HEALTH chiefs are set to confirm plans to permanently shut birthing facilities at a Lichfield hospital.
A temporary closure at the Samuel Johnson Community Hospital began before the pandemic.
But after the birthing services failed to return, a consultation began last year on proposals to shut them on a permanent basis.
Although some ante- and post-natal services remain at the maternity unit on site, community campaigners fighting the proposals said the birthing unit was "a cherished part of our community".
Hospital bosses said at the time of the original proposals that before the original temporary closure, fewer than three in 100 of babies in the area were born there:
"We also know that high-risk pregnancies are becoming ever more common, so we expect that in future even fewer women would choose to give birth in a smaller hospital without specialist support at close hand."
A report to the NHS Shropshire, Telford and Wrekin and NHS Staffordshire and Stoke-on-Trent Boards has now recommended the closure of the unit at Samuel Johnson Community Hospital and a similar one at County Hospital is made permanent.
It said:
"This recommendation is consistent with national and local strategy for maternity services and has been developed following extensive involvement and formal consultation.
"During 2022 it was anticipated that both Trusts would be in position to reinstate services either as per the clinical model of 2020 pre-COVID or through the implementation of an 'on-demand model'.
"However, workforce challenges in relation to recruitment and retention of staff meant that neither provider was able to implement a revised service offer.
"Due to continued staffing pressures throughout 2022-23, both organisations informed the Integrated Care Board in April 2023 they could not reinstate services as per the model of care considered in 2021."
The report added that the units had not been used enough before the closures to justify reinstating them.
"Before the temporary closure, the number of babies born in a Freestanding Midwifery Birth Unit (FBMU) was very low.
"Based on the number of births in 2019-20, this amounted to an average of eight per month at County Hospital in Stafford and 18 per month at Samuel Johnson Community Hospital.
"The units had to be staffed 24/7 with two midwives present for a birth. The low number of births meant we were not making the best use of our staff's time. This is a concern, especially given staffing pressures.
"Although the trusts promoted birthing services at the FMBUs, the number of births there continued to fall, as most low-risk women were choosing to give birth in the midwife-led units at the main hospitals instead.
"To run the birthing services at the FMBUs and safely staff them 24/7, a minimum of 12.15 experienced Band 7 midwives would be needed for each unit."
The report also recognised the impact on those giving birth if the unit closed, saying that the average travel time to alternative sites for those using the FMBUs would increase by around 14 minutes.
But the report said:
"While it is recognised there will be an impact on a small cohort, the advantages are significant for the trusts to deliver the best-quality care.
"A centralised workforce to support clinical pathways and escalation as required provides enhanced opportunities for learning and support given the range of births and deliveries across low, moderate and high-risk births and pathways and the range of specialists involved in such care.
"This also means our midwives are able to maintain their competencies when supporting a mix of low- and high-risk births.
"There is a more efficient and robust staffing model when birthing services are centralised on one site, which supports the longer-term sustainability of the workforce at a time when there are national staffing shortages in midwifery.
"There is improved responsiveness to any intervention required as a result of a change from low-risk to high-risk care. This is due to the proximity of interdependent services at the acute units compared to within the FMBUs where an ambulance transfer to an acute site would be required for any additional support.
"FMBUs are for low-risk pregnancies only and the vast majority of the population (89%) fall into the moderate to high-risk category.
"The rising complexity of pregnancies over the years means even fewer women are now suitable for low-risk care. We must therefore ensure our midwives are able to support those who are moderate or high risk and not divert what would be a disproportionate level of resource to an underutilised unit."
Cllr Janice Silvester-Hall, Lichfield District Council cabinet member and representative for Hammerwich with Wall, said the recommendations of the report were a blow for the local community.
She said:
"This recommendation is much more than just disappointing.
"Following countless reports, locally and nationally, I saw this as an opportunity to give more choice to support birthing women in Lichfield district."
The report will be discussed at a meeting of the NHS Shropshire, Telford and Wrekin and NHS Staffordshire and Stoke-on-Trent Boards on 24th September.
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