The Health Oversight & Scrutiny Committee has published its final report and recommendations that it will submit to the CCGs.

The full report is available on the HOSC website, but as it is a very large report (covering more than just this one topic) we have extracted the relevant findings which are reproduced below.

The original HOSC website is no longer on-line (5Feb17). The full report can now be downloaded from this website.

Special Issues relating to Crowborough Birthing Centre (CBC)

74        The Friends of Crowborough Hospital representative who gave evidence to HOSC provided evidence to show that, in the High Weald, concerns over the future of the CBC are very much at the forefront of women’s minds. The evidence and arguments include:

• The Crowborough midwife team provides antenatal and postnatal care for approximately 800 women who use the service annually; 70% of the workload is antenatal care.
• The safety record at CBC is very good.
• Women using CBC also require other services such as scans, blood tests and referrals to a consultant. Since 2010, ESHT has gradually moved these support services further away from High Weald when ESHT stopped the scanning facility at CBC.
• Since the temporary changes in May 2013, only 6% of High Weald women now have their birth at the obstetric unit at the Conquest. Most High Weald women now refer themselves to an alternative, local provider.
• Half of North Weald women are birthing at Pembury. In an emergency women are sent to Pembury because it is closer. However, there have been problems in transferring medical record data; the midwives have worked well to mitigate these problems.
• CBC has been temporarily closed on a number of occasions in recent years in order to manage staffing difficulties and to prioritise services elsewhere; this has led to a reducing confidence locally in the sustainability of the service at Crowborough.

75        Women in the High Weald have voiced their strong concerns about a disjointed maternity care pathway, with different parts of their care being provided by different trusts and midwife teams. This situation does not, in their experience, make for a seamless, flexible care pathway and effective continuity of care. There has been significant adverse media attention over the last year and number of senior staff have left.

76        All of these factors are collectively undermining women’s confidence in using the services at CBC. The Friends of Crowborough Hospital are now very concerned that there has been such a significant drop in birth numbers that the viability of the CBC has now been undermined. In 2010 the number of births at CBC was 322 and rising; however, since 2010 when the scanning facility closed, the number of births began to fall.

77        Clinically robust alternative arrangements are urgently needed to enable local providers to re~join maternity services in this area and deliver services more cost effectively. Overcoming the pathway and other issues will raise confidence and thus enable women, when trying for a low risk midwife-led birth, to be safe in the safe knowledge that they would have easy access to local consultant-led care.

HOSC findings on CBC

78        HOSC’s findings on CBC are as follows:

• Consultation in Crowborough amongst the public and medical community has overwhelmingly supported CBC.
• Maternity services in Eastbourne or Hastings do not currently provide a natural pathway for women residing in the North Weald requiring obstetric services.
• The maternity care pathway, and especially the links between CBC and Pembury, need to be addressed as a matter of urgency.
• Women should have the opportunity to give birth at CBC with the option to go to, or transfer to, Pembury seamlessly should an obstetric service be required or requested.
• The administrative pathway issues current being experienced (such as formats of patient notes and booking arrangements operating differently in different trusts) should be resolved as a matter of urgency.
• Obstetric scanning should be reintroduced at CBC as one step towards improving services and confidence locally.
• With all these improvements and focus on long term service improvements, the number of births at CBC can be increased and the unit made sustainable. (See recommendation 2)