Hospital bosses deciding 'day-to-day' on keeping maternity unit open due to staff pressures

Bosses say they have had to "temporarily step down" an area used for orthopaedic elective surgery and are making decisions "day-to-day" on whether to open the Wrekin midwife-led-unit (MLU) due to staffing pressures.

They say some colleagues are having to self-isolate, but a "comprehensive service" is still being offered.

Meanwhile, reassurances have been given that major cancer surgery is continuing to go ahead and the trust is working with the Robert Jones and Agnes Hunt Orthopaedic Hospital, near Oswestry, to try and relieve some of the pressures.

Bosses have been battling to reduce record levels of patients waiting for planned operations and procedures, with a significant rise seen during the pandemic.

Nigel Lee, chief operating officer at The Shrewsbury and Telford Hospital NHS Trust, which runs Royal Shrewsbury Hospital and Princess Royal Hospital, said: “Our hospitals continue to be under extreme pressure and we are still seeing very high levels of demand for patients needing urgent care.

"To manage this demand and ensure that these patients receive the urgent treatment they need, we have had to temporarily step down one of our elective areas (orthopaedics) at the Princess Royal Hospital.

"Numbers of Covid-19 patients needing inpatient care are also rising.

“Major cancer surgery, such as head and neck and gynaecology, is still being maintained as is all day case surgery for our day case patients, most of whom are on urgent and cancer pathways.

“We are continuing to work with our health partners at the Robert Jones and Agnes Hunt Orthopaedic Hospital to manage higher priority orthopaedic patients and treat those facing the longest waits.”

Latest figures from NHS England show there were 30 Covid patients occupying beds at the trust's hospitals as of last Tuesday.

The Wrekin MLU, which was made possible after £4 million of funding was secured from the Department of Health, opened at PRH last year – replacing a facility which was 30 years old.

It is used by women with low risk pregnancies who have not experienced any complications.

Located next to the obstetric unit, it has three en-suite birthing rooms as well as outpatient facilities with five consultation rooms and space for specialist midwives to work from, including for screening and infant feeding.

But bosses say current staffing pressures are impacting on its operation.

Hayley Flavell, director of nursing at SaTH, said: “Due to staffing pressures, including colleagues having to self-isolate – an issue which is common across trusts nationwide – we are making day-to-day decisions on the opening and operation of the Wrekin MLU.

“Throughout this, we are continuing to offer a comprehensive service to our mothers-to-be and making all efforts to ensure that their birth preferences and choices are still met.

“Our mothers-to-be can speak with their community midwives to ensure that they are prepared and know what options are available, or if they are concerned.”

It has also been confirmed that plans remain in place to shake-up maternity services in the county.

Local health commissioners signed off on the proposals in early 2018 to bring them to public consultation, but there have been delays while awaiting a decision by NHS chiefs nationally.

They must go through an assurance process before people are allowed to have their say in a consultation.

The process has been delayed further due to the impact of the Covid pandemic.

But Shropshire, Telford and Wrekin Clinical Commissioning Group says it still intends to consult on the proposals and is currently "refreshing" the pre-consultation documents in order to progress when possible.

The proposals put forward were to see a permanent end to births at rural maternity units in the county.

Under the plans, women will be able to give birth at the consultant-led unit at PRH, at the hospital’s neighbouring midwife-led unit, at a free-standing midwife-led unit at Royal Shrewsbury Hospital or at home.

A series of maternity ‘hubs’ would also be created to support women before and after birth.

At the time, SaTH said an increasing number of women were choosing, or being assessed as needing, to have their babies in consultant-led units over rural midwife-led units.

The suspension of births at MLUs in Oswestry, Ludlow and Bridgnorth led to a backlash from health campaigners.

The Future Fit plans will also have an impact on the proposals as consultant-led women and children's services are due to move from PRH to Shrewsbury.

Under that scheme, which has been renamed the 'hospitals transformation programme', RSH will house the county's main A&E, with PRH due to get an 'A&E local'.

PRH will also take over responsibility for planned care.

The initial business case is being drawn up and was expected to be finalised by the end of this month.

Details on whether it has are yet to be confirmed by SaTH.