The two CCGs came to decisions based on their review and consideration of all the clinical evidence and feedback from a process of public consultation over the past year. You can read the consultation feedback, evidence and supporting information here.
Now, changes have been agreed on how these services will be arranged in the future, this means they can improve and, ensure better care for patients as well as provide the new opportunity to develop a modern holistic birthing centre for the first time in South Tyneside and Sunderland. The decisions mean that clinical leaders at South Tyneside NHS Foundation Trust and City Hospitals Sunderland NHS Foundation Trust can start to work with local staff teams to make changes over the next several months.
Maternity (obstetrics) and women’s healthcare (inpatient gynaecology) services
Option 1 will be implemented which is the development of a free-standing midwifery-led unit (FMLU), known as a birthing centre, at South Tyneside District Hospital and medically-led obstetric unit at Sunderland Royal Hospital. Gynaecology care requiring an overnight hospital stay will be carried out at Sunderland Royal Hospital, and care for minor gynaecology conditions, including day case surgery and outpatients clinics, will continue at South Tyneside District Hospital.
This provides an exciting new opportunity for both South Tyneside and Sunderland women as they said they wanted the choice of a home away from home birthing experience, a birthing centre for pre and post-natal care, with more holistic therapies.
This new centre will be developed with staff, women and other interested partners, and the ambition would be to create a vibrant new birthing centre at South Tyneside District Hospital which offers more choice for women across both South Tyneside and Sunderland.
CCGs decision-making on maternity and gynaecology services
This decision is made on the basis of all evidence considered, including that a strong preference for choice and to retain births in South Tyneside was expressed by patients and the public, through both the pre-consultation and consultation processes.
Both options were supported by the Northern England Maternity Clinical Network, but it was recognised that option 1 offered greater choice of birth options to expectant mothers.
It presents the opportunity to develop a new free-standing midwife led unit that could become a holistic, community-facing birthing centre, with the potential to be right at the heart of the South Tyneside community and provide more choice to both South Tyneside and Sunderland women on where and how to have their baby.
In terms of the public engagement and consultation, it was noted that option 1 had greater support than option 2 and particular consideration was given to the feedback about:
- Low to high risk births, it was noted that this was a key concern, but also that the national clinical evidence is clear, that free-standing midwife led units are at least as safe as obstetric units and may also be associated with better outcomes. Clear assurance about the transfer of patients has been provided by North East Ambulance Service and the local clinical teams.
- Sustainability of free-standing midwife led units – concerns about the sustainability of these units were noted. However, it is clear that there are a large number of these units around the country that are sustainable. Furthermore, it is proposed that a group of patients, staff, elected members and other partners be established to develop a co-produced model seeking to ensure sustainability. This group should also continue to monitor and assess the success and viability of the FMLU post-implementation. It is also recognised that new clinical protocols will need to be implemented and that midwives would need to be supported to working within a new clinical environment.
- Travel and local services – it was noted that there would be a travel impact for South Tyneside patients under both options, but that this was lessened under option 1. It was felt that the increased consultant presence through colocation of obstetrics and inpatient gynaecology offers a substantial opportunity to improve quality, but also that a significant amount of work is being undertaken to help mitigate the travel and transport impact.