11 delivery rooms ‐ Co‐located Midwife Led Unit with 5 delivery rooms ‐ 3 Antenatal beds ‐ 6 Day assessment beds ‐ 5 Triage beds ‐ 20 Post natal beds
Maldon – St Peters Hospital (Midwifery led unit) ‐ 2 day assessment beds ‐ 2 delivery rooms ‐ 8 postnatal beds
Braintree – WJC (Midwifery led unit) ‐ 2 day assessment beds ‐ 2 delivery rooms (delivery rooms flex as Postnatal beds)
2 Obstetric Theatres and a four bed recovery area Level 1 Neonatal Unit working towards level 2 status but do not currently have the nursing staff in establishment for British Association of Perinatal Medicine (BAPM) standards. Community Services include integrated and case loading teams proving care in all settings for ante natal intrapartum and post natal women No HDU Facilities 60 hours of Consultant presence on Labour Ward Midwife Ratio 1:34 with 20% uplift Home Birth rate flexes between 2‐3% 6
Colchester Hospital University Foundation Hospital Trust (CHUFT)
Approximately 4,061 deliveries in 2011/12 Care is provided across four sites in North East Essex:‐
Colchester Hospital NHS Foundation Trust ‐ Consultant led unit with 8 delivery rooms ‐ Co‐located midwifery led birthing unit with 4 beds ‐ 1 special delivery room ‐ 1 bereavement suite ‐ 5 single rooms for women to recover post delivery ‐ 34 ante/postnatal beds
Clacton Hospital – stand ‐alone midwifery led unit ‐ 2 delivery rooms ‐ 8 postnatal beds
Harwich Fryatt Hospital‐stand‐alone midwifery led unit ‐ 2 delivery rooms ‐ 6 postnatal beds
Halstead Birthing Centre (Owned by NHS Mid Essex) ‐ 1 delivery room with en suite facilities
Traditional community‐based midwifery service and 2 midwifery group practices Level 2 Neonatal Unit with 12 special care cots, 4 HDU cots and 1 ITU cot 60 hours of Consultant presence on Labour Ward Midwife Ratio 1:32 139 Home Births in 2011/12
Southend Hospital University Foundation NHS Trust
Approximately 4000 deliveries in 2011/12 Consultant led unit with 6 labour rooms Co‐located Midwife led unit with 4 delivery rooms There is a system of Antenatal Triage and no dedicated inpatient beds. Women are encouraged to go home overnight but in extreme cases accommodation is found within the Delivery Suite if required. 2 dedicated Obstetric Theatres staffed and run by the Maternity Unit 5 bedded Extended Care area within the Delivery Suite Post Natal Capacity 25 Post Natal Beds and Cots (static since services where centralised over 16 years ago) Level 2 Neonatal Unit with 2 intensive care cots, 3 high dependency cots and 13 special care cots 60 hours Consultant presence on labour ward Midwife ratio 1:31 Home Birth rate approximately 5% Bereavement Suite on CDS
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Barking, Havering & Redbridge University Hospitals NHS Trust
Approximately 9361 deliveries in 2011/12 Care is provided across two sites within Barking and Havering:‐
Queens Hospital - 7535 Deliveries per year - 17 delivery beds
King George Hospital - 1826 Deliveries per year - 10 delivery beds Co‐located midwife led unit will be opening in January 2013 at Queens Hospital with 8 beds and water birthing pools – The Queen’s Birth Centre Community Midwifery care and the home birth service are provided by 14 Community Teams. There are dedicated midwives for teenage pregnancy, substance misuse, bereavement team and HIV specialist. Dedicated Level 2 maternal HDU‐Queens‐2 beds and 4 recovery beds Labour Ward Rooms with en suite facilities Bereavement Suite 4obstetric theatres with dedicated staff, 2 on each site Water birthing pool on obstetric‐ led unit Dedicated 5 bay triage area attached to the Labour Ward Day Assessment Unit open 7 days a week Fetal Medicine Unit providing a full range of screening and diagnostic tests including Chorionic Villus Sampling 16 bedded antenatal ward 2 post natal wards‐one high risk Level 2 NICU with 7ITU, 4HDU,14 SCBU;KGH‐14SCBU 98 Hours Consultant Cover on Labour Ward Midwife Ratio 1:29 Home Births ‐1‐2%. Home Birth Team to be implemented
Basildon and Thurrock University Hospitals NHS Foundation Trust
Approximately 4356 deliveries in 2011/12 Consultant Led Unit – 6 high risk delivery beds and 4 high risk induction labour rooms 2 Obstetrics theatres Co‐located Midwife Led Unit – 5 delivery beds (2 with birthing pools and the other delivery rooms with private en‐suite facilities and 4 post natal beds) 3 bedded Close Monitoring Unit Bereavement Suite Maternity assessment centre with four beds to be increased to 7 in December 2012 The combined antenatal and post natal unit has 29 beds of which 6 are used for antenatal inpatients, to be increased by 5 beds in January 2013 Level 2 Neonatal Unit with 21 cots 8
60 hour Consultant cover Midwife Ratio 1:33 (temp staff currently used to achieve 1:30) 2.25% Home Births in 2011/12
Steady State Capacity
Princess Alexandra Hospital NHS Trust (PAH)
Steady State Capacity approximately 4500. Births are monitored month on month.
Mid Essex Hospital Services NHS Trust (MEHT)
Steady State Capacity of 4900 deliveries per year.
In addition, Mid Essex Hospital Trust (MEHT) have a referral management plan of 390 births per month. This is a non‐geographical plan to enable women to retain the option of choice of place of birth and has been implemented as the birth rate in Mid Essex continues to rise significantly. There is a ceiling of 410 births per month allowing a flex of 20 births per month for Mid Essex women. This is absorbed by late bookers and those moving into the area. 5% attrition is factored in. It is predicted that 15% of births each month will be from out of area women.
Colchester Hospital University Foundation Hospital Trust (CHUFT)
Currently there is a steady state capacity of 4000 deliveries per year which has remained the same since 2010. It is expected that there will be an increase in women of child bearing age by 2020 and an further increase by 2025. CHUFT is able to serve the population who accesses the maternity service.
Southend Hospital University Foundation NHS Trust
Steady State Capacity of 3840 deliveries per year.
The predictability of the delivery rates enables the service to plan for the times of increased capacity and ensure staffing cover is available if required. Bookings are reviewed on a monthly basis as part of the obstetrics dashboard.
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Barking, Havering & Redbridge University Hospitals NHS Trust
As part of the Health for North East London strategy for maternity services, births are to be equalised across the sector and the campus model for maternity care is being implemented. This will see a reduction of births at BHRUT hospitals from 9500 in 2011/12 to 8000 in 2013/14. However there is a predicted increase in births across the North London sector from 2014/15 onwards, which it is proposed would be managed operationally across the North London sector primarily with input/support from the Essex economy.
The campus model gives women the choice of a range of birth environments including : High risk obstetric units Co‐located birth centres Stand alone birth centre Home Birth
Basildon and Thurrock University Hospitals NHS Foundation Trust
Steady State Capacity of 4500 deliveries per year, booking 360‐380 women per month with the available space to increase capacity for up to 4700 deliveries.
Anticipated Increase in Service Growth (with Public Health data / information)
Princess Alexandra Hospital NHS Trust (PAH)
There is currently no cap in place on the service but there is a predicted increase to 4500 births by end of year and further increase to 5000 by 2014/15. The significant strategic change has been the closure of maternity services at QEII Hospital in Welwyn Garden City and the threat of closure of the birthing unit at Chase Farm Hospital.
The Office of National Statistics has predicted a 20% growth in the catchment population over the next 18 years. This accounts for natural population growth and migration, and includes plans for the redevelopment of Harlow North. It is proposed that Harlow North will provide residential housing for approximately 60,000 people. This figure does not, however, take into account the transfer of some hospital services from Hertfordshire. This could equate to an additional 20,000 people.
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Mid Essex Hospital Services NHS Trust (MEHT)
Mid Essex has a population of 359,663. The population growth is high especially in Braintree and Maldon and by 2028 there will be an additional 59,000 people in Mid Essex, 84% of which will be aged over 60.
The greatest increase in population growth of 0‐4 year olds occurred in 2007‐2010. Although the population is growing the % of 0‐4 years old within Mid Essex for the next 5 years remains static at approximately 5.1 % of population.
The increase in birth rate therefore will be from out of area women choosing to give birth at MEHT. Traditionally areas such as Brentwood, Gt Dunmow and parts of Billericay have chosen to book for care at MEHT. These are out of area and will be accepted until 380 bookings per month are reached after which the cap will be imposed for out of area women.
The capping of the birth rate at 410 means outpatient, under 4 hour activity and labour and inpatient stays can be better predicted i.e. 410 bookings a month will generate 360 admissions per month. This will exclude labour activity and will be absorbed throughout the 3 sites.
Colchester Hospital University Foundation Hospital Trust (CHUFT)
Overall the number of women of childbearing age is increasing in Colchester and Tendring. The size of the female population aged 15‐44 years is likely to increase from 60,800 in 2008 to 68,300 in 2020 and to 72,400 by 2025. This would be a 12% increase overall by 2020 and an increase of 19% by 2025. The demand for maternity care is expected to grow in line with this population increase.
Southend Hospital University Foundation NHS Trust
Demographic information of the childbearing population suggests for the area of South East PCT that there will be a stand still situation in relation to the current delivery rate of 4000 per year. There are no evident peaks of change.
Changes in the delivery rate will affect the baseline numbers of both Midwifery staff and Consultant Obstetricians.
Barking, Havering & Redbridge University Hospitals NHS Trust
It is anticipated that King George Hospital maternity unit will close inMarch 2013 once the co‐located birthing centre at Queens Hospital is established. Current service moving from 9300 births to 8000 births by 2013/14. Capacity at Queens Hospital will be up to 9000 births. Community boundaries are being redefined in Barking and Redbridge but this will not impact on Essex. In 2013/14 it is anticipated that BHRUT will be able to provide for 500 Essex Births
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Basildon and Thurrock University Hospitals NHS Foundation Trust
Basildon Maternity unit is predicted to deliver approximately 4500 women in the financial year 2012‐2013.
It is predicted that there will be a further increase in deliveries during the next 5 years, escalating to approximately 4700 deliveries. Basildon Maternity Unit is currently working with the Public Health Team at NHS South Essex to confirm these figures.
Basildon Maternity unit has the available space to increase capacity for up to 4700 deliveries.
Impact of Capacity Expansion on Current Service and other Providers
Princess Alexandra Hospital NHS Trust (PAH)
Service has not been impacted by the caps put on some of the other hospitals, although there was an expectation that women would transfer from Queens the latter part of last year and beginning of this but in reality there were few.
Mid Essex Hospital Services NHS Trust (MEHT) The impact of capping at BHRT last September saw a slight increase in Brentwood and Romford women transferring care to MEHT, on the whole this was planned and formed part of the Essex‐wide approach to supporting the capacity issues at BHRT at the time.
The steady influx of out of area women has meant MEHT imposed a referral management plan, which will remain at 410 births per month. There are no plans to expand the current service in terms of the birth rate as there is no facility for expansion. Normal births will be flexed out to the 2 standalone units.
There are no plans to reduce activity at either stand‐alone units. Postnatal beds are being reintroduced at William Julian Courtauld Hospital to help with capacity issues at the acute site. All low risk women will continue to be offered the choice of birth at both units as the first option for women on the ‘healthy’ pathway.
There are no plans to increase capacity at MEHT as there is not physical capacity nor midwives in post to provide a safe service with a birth rate over 4900
Colchester Hospital University Foundation Hospital Trust (CHUFT)
There has been no impact in NEE in the number of women cared for and this is most likely due to geographical location. The development of a co‐located Midwifery Led Unit “Juno” has provided Colchester Hospital University Foundation Trust with additional capacity for maternity services. There is also capacity at the 2 MLU stand‐alone units (Harwich and Clacton). Workforce would have to be reviewed in the event of further increase in births.
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The PCT have recently led on a consultation with the public on the future of maternity services in North East Essex to plan services for the future. This has recently been completed and the responses being analysed prior to a report being published. It is anticipated that the results of this will inform on the model of future community‐bases maternity service delivery commissioned in North East Essex.
Southend Hospital University Foundation NHS Trust
There is limited availability to expand the current service with the current maternity staffing levels in place and also due to the restriction on physical space. Small increases are able to be absorbed into the current capacity but any significant rise in the birth rate would necessitate a more frequent introduction of the escalation policy.
There are currently no plans to expand the service based on our delivery rate. The template of the Unit within the Trust’s infrastructure does not easily allow for any internal expansion of bed capacity.
Barking, Havering & Redbridge University Hospitals NHS Trust
Bookings are reviewed on a weekly basis across the North East London sector through teleconferencing and sharing of booking data to ensure that demand and capacity issues are addressed in a timely fashion across all the providers. Equalisation of bookings across the sector will allow for growth and expansion in future years.
It is anticipated that on‐going discussions with Essex providers and Clinical Commissioning Groups (CCG’s) will continue.
Basildon and Thurrock University Hospitals NHS Foundation Trust
The increase in activity currently predicted would have an impact on capacity and staffing within Basildon Maternity unit.
There has been recent Estates work carried out which will provide additional clinical areas including postnatal and delivery rooms, with plans to introduce extra capacity within the antenatal ward.
There is a significant drive to also increase the home birth delivery rate which will in turn create additional capacity.
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Summary of Essex‐wide position
It is evident from the information we have gleaned in undertaking this plan that concerns relating to the capacity of maternity units to meet the demands of the escalating birth rate will continue and it is imperative that maternity capacity pan‐Essex is awarded a significantly high profile in terms of risk in Clinical Commissioning Groups (CCGs) and the Commissioning Support Unit (CSU) pan‐Essex.
The overarching aim remains to provide a safe and accessible service.
The patient choice agenda concurrently impacts heavily upon the ability for acute Trusts to accommodate all women who require their services and women may choose to utilise the services they wish. The ability to demand manage this particular area of healthcare, therefore is reduced.
There are additionally clear lines of patient flow across the county which often results in Trusts that do have the capacity not being utilised as effectively as they may be in times of increased demand and this is a difficult challenge to address .
Some Trusts simply do not have the capacity to expand their services further in terms of physical space and accommodation. Midwifery staffing however continues to play a significant part in the ability to meet capacity demands and it is crucial that Trusts continue to work very closely with CCGs to determine an action plan and related trajectory to address this going forward, which will in turn include all actions pertaining to the ‘Birthrate Plus’ agenda.
Whilst it is recognised that some areas have an increasing population, which in turn creates an increase in birth rate and deliveries, it is also recognised that there are areas across the patch that have an increased population but not an increase in deliveries.
Next Steps….
This is the first time that such evidence and a dataset and agreed escalation plan for maternity services has been developed for Essex.
This paper has served to demonstrate to the whole economy that there are wide capacity issues that should be understood. The paper is not providing a solution but provides the opportunity for further discussions and definitive actions to take place.
For maternity services in Essex this means the ability to manage the demand on services by ensuring sufficient capacity (physical space, appropriately skilled workforce and necessary equipment), whilst maintaining quality and safety within all care settings. The key principles are:‐
A focus on midwifery led care and normalised pathways as the default option for all women (identified as low risk)
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Ensuring choice for women – between obstetric led unit (OLU), midwifery led unit (MLU) (alongside or free standing ) and home Antenatal and postnatal care provided in a variety of community settings e.g. home, GP practice & children’s centres Out of hospital births i.e. home birth encouraged where appropriate All providers/sites signing up to a Pan Essex Capacity wide operational system based on cooperation and network working
Recent extensive work undertaken by North and East London Commissioning Support Unit has demonstrated the benefits of collaborative working with all maternity providers and commissioners to develop a set of operational guidelines to provide support and advice specifically :
• To GPs on how and where to refer pregnant women. • To the receiving trusts on the collaborative approach to managing referrals so that each unit has the capacity to accept referrals within their agreed cap. • To all parties on how caps are set and referrals are monitored.
In addition there are three measures that are being taken to achieve the change to flows of patients:
• Change in GP referrals. A number of selected GP practices have been chosen because of their location. GPs in these practices are being asked to change their traditional referral patterns.
• A cap on the number of bookings that each hospital can take from the GP practices in each area. If the cap is reached the hospital cannot take anymore bookings from that area.
• A caseload transfer of women booked with one provider to another when it is clear that capacity in that hospital is likely to be greater than deemed to be safe. Caseload transfers should be rare events however. This has resulted in a robust and effective maternity capacity management plan in Outer North East London. It is therefore suggested that Essex replicates this work undertaken.
Workforce There is a direct correlation between midwifery workforce, birth outcomes and women’s reported experience of childbirth. Ensuring safe and sustainable staffing levels, particularly of midwives and obstetricians, requires a strategic approach to education, commissioning and workforce planning to ensure the right staff, with the right skills, in the right place for the future.
It is vital that adequate staffing, skill mix and deployment are in place to ensure that midwives are able to deliver continuity and quality of antenatal and postnatal care in a safe environment. Although this is the requirement of each local provider and associated commissioning body there are significant benefits to be gained by adopting an open and transparent approach to workforce planning pan‐Essex and by working collaboratively to address local issues in terms of sharing best practice and utilising solutions to staffing issues that have been found to be successful elsewhere.
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Next steps required with all agencies are to gain a broader understanding of : The future population projections pan‐Essex The proportion of women having high risk pregnancies with increased complexity and acuity Variations in outcome between providers and geographical areas
This exercise will ensure that there is a much more detailed overview of current and projected capacity pan‐Essex.
The pan‐Essex Maternity Capacity Steering Group will therefore continue to meet on a regular basis (frequency to be determined) to take forward this work as a matter of priority and will continue to work closely with North and East London Commissioning Support Unit to share best practice and ensure that maternity services pan‐Essex are fit for the demands that the future will inevitably bring, sharing updates on the progress of this work as applicable with all relevant bodies.
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Glossary
BAPM British Association of Perinatal Medicine
BHRT Barking, Havering & Redbridge Trust
CCG Clinical Commissioning Group
CSU Commissioning Support Unit
DH Department of Health
HDU High Dependency Unit
ITU Intensive Treatment Unit
KGH King George Hospital
MEHT Mid Essex Hospital Trust
MLU Midwifery Led Unit
NEE North East Essex
NHS National Health Service
SCBU Special Care Baby Unit
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APPENDIX 1
PAN – ESSEX ESCALATION
AND COMMUNICATION PLAN
Maternity Co‐ordinator undertakes risk assessment based on activity, acuity and staffing in liaison with Duty Manager on call, Obstetrician and Paediatrician
All options considered including Divert, Transfers out etc.
Decision made and agreed internally at Trust, including Duty Manager/Director on Call/Director of Operations / If this decision is made out of hours, the HOM and Site Manager/Director on Call are to be informed. Wider partners to be advised next
Following authorisation by the Director of Operations/Exec on call the Trust duty team/manager will action the following: Communication sent to East of England units (Please see attached) East of England Ambulance Service (EEAST) informed On‐Call Director @ PCT informed/CCG/SHA Document process, timings and rationale for escalation and record on CAMS Inform the Supervisor on Call who will contact the Local Supervisory Authority (LSA) and complete database during normal working hours
18 This document should be considered in conjunction with neo‐natal acuity and flow charts PAN – ESSEX ESCALATION & COMMUNICATION PLAN
CONTACT DETAILS
East of England Unit Contact Area covered Colchester Hospital Consultant on North East Essex University NHS call/Maternity Mid Essex (Broomfield) Foundation Trust Bleepholder/Duty Manager Operator – 01245 443673 on Call/Site Matron on Duty Delivery Suite ‐ 01245 513926
Delivery Suite Co‐ordinator Ipswich 01206 742474 Operator – 01473 703400
Basildon & Thurrock Delivery Suite Co‐ordinator Southend University Hospitals Matron Operator ‐ 01702 435555 NHS Foundation Trust 01268 524900 Delivery Suite – 01702 385163 Ext 3550 or 3553 or bleep 6192 Colchester Delivery Suite ‐01206 742738/9
Mid Essex Delivery Suite ‐ 01245 513926
Darenth Valley Operator – 01322 428100 Delivery Suite – 01322 428273
Princess Alexandra Hospital MLBU – 01279 827176 Delivery Suite – 01279 441607
Mid Essex Hospital Maternity Bleep holder Basildon Services NHS Trust 01245 44 3673 Operator – 01268 524900 Delivery Suite – Ext 3550 or 3553 Labour Ward co‐ordinator 01245 51 3056 (out of Princess Alexandra Hospital hours) MLBU – 01279 827176 Delivery Suite – 01279 441607
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East of England Unit Contact Area covered Barking, Havering and Maternity Manager on call Whipps Cross Redbridge University 01708 435000 Operator – 0208 539 5522 Hospitals NHS TRUST Newham Operator – 0203 416 5000
Homerton Operator – 0208 510 5555
Basildon Operator – 01268 524900 Delivery Suite – Ext 3550 or 3553
Southend Operator ‐ 01702 435555 Delivery Suite – 01702 385163
Mid Essex Delivery Suite ‐ 01245 513926
North Middlesex Operator – 0208 887 2000
Royal London Operator – 0207 377 7000
Southend University CDS Coordinator Basildon Hospital NHS 01702 435555 x 6485, 6487 Operator – 01268 524900 Foundation Trust 0r 01702 385163 Delivery Suite – Ext 3550 or 3553
CDS Manager and Matron x Mid Essex 6486 Delivery Suite ‐ 01245 513926
Princess Alexandra Maternity Manager on call Mid Essex Hospital 01279 444455 Delivery Suite ‐ 01245 513926
Stevenage (Lister Hospital) Operator ‐ 01438 314333
Whipps Cross Operator – 0208 539 5522
Rosie (Addenbrookes) Operator ‐ 01223 217617
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i http://webarchive.nationalarchives.gov.uk/+/www.dh.gov.uk/en/Aboutus/Chiefprofessionalofficers/Chiefnurs ingofficer/Energiseforexcellence/DH_120761 ii May 2009 Royal College of Midwives “Staffing Standard in Midwifery Services” Guidance Paper iii http://www.birthrateplus.co.uk/
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