Following recent media and social media coverage we would like to take the opportunity to correct some of the inaccuracies that have appeared.
Whilst we recognise that the structure and internal working of the NHS is complex we feel it is important that people understand these changes and recognise that some changes are being made outside of the Clinical Services Review. This is so that services can be improved quickly in order to offer benefits for local mums-to-be and their children at the earliest opportunity.
Any changes that are agreed following the public consultation phase of the Clinical Services Review are not likely to be implemented for up to five years.
The changes detailed below are to deliver safer care now for people living in and around Dorset. The re-designation of the Local Neonatal Service to a Special Care Baby Unit lies outside of the Clinical Services Review.
Dorset County Hospital currently has a Local Neonatal Unit (LNU) which treats babies born after 27 weeks. It was agreed by the South West neonatal network that this should be re-designated as a Special Care Baby Unit (SCBU) which means babies born more than eight weeks early will routinely receive early care elsewhere in the closest appropriate unit with the expertise. This was also recommended in the review of local services carried out by the Royal College of Paediatric and Child Health during 2015 as part of the ongoing Clinical Services Review.
This agreed change is being implemented by NHS England who is responsible for the planning and commissioning of these services and have been through the necessary assurance process.
Only a small number of babies born between 27 and 32 weeks gestation will be affected by this change. This will affect about 15 babies per year (out of a total of 1900 births at DCH), and care will be transferred for those very few premature babies to the closest unit with the appropriate expertise, in most cases this would be to Poole.
Babies born under 27 weeks gestation will receive care at the regional specialist unit in Southampton, as happens now, and so no changes are being made for this group.
It is important to be clear that there will still be a Special Care Baby Unit at Dorset County Hospital and that this re-designation will only affect around 15 mums-to-be a year, who are likely to deliver in the units where their babies will receive their initial critical care. Babies born in units other than DCH will be transferred back to DCH when their clinical condition improves.
DCH will retain the expertise to initially care for any babies born there under 32 weeks so that they can be safely stabilised prior to transfer.
The new Midwifery-Led Unit (MLU) within DCH’s Maternity Unit will provide a designated area so that low risk women are cared for by a skilled team of midwives in an environment wholly designed to keep births normal and natural. This service was designed in consultation with members of the public who provided suggestions and ideas to ensure the service met their needs. This service will be offered in addition to the services already provided by the Maternity Unit and is about offering women more choice, not less. The MLU will be located next to the obstetric unit within maternity so women are reassured they will get obstetric support if they need it.
In order to establish the Midwifery-Led Unit three postnatal rooms will be redesigned as birthing suites with an inflatable pool available in each room. The planning and investment for the unit has come from Dorset County Hospital and is a very positive development – viewed as such by staff and service users.
To re-iterate; the re-designation of Special Care Baby Unit and the creation of a Midwifery-Led Unit at DCH are not part of the Clinical Services Review.
As has been made clear, no decisions on the recommendations and proposals that form part of the Clinical Services Review will be made until we have undergone a full public consultation. This is still the case and we hope to be able to announce a start date shortly.