Health bosses say no decision yet on reinstating midwife-led birthing services at Lichfield hospital

Community leaders have been told that no decisions have been made on the return of midwife-led birthing services in Lichfield.

The Freestanding Midwifery Birthing Units (FMBUs) at Samuel Johnson Community Hospital and in Stafford were available for mothers considered low-risk to give birth in – but these services were suspended at the start of the Covid pandemic in 2020.

Almost four years on and the future of the units is being considered, members of Staffordshire County Council’s Health and Care Overview and Scrutiny Committee heard at a meeting this week.

Antenatal and post-natal care continue to be provided at the sites, a report said, but expectant mothers have to travel to sites such as Queens Hospital in Burton to have their babies.

Health services bosses were asked whether consideration had been given on reopening the sites for births given increasing population numbers in the local area.

Helen Slater, associate director of transformation at Staffordshire and Stoke-on-Trent Integrated Care Board (ICB), said:

“We recognise it has been a number of years since the temporary units closed, initially due to the Covid response. Over the last 12 months the challenge has been around the workforce – we’ve seen more positive recruitment campaigns and been able to recruit more midwives.

“Some of those are more junior midwives, some are overseas and there is a programme of work to get them to be able to support both the community services and the hospital-based services.

“The challenge at the moment is we’re still not up to those full workforce numbers, so we are undertaking a process where we are looking at all different proposals.

“When we came out of Covid in 2021 we looked at, rather than a 24/7 staffed model at the free-standing midwife-led units, an on-demand model where the midwives would meet the ladies at the birthing unit. That was the model we were hoping to move forward with but we have been unable to progress with that.

“The process we are undertaking at the moment is to go back and look at all the different models, taking information from national best practice, looking at the complexity of the women who are presenting now to the units, looking at the eligibility of the type of women that would be suitable for birthing in those units – they were for low-risk women – and being able to look at what the clinical model needs to be and also what the workforce model needs to be.

“That process is up and running and we are looking to hold patient, public and stakeholder meetings so we can talk through those and look at the impacts in terms of the women and families that would be potentially using those services and the impact of any changes we would put forward.”

Helen Slater, Staffordshire and Stoke-on-Trent Integrated Care Board

Cllr Janice Silvester-Hall, whose Lichfield division includes the Samuel Johnson Community Hospital, asked for further details of the public events.

She said:

“Is it a case of sharing the information? Are we sending out information or gathering information from those? There would be an appetite for that in Lichfield City North in particular.

“Is it complexities which mean some mothers aren’t necessarily appropriate to birth at those units? Or is it the amount going through those particular areas?”

Cllr Janice Silvester-Hall, Staffordshire County Council

Ms Slater said:

“The numbers going through those units prior to them temporarily closing was low.

“They were lower at County Hospital than at Samuel Johnson, probably because of the geographical area, and we recognise there were women from outside Staffordshire utilising Samuel Johnson, so we are working with Derby and Derbyshire ICB as well.

“The review that both the providers have undertaken demonstrates that the complexity of women presenting, in terms of being able to monitor women, has risen quite a lot since before Covid. That’s where the workforce numbers need to reflect the type of women who are medium and high-risk and have the services in place for them.

“We recognise at the moment we have got a temporary pause on the home-birthing service as well. Both of the organisations are looking to reinstate that service so we can offer such a choice as well for low-risk women.

“The event will talk through the proposals we have looked at across the organisations and within the ICB. We will ask for alternative proposals to come forward. We will look for the impacts in terms of each of those different proposals so we can then take that away and look to build that into a business case as we have done with other service change processes.

“We will share the information that we have to date, but are happy to take feedback from patients, public and stakeholders at those sessions.

“We have set up a patient panel that people can register for and we’ve circulated information through the maternity units and through community sites so that people can come forward and share their views with us as we go through this process.”

Helen Slater, Staffordshire and Stoke-on-Trent Integrated Care Board