Birthing services closed until at least the end of September
Health chiefs deny suspending birthing at North Devon District Hospital is a “deliberate downgrading” of England's most remote acute mainland hospital
Health chiefs have denied that suspending birthing services at North Devon District Hospital (NDDH) is a “deliberate downgrading” of the most remote acute mainland hospital in England.
They say they are “absolutely committed” to reopening the services but it won’t be until “at least the end of September”.
Leaders of the Royal Devon University Healthcare NHS Foundation Trust and Devon Integrated Care Board (ICB) faced many questions from councillors at a special meeting of Devon County Council’s health and adult care scrutiny committee on Monday.
Birthing services at NDDH were suspended on August 11 resulting in women having to travel 90 minutes or more to Exeter to have their babies.
The move was described at the meeting as “sudden and chaotic” by Cllr Paul Crabb (Con, North Devon Council, Ilfracombe).
The trust said it was an “extremely difficult” decision to make but it was not able to provide “effective and safe services” due to staffing issues.
Fragilities in the system were raised last year but the tipping point came when a member of staff suffered a sudden bereavement and had to travel overseas and a locum doctor withdrew from the service, leaving the unit of eight doctors unable to provide 24-hour cover.
But councillors questioned whether more could have been done to prevent the suspension which had left many women in North Devon and the catchment area of North Cornwall and Somerset “terrified” and “anxious”.
They said residents of North Devon now had “little faith in the trust”.
Council leader Julian Brazil (Lib Dem, Kingsbridge) said closing services should never had been an option.
He called it “a catastrophic failure of senior management” adding that he was not convinced that it would not happen again or to other services in the north of the county fearing that things would “centralise around Exeter”.
Devon County Council cabinet member for rural affairs Cllr Cheryl Cottle-Hunkin (Lib Dem, Torrington Rural) said she could not quite believe what was happening and that North Devon and Torridge should not be disadvantaged because they were rural.
“Our geography is a fact but it should never become an excuse for providing families with a lesser standard of access to essential healthcare,” she said.
Cllr Andrea Davis (Con, Combe Martin Rural) said there was no Uber waiting around the corner in remote North Devon for people whose families did not have access to a vehicle and no mobile signal in many areas.
From Ilfracombe and more remote parts of the district it was a two journey journey to Exeter. Road infrastructure was poor so too was public transport. If you could get a taxi, it would cost £150 each way.
“This is subjecting women at their most vulnerable to an unbearable level of anxiety,” she said. “The thought of a mother labouring in a car with zero mobile phone signal is nothing short of terrifying.”
A petition instigated by North Devon Liberal Democrat MP Ian Roome to protect maternity services has 15,000 signatures on it. Over the weekend hundreds protested in Barnstaple over the unit’s temporary closure.
Attending the council meeting remotely Mr Roome that he written to health secretary Yvette Cooper about the situation: “We are not asking for special treatment, just something very basic,” he said and highlighted that travel and accommodation costs for all families should be met by the trust while birthing services were suspended at Barnstaple not just those on benefits.
Dr Vanessa Purday, chief medical officer for the trust and a mother of three, said the decision to suspend birthing services had weighed heavily on herself and executive colleagues.
In the last 12 months there had been five recruitment drives and enhanced packages to attract consultant obstetricians and tier 2 doctors (registrars) but the response had been limited and some withdraw their applications after being offered positions elsewhere closer to their homes. The meeting was told that there were 93 vacancies nationwide for the same posts.
Recruiting to NDDH had always been challenging because of its remoteness and size, although it served a population of nearly a quarter of a million people and a geographic area the size of London, the meeting was told.
Councillors said the fact that the hospital was well overdue for a rebuild was not attracting doctors.
However two locums had now been appointed and two tier 2 doctors were available to start in September – it was just a case of confirming working visas, said Dr Purday.
“We have also had offers of support from colleagues in the region and neighbouring trust which is invaluable. I hope that in the coming three to four weeks I will be in a position to be really clear on rotas.”
Since last Wednesday (August 12) nine women who were due to have babies at NDDH have delivered at the RD&E and there had been “no incidents” with mothers and babies.
An additional 14 beds have been added to expand capacity and last week there was an 80 per cent bed occupancy, councillors were told.
Twin babies and another newborn were admitted back to NDDH for transitional care.
Staff had been “well supported” and 95 per cent of midwives at NDDH had transferred to Exeter.
Chief executive of the Royal Devon University Healthcare NHS Foundation Trust Sam Higginson said the maternity services were not the only healthcare services at NDDH that were fragile.
He said he believed the right decision had been made but denied a comment from Cllr Jacqueline Fry (Reform, Newton Abbot North) that the hospital was being “deliberately downgraded” and that this was the thin end of the wedge.
“We are absolutely committed to this being a temporary closure and we are redoubling our efforts to get staff,” he said. “We are also very conscious of the impact of this.”
He admitted that he could have lobbied harder for a rural and coastal communities maternity services model as the national approach one size fits all was not working for North Devon.
He also said that the trust could have worked more extensively with the NHS Deanery to get postgraduate trainees into the hospital who were more likely to stay.
Devon County Council chief executive Donna Manson made a plea for better collaboration to highlight the challenges that North Devon was facing with NHS England.
She called for strategic thinking and an action plan around fragile services similar to what had been done in Wales.
The county would be stepping in to organise transport for expectant mothers who requested it over the coming weeks while the suspension of birthing services was in place.
“We have started this morning to get it right for families over the next few weeks,” she said. “If there is no car provision we can absolutely get that in place. There will be a wrap around package.”
Midwives will be discussing each patient’s travel arrangements with them and 300 women and birthing people affected by the change have been communicated with.
The scrutiny committee is requesting that a restoration plan for birthing services is submitted by the health trust/ICB along with an impact assessment, a lessons learned review and fragile services report.
It also plans to write a letter to the secretary of state expressing serious concerns over the suspension of birthing services at NDDH.