Better Beginnings HOSC evidence pack 1 17th February 2014 Contents 1 Evidence from national bodies and other published evidence State of Maternity Services Report 2013; 2013 (The Royal College of Midwives) 1.1 A report on the state of maternity services in the UK in 2013. The report details birth rates, increases in complex births, and the scale of the national shortage of midwives. Birthplace programme overview: background, component studies and summary findings; November 2011 (Birthplace in England 1.2 Collaborative Group) A report on the costs and outcomes of giving birth in different settings in the NHS in England. Reconfiguration of Women’s Services in the UK; December 2013 (Royal College of Obstetricians and Gynaecologists) 1.3 A guide to understanding the principles that affect the reconfiguration of women’s health services and to assessing the quality and standard of women’s services following reconfiguration. Good Practice No. 10: Labour Ward Solutions; January 2010 (Royal College of Obstetricians and Gynaecologists) 1.4 A document highlighting the challenges and issues that arise from the process of expanding consultant presence on the labour ward and presenting facts and tips for those responsible for implementing changes. Emergency Surgery standards for unscheduled surgical care; February 2011 (The Royal College of Surgeons of England) 1.5 A report on the standards for the care of unscheduled adult and paediatric surgical patients. Advice on proposals for changes to maternity, special care baby services and inpatient gynaecology services in East Sussex; July 2008 (Independent Reconfiguration Panel) 1.6 The report by the Independent Reconfiguration Panel to the Secretary of State for Health on the Primary Care Trust’s proposals for changes to maternity, special care baby services and inpatient gynaecology services in East Sussex in 2008. NCAT Review: East Sussex Healthcare NHS Trust Maternity and Paediatric Services; January 2013 (National Clinical Advisory Team) 1.7 A review of East Sussex Healthcare NHS Trust’s (ESHT) proposals to temporarily change the configuration of maternity, gynaecology and paediatric services. 1 Review of the Obstetric and Neonatal Services of East Sussex Healthcare NHS Trust at Conquest Hospital; August 2013 (Royal 1.8 College of Obstetricians and Gynaecologists) An independent review of ESHT’s temporary reconfiguration of maternity services at the Conquest Hospital. Service Review: East Sussex Healthcare NHS Trust; November 2013 (Royal College of Paediatrics and Child Health) 1.9 An independent review of ESHT’s temporary reconfiguration of paediatric services. 2 Evidence from the Clinical Commissioning Groups (CCGs) Better Beginnings: Proposals for the future of NHS maternity, in- patient children’s services and emergency gynaecology in East Sussex; 2014 (Eastbourne, Hailsham and Seaford CCG, Hastings and 2.1 Rother CCG, & High Weald Lewes Havens CCG) The primary consultation document explaining the proposals for the future of NHS maternity, in-patient children’s services and emergency gynaecology in East Sussex. Pre consultation business case for maternity and paediatric services in East Sussex: Appendix 12 - Maternity and Paediatric Needs Assessment; December 2013 (Public Health) 2.2 A maternity and paediatric needs assessment of East Sussex’s population that was included as an appendix to the CCG’s pre-consultation business case. 3 Media reports ‘Women’s Experiences of maternity care have improved, but further 3.1 progress is needed’; 12 December 2013 (Care Quality Commission) 4 Evidence from campaign groups and stakeholder groups Save the DGH Evidence: • Save the DGH campaign statement • Notes of meeting with Yeovil NHS Trust 4.1 • Notes of meeting with Hinchingbrooke NHS Trust • ‘Homebirth and the Future Child’; 22 Jan 2014 (Lachlan de Crespigny, Julian Savulescu) • EDGH to Conquest by public transport Maternity Services in the High Weald Locality: Not where…but how & 4.2 by whom; February 2014 (Richard Hallett) An alternative viewpoint affecting maternity services for the people of 2 Crowborough and the High Weald. Review of Obstetric Scanning at Crowborough; June 2012 4.3 (Crowborough Birth Centre Stakeholder Consultation Group) A review of Obstetric Scanning at Crowborough Birth Centre. 5 Evidence from members of the public 5.1 Comments received by email from members of the public 3 4 5 6 #soms2013 State of Maternity Services report 2013 1 | The Royal College of Midwives 7 Executive summary This is the third report in our annual there were 85 per cent more babies The total number of students studying State of Maternity Services series. born to women in England aged 40 midwifery has now topped 6,000 Our two previous reports, the 2011 or over than there had been in 2001. in England. That is good news, and and 2012 editions, have set the In Scotland the rise for mothers aged needs to continue. The UK Government standard as go-to points of reference 40 to 44 was 71 per cent over the same increased training places in England for the latest numbers on NHS period, and 165 per cent for women to a record level before letting them maternity services for each part of the older than that. In Wales the rise was slip back in 2013/14; they should return UK. Over time the reports will serve 64 per cent for births to women aged the number of student places to their as an evolving commentary on the 40 or over. And in Northern Ireland record level. changing state of maternity services; it was 64 per cent for women between meantime they provide commentators the ages of 40 and 44, and 53 per cent The fact that the NHS in England is and decision-makers with a snapshot to women above that age range. thousands of midwives short of where of today’s maternity care. it needs to be was confirmed in November 2013 by the publication of The report is not a review of, say, the National Audit Office (NAO) report, structural changes. It has a very specific Any falling away Maternity services in England. The focus: the collation and interpretation of report’s findings largely confirmed some of the basic numbers that tell the of the baby boom what the RCM has been saying for story of the state of maternity services. should not be some years now. England remains the problem child. Outside of England, we need politicians The number of births in England seen as a reason to ensure that they keep putting into continued to rise in 2012, reaching NHS maternity services the resources its highest number (694,241) since 1971. to take a foot off required to maintain everything on an This was 23 per cent higher than 2001. even keel, particularly keeping an eye London (up 29 per cent) along with the accelerator on the age profile of midwives so that the South West and the East Midlands retirees are replaced in good time by (both up 25 per cent) are the regions newly-qualified staff. that have seen the biggest rises. Obesity is another area of growing complexity, which compounds the Within England we need to see In Scotland, births fell for the fourth effect of the baby boom1. The incidence an explicit commitment to maintain year in a row, although remained of maternal obesity in the first three and speed up the elimination 10 per cent higher than in 2001. In both months of pregnancy in England, of the midwife shortage. A cut Wales and Northern Ireland the number for example, more than doubled from in the shortage of 200 midwives in of births fell in 2012 for the second year 7.6 per cent to 15.6 per cent between a year is okay, but it is by no means in a row, but in both cases the number 1989 and 2007. The result is an extra fast enough. remained 15 per cent higher than it had 47,500 women requiring more been in 2001. demanding care. We need to see training numbers maintained at their current levels The very latest figures, for the first Our assessment of the shortage and newly-qualified midwives given half of 2013, may however suggest of midwives in the NHS in England employment not least because of that the baby boom in England is in 2012, the latest full year for the growing dropout rate amongst over. In the first six months of the year which we have both midwife and student midwives, as referenced in the number of births in England fell birth figures, is around 4,800. the NAO report. by 18,000, compared to 2012. Smaller This is an improvement of 200 on falls in the first six months of 2013 last year. Indeed, this is the fourth Above all it is important for the RCM were seen across the rest of the UK. year in a row in which the shortage to communicate the fact that any has fallen, having stood at more falling away of the baby boom should Scotland, Wales and Northern Ireland than 6,000 in 2008. not be seen as a reason to take a foot have thankfully not used the tailing off the accelerator; instead, it should off of their baby booms to cut midwife This report also publishes for the first be seen as an opportunity to eliminate numbers. Whilst individual units or time a calculation, for England, of the the shortage much faster. areas in those parts of the UK may be difference between the number understaffed, overall they employ of births that took place in a year and We remain hopeful for better days broadly the right number of midwives. the number of births for which the ahead. It would appear that the baby midwifery workforce during that year boom may have ended, although The effect of this higher number of was suited.