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Maternity Services in NHSGGC

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The Case for Change

NHSGGC is providing high quality maternity and neonatal care, with specialised services available at the Princess Royal Maternity Unit (Glasgow), the Royal Alexandra Hospital Maternity Unit (Paisley), the Queen Elizabeth University Hospital Maternity Unit and the Royal Hospital for Children in Govan.

Our current services have evolved over many years and the time is right for a refreshed model of maternity and neonatal care based on the current available evidence, best practice, and feedback from families and frontline staff to design and further improve existing services.

Family-centred care will maximise the opportunity to establish the building blocks for strong family relationships and for confident and capable parenting. This can help to reduce the impact of inequalities and deprivation which can have longer term health consequences for families. Good maternity and neonatal care will support the best possible outcomes for mothers, babies, and the wider family.

Recommendations to improve the service across NHSGGC

  • Engage with women and their families to describe the options for care in the new model for their midwifery, means ensuing care choices are available where and when required
  • Apply quality improvement tools to ensure all women, babies and families receive fair, high quality, safe and compassionate care
  • Education and training to enable staff to continue to deliver high quality care supporting the requirements of the new model for midwifery care.

The current model

The overall framework for maternity and neonatal services is established at a national level. Each NHS Board has a responsibility to design services locally for their own population.

Within NHSGGC, maternity services are provided in 3 Consultant led maternity units with midwife-led and obstetric led care in these units.

The Royal Alexandra Hospital has an alongside midwifery unit available with 2 community freestanding Midwifery units in the Vale of Leven Hospital and Inverclyde Hospital which offer a range of midwifery led care. These services are accessible to all women in NHSGGC.

Over 99% of births within NHSGGC take place in hospital. There has been a steady rise in interventions in labour and birth including a rise in caesarean sections to 36% of all births in 2017/18.

Neonatal services are provided from 3 neonatal units. Outcomes and survival rates for all preterm and sick neonates have improved significantly over the last 20 years with enormous advances in neonatal care. The majority of additional care provided to newborn infants is classified as high dependency or special care with only a small proportion requiring intensive care. However, for that small proportion, the complexity of neonatal intensive care has increased.

Overall, women have reported very positive experiences of their care and treatment within NHSGGC. However, they hav...

Views of women icon

Overall, women have reported very positive experiences of their care and treatment within NHSGGC. However, they have identified key elements of maternity care that could be improved including:

Continuity of care and carer

  • Building relationships with staff and seeing the same person or team throughout the care process
  • Breastfeeding support
  • The opportunity for more partner support for bonding with their babies and minimising separation.

More information and choice

  • Communication and consistent advice including the use of digital technology.

Support

  • Emotional support for families with babies in neonatal care
  • Care for bereaved parents
  • Infant feeding.

Services

  • Access to services locally
  • Support for parents of babies in neonatal units to stay with their babies.

Staff described positive views and experiences, but also highlighted challenges in providing care within the curren...

Views of staff icon

Staff described positive views and experiences, but also highlighted challenges in providing care within the current system. In particular:

Maternity staff

  • Providing continuity of care
  • Offering women real choice
  • Concerns about rising rates of interventions in labour and birth.

Neonatal staff

  • Access to facilities for parents to be with their babies
  • Information and communication
  • Working across the system, especially with regard to transport and support for early discharge home.

Suggested solutions

  • Shared communication and monitoring through electronic records and a national dataset
  • The use of telemedicine.