Report recommends keeping consultant-led maternity services at Whitehaven
An independent review has outlined six options for the future of maternity services in Cumbria and North Lancashire.
The preferred option would mean consultant-led maternity services would remain at the Cumberland Infirmary in Carlisle, and the West Cumberland Hospital in Whitehaven.
That would be good news for campaigners, who have been protesting against the possibility of transferring some services (including consultant-led maternity care) from West Cumberland Hospital.
However, it would require increased investment, and a drive for more medical staff.
The following options were recommended by assessors, and are more likely to be adopted:
Option 1 - Four consultant-led maternity units at Carlisle, Whitehaven, Barrow and Lancaster. The immediate development of midwifery-led units at Carlisle and Lancaster, on the same site, or next to them. To evaluate whether midwifery-led units could be developed at Barrow and Whitehaven. This is the preferred option.
Option 2a – Two consultant-led units at Carlisle and Lancaster and developing two on the same site or next to midwifery-led units at Carlisle and Lancaster. This is the assessors’ second favoured option should it not be possible to achieve Option 1. It would mean the closure of consultant-led units at Whitehaven and Barrow. The report says this option would be more likely to provide better medical cover for women and babies, but could lead to increased travel time and costs for people in West Cumbria.
Option 2b - Two consultant-led units at Carlisle and Lancaster, developing two on the same site or next to midwifery-led units at Carlisle and Lancaster, while converting the consultant-led units at Whitehaven and Barrow to become ‘free-standing’ midwifery-led units. This would require significant investment in midwifery training in West Cumbria.
The final three options have not been recommended by assessors:
Option 3 - Three consultant-led units at Carlisle, Lancaster and Whitehaven and developing on the same site or next to midwifery-led units at Carlisle and Lancaster.
Option 4 - Three consultant-led units at Carlisle, Lancaster and Barrow and developing on the same site or next to midwifery-led units at Carlisle and Lancaster. This would mean the closure of the consultant-led unit at Whitehaven and the relocation of services to Carlisle. While the workforce challenges at Whitehaven are significant the report says that closure would create significant disruption for patients.
Option 5 - Centralising all services in one unit. While prior to their visit the assessors felt this was likely to be a preferred option, because of the benefits that such a larger unit with 5,000 deliveries would have for women and their babies, given the geography involved they did not think that this option could realistically be developed further.
The report recognises that for NHS Cumbria CCG, and NHS North Lancashire CCG, recruitment is a real problem.
It also takes into account the geography of the area, and the travel difficulties of some people, like those in West Cumbria, if consultant-led maternity services were moved.
It says that if Option 1 is chosen, a project team should be established immediately, including an external senior manager, external obstetrician, head of midwifery and patient representatives.
The team would be accountable to the lead clinical commissioning group and would develop a detailed feasibility report on the cost, viability and risks of proceeding with Option 1. Local views and social deprivation would be important considerations.
The NHS Trusts now have to decide the best way forwards: