CHAT calls for radical infrastructure improvements in wake of major report into Caithness maternity services
18th November 2016
The long-awaited report of Public Health Scotland (PHS) into maternity services at Caithness General Hospital was launched today, and recommends that the Henderson Maternity Unit moves to a midwife led model (CMU). The Report concludes that Caithness does not have the population to support an obstetrician, and that the presence of specialists without the backup of intensive care facilities or a paediatrician creates unnecessary risk factors for patients.
The Report will now be discussed by the NHS Highland Board, and if as expected the Board decides to accept the findings of the Report, Caithness General Hospital would lose its consultants and no longer be permitted to perform elective or emergency caesarean sections. It is expected however that first time mothers would once again be allowed to deliver in Caithness, provided their pregnancy remains low risk.
Caithness Health Action Team has expressed numerous concerns over the proposed new maternity model, believing that patient safety will be compromised unless transport services and emergency obstetric cover are greatly enhanced. Going forward, CHAT will urgently seek answers to the following questions:
- If we are to lose our obstetricians, what happens in the event of an emergency caesarean section or cord prolapse, when there is no time to transfer the patient to Inverness?
- What happens when a low risk, ‘green pathway' pregnancy suddenly takes a turn for the worse and becomes a high-risk labour - who will be there to intervene?
- With the Scottish Ambulance Service already under major pressure from the increased number of patient transfers, how will they find the resources to provide more ambulances?
- With labouring women requiring fixed wing transportation, do we have sufficient provision?
- What happens in the event of a road closure due to accident or adverse weather?
- Without consultants, do we lose our obstetrics and gynaecology services?
- What impact will the falling birth rate have on midwife recruitment and skills?
Nicola Sinclair said: "This Report raises as many questions as it does answers. We have already submitted FOI requests to NHS Highland and SAS to gain accurate statistics on key issues such as the frequency of patient transfers and average wait times for an ambulance. We are researching creative care models that have been successful in the past, such as consultants running local ‘hubs' and maintaining their skills through secondments.
"Island health boards have been particularly innovative in finding solutions to the challenges of rural services, and we're contacting them for ideas and inspiration. Caithness has an island postcode after all, so it's not unreasonable to explore whether we could be treated as an island community and shape services that meet our unique challenges.
"If the NHS Highland Board accepts the PHS recommendations, we would expect them to move to a full public consultation, and CHAT has been invited to provide input on what form that consultation should take. As ever, we will advocate for Caithness patients and make sure their voices are heard."
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