External Review of Maternity Services provided by Colchester Hospital University NHS Foundation Trust

An external review of maternity services across North East Essex has been published by North East Essex Clinical Commissioning Group (CCG) and Colchester Hospital University NHS Foundation Trust (the Trust).  The review by the NHS England Strategic Clinical Network, which was jointly commissioned by the Trust and the CCG, noted much good practice and commended the enthusiasm and commitment to women and their families. Out of a total of 19 recommendations in the report, there was just one major concern requiring immediate action.

The report recommended that the Trust should ensure the delivery suite at Colchester General Hospital should have an extra (supernumerary) senior midwife on duty in line with a previous recommendation by the Royal College of Obstetricians and Gynaecologists (RCOG). Work is already underway to ensure the Trust meets this recommendation.  The report also comments on the small number of women giving birth at the midwife-led units at the community hospitals in Clacton and Harwich, stating there are insufficient births to warrant a 24 hours a day 7 days a week service. It adds that the need to cover three sites is part of the difficulty in meeting the midwife to birth ratio recommendation from the RCOG.

Lisa Llewelyn, Director of Nursing and Clinical Quality at the CCG, said:

The report gives the CCG external assurance about the service and supports us in preparing for consultation with the public on a sustainable and safe service. We note the comments around the number of births at the midwife-led units at Clacton and Harwich but are also conscious of the need to provide choice of birth location as recently proposed in draft guidelines by the National Institute for Health and Care Excellence.

Amanda Hallums, Divisional Director of Women’s and Children’s Services at the Trust, said:

We are grateful to the Peer Review Team for carrying out a very thorough review. We welcome the findings of the report as it identifies many strengths and areas of good practice. We will be working jointly with the maternity multidisciplinary team and CCG colleagues to address the recommendations.”

Commissioned to assess opportunities for improvement in and to assess the viability of births from three sites across North East Essex (Colchester, Clacton and Harwich), the report’s 19 recommendations were grouped under the following headings:

• Clinical governance
• Operational efficacy
• Clinical  leadership

Included in the recommendations were:

• An urgent review of midwifery staffing together with clinical pathways, patient information, communication, quality and governance
• Annual review of staffing to ensure resources match demand
• A wider Essex review of maternity services
• Build on good practice to ensure continuous improvement including reviewing risk management structures and clinical governance
• Boards of both organisations need to ensure they have sight of outcomes as well as performance