To consider a report by the Chief Operating Officer, NHS North Cumbria Clinical Commissioning Group (copy enclosed).
The Committee considered a report from NHS North Cumbria Clinical Commissioning Group which provided an update on the progress made following the Healthcare For the Future Consultation.
(1) Maternity and Paediatrics
Members were informed that North Cumbria Clinical Commissioning Group (CCG) had met on 3 July 2019 to consider the findings of the Independent Review Group chaired by Dr Bill Kirkup CBE.
The Committee noted that the Governing Body had considered the following recommendations:
(a) The existing pattern of maternity services with consultant-led units in Whitehaven and Carlisle was operating effectively at present and was proving innovative and adaptable in overcoming challenges. A commitment should be given to sustain this service pattern.
(b) Midwifery-led services operating alongside those units were important in offering choice of birth setting in line with Better Births. A commitment should also be given to sustain this element of the service pattern.
(c) There will be challenges to sustaining this service pattern. It was important that a decision about Option 1 does not lead to any sense of complacency or ‘job done’. It was also important, however, that the stability of Option 1 was not undermined by a perception of crisis every time a challenge arose. A commitment should be given to maintaining vigilance and supporting innovative measures to counter those challenges in future, continuing the collaborative Working Together approach between the community and the NHS.
Members were informed that the Governing Body had voted unanimously to accept the recommendations and acknowledged and thanked North Cumbria University Hospitals NHS Trust for its hard work and creativity in tackling the issues undermining sustainability.
The CCG recognised the importance of working with the Cumbria Health Scrutiny Committee and emphasised the need for this to continue, as well as highlighting that a key need was to also involve the community.
The Committee drew attention to the difficulties regarding the recruitment of staff to the existing consultant-led units in Whitehaven and Carlisle and concerns raised regarding whether both units could be sustained safely. It was agreed the Committee would continue to receive a progress report on the challenges.
A discussion took place regarding the Royal College Standards regarding training which were based on big cities, therefore, created problems in rural areas such as Cumbria. The Committee welcomed the opportunity to work together to ensure models were adjusted for rural areas.
Members were informed that the Standards were written in order to protect patients; but over a period of time there had been an overall drift in the number of clinicians required in certain areas, therefore, this would continue to cause a challenge in Cumbria. It was explained that the national NHS Long Term Plan was to establish a clinical model for geographically remote hospitals which should prove beneficial for the county.
During the course of discussion a member raised a concern regarding the denial of risk by the NHS, highlighting the substantial risk to pregnant women haemorrhaging. A concern was also raised regarding the dynamics in social media. It was explained that if anything inappropriate or illegal had been posted action would have been taken but the Commissioners were unable to regulate social media.
A discussion took place regarding the comparisons made in relation to maternal mortality ratio and neonatal mortality rates by country and whether there had been any specific findings which could be applied to Cumbria. It was explained there was a potential correlation between distance and risk highlighting that other countries had to travel much further than those distances in the county.
The Committee, whilst welcoming women in North Cumbria having the ability to register their pregnancy and have access to their maternity notes via an app, raised concerns regarding those who did not have access to the technology required. It was explained that the information could still be made available in paper form.
The Chair, on behalf of the Committee, congratulated the CCG and echoed their sentiments whilst drawing attention to the high standard set for future co?production. It was felt the report from the Independent Review Group was well balanced and that the recommendations emphasised this was a very nuanced decision.
(1) the report be noted;
(2) the work being undertaken to retain consultant?led maternity services at the West Cumberland Hospital continue to be reported to the Cumbria Health Scrutiny Committee.