NHS Crisis Hits Hundreds of Mothers-to-Be

By Kate Foster

SCOTLAND’S maternity hospitals are turning away hundreds of pregnant women in need of emergency treatment because of serious staff shortages, a damning new report by Government auditors has found.

One in six women in need of lifesaving treatment are being forced to endure risky journeys across the country.

The report by the Scottish Government’s health service watchdog NHS Quality Improvement Scotland found more than 100 pregnant women endured “inappropriate” transfers over six months.

A total of 28 women who developed complications in midwife-led units could not be admitted to their nearest major maternity hospital.

A further 86 women who developed complications at major hospitals had to be sent to another unit because of a lack of staffed neonatal cots.

The investigation lays bare for the first time the extent to which pregnant women and dangerously ill babies are being turned away from maternity hospitals because of a crippling lack of staff.

There is a shortage of around 200 specially qualified neonatal nurses in Scotland.

Last night campaigners warned the findings were “extremely concerning” and called for more specially trained nurses.

The Perinatal Collaborative Transport Study examined the case of every woman undergoing an emergency transfer in labour between August 2006 and February 2007 – a total of 599 cases.

The study examined all of Scotland’s major maternity hospitals, known as tertiary units, as well as smaller community midwife-led units.

Cases where women needed emergency treatment included premature labour, haemorrhaging and pre-eclampsia, which can all be life- threatening for the mother or baby.

The report’s authors were happy with the way midwife-led units are handling emergencies, by organising transfers to emergency units effectively.

But other aspects of Scotland’s maternity services gave “cause for concern”.

These included the number of days on which each major hospital was unable to accept new admissions.

The worst performer was Aberdeen Maternity Hospital, which was unable to accept new cases for 62 per cent of the time.

At the Princess Royal Maternity in Glasgow, this occurred 41 per cent of the time. The Edinburgh Royal Infirmary closed its doors to new admissions 30 per cent of the time, Ninewells in Dundee 27 per cent of the time and Wishaw General 24 per cent of the time.

Sometimes this was because all hospital cots were full. However, on other occasions new patients were turned away because of a lack of staff.

As a result, 114 women made journeys elsewhere that were unnecessarily long or should not have taken place at all.

Of the 599 cases studied, 11 babies died, although it is unclear whether their deaths could have been avoided.

Yesterday Dr Charles Skeoch, chair of the report steering group, said: “Transferring a woman between maternity units carries an inherent risk and should only be done when there is a clear clinical need to access more advanced care. In almost all cases, these transfers were done in the right way.

“We did find a number of cases where women have been transferred between tertiary maternity units. This is a cause for concern, as tertiary units offer among the most comprehensive packages of care.

“We found that a lack of staff, rather than any clinical issue, meant they were forced to transfer some women to other tertiary units.”

The investigation also found doctors and nurses were spending up to two hours on the phone organising the transfer. Skeoch believes a national system should be set up to do the organisational work instead.

Critics last night said they were “shocked” at the findings.

Andy Cole, chief executive of baby charity Bliss, said: “It is extremely concerning that the most specialised baby units in Scotland are often unable to accept vital transfers, mainly due to lack of staff.”

Scottish Conservative health spokeswoman Mary Scanlon called for immediate Government action.

She said: “This highlights a critical shortage of beds and staff. I am shocked that [Health Secretary] Nicola Sturgeon has not brought forward any ministerial statement to Parliament on this issue.”

Public Health Minister Shona Robison said 20 extra specialist nurses had been deployed across Scotland since the audit. She added: “There has been considerable investment in Scotland’s neonatal unit nursing provision. We are investing in the current financial year a further GBP 100,000 in neonatal nurse education. “

A spokesman for NHS Grampian said:

“At the time of this study we did have periods of nursing shortages. Since the beginning of the year, the unit has recruited an additional six nurses, and we are awaiting the outcome of a national review of neonatal services, which we hope results in the recruitment of further nurses.”

NHS Lothian and NHS Lanarkshire both insisted patient safety was their priority. NHS Greater Glasgow said its risk management systems had not flagged up any concerns about transfers.

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