Agenda item

To consider the proposals put forward by the Health Board for temporary changes to women’s and maternity services in North Wales (report attached) and to provide the Health Board with the Committee’s views on the proposals as part of the ‘Have Your Say’ consultation.

10.05 am – 10.45 am

The Betsi Cadwaladr University Health Board’s (BCUHB) Assistant Director, Strategy and Engagement (ADS&E), Sally Baxter, introduced the Temporary changes to Women’s and Maternity Services in North Wales. “Have Your Say”.

A copy of the summary version had been distributed to members on publication of the committee papers.   In her introduction, the ADS&E emphasised that the proposed changes were a temporary measure until the staffing situation could be stabilised.  The proposals involved temporary changes to the location of consultant-led obstetrics, gynaecology and breast surgery services.  Midwifery services and neo-natal services would remain on all three sites.  The Board acknowledged that the proposals were a cause of great concern to residents across the region, but it felt that something had to be done in the interim to minimise the risk to expectant mothers and their babies.  The Board’s preferred option was Option 4, temporary changes to maternity services at Ysbyty Glan Clwyd, as in its view it had the least significant impact on travel and other services could be put in place quickly.  The Board was open to suggestions, and all four options were out for consultation until 5 October 2015.  Members were advised that they could respond as individuals and collectively as a Committee to the consultation.  Members were also requested to encourage residents within their wards to respond.

Discussion took place on all options and responding to Members’ questions, the ADS&E:

·       Informed members that an additional public consultation event had been arranged for 2 October in Denbigh, with sessions being held at 2.00 p.m. and 5.30 p.m.  The ADS&E asked members to draw this to residents’ attention

·       Medical and technological advances had moved on significantly since the time when the three district general hospitals were built, as had the Deanery and national expectations for the health service.  There was much more emphasis now on specialist medical centres of excellence and on moving patients out of the hospital environment as soon as it was safe to do so

·       Reassured members that the Board would have measures in place to move mothers who would require consultant-led care to the appropriate site as quickly as possible – if it was a pre-planned consultant-led birth, arrangements would be made well in advance for them to attend their preferred site.  If it was an emergency situation, a general medical team would be on hand to stabilise the patient whilst arrangements were put into motion with the Ambulance Service to move her to the nearest consultant-led site

·       The number of emergency caesarean births in North Wales per year, was approximately 1% of the total number of births

·       Re-affirmed that the proposals were a temporary measure and were linked to the development of the Sub-Regional Neonatal Intensive Care Centre (SuRNICC) at Ysbyty Glan Clwyd as the centre of excellence for babies with more complex needs – this unit would be consultant-led

·       If it transpired that the staffing problems could not be solved and the temporary changes needed to be extended for a longer period of time, the Board would be required to re-consult on the proposals as they could not be extended indefinitely

·       Stated that there were deaths occasionally even in consultant-led maternity units

·       Confirmed that there was not a shortage of midwives in North Wales at present, and an additional 27 midwives had been recruited recently

·       Assured members that the temporary changes were not a cost saving exercise.  They were being proposed as a measure to address staffing level problems which could pose a risk to women and to the Board.  At the conclusion of the consultation exercise, the implementation of whichever option, would have a cost implication

·       The current service was heavily dependent on locum consultants, this was unsatisfactory and very expensive

·       Confirmed that whilst neither Ysbyty Gwynedd nor Wrexham Maelor had parent accommodation similar to Tŷ Croeso Dawn Elizabeth House on site, arrangements would be made to accommodate parents near the hospital site if required

·       Confirmed that a summary of the consultation responses would be available on the Board’s website in due course, and

·       That the points raised at the current meeting would be fed back as part of the evidence gathered during the consultation period.

Prior to concluding the discussion, the ADS&E agreed to furnish members with the following information:

·       A link to the full consultation document

·       The number of problematic/complicated births at each district general hospital site during the last 3 years, and

·       The number of midwives who had left the Board’s employment during the last three years as well as the number of midwives recruited in that time (including the total number of midwives in post for the years in question).

Members were encouraged to send any additional questions or comments they wished to submit as part of the consultation exercise to the Scrutiny Co-ordinator who would then forward them on to the Assistant Director, Strategy and Engagement.

The Committee expressed their gratitude to the Assistant Director of Strategy and Engagement for attending the meeting, and it was:

RESOLVED that subject to the provision of the above information, to note the proposals put forward and request that in the long-term, the residents of Denbighshire should be served by a safe consultant-led obstetrics and gynaecology service at a site as near as possible to their homes, preferably within the county boundary, unless they were nearer to a unit that was outside the county.