Memorandum by Shropshire Maternity Services,
Royal Shrewsbury Hospitals NHS Trust (MS 65)
INTRODUCTION
The maternity service in Shropshire is a county
wide acute and community service. All obstetric and midwifery
services are co-ordinated and managed by the Royal Shrewsbury
Hospitals NHS Trust.
THE AREA
WE SERVE
Maternity care is offered to women throughout
the 1,347 square miles of Shropshire (1/3 of the area of the West
Midlands). Whilst the majority of Shropshire residents are comparatively
affluent there are pockets of depravation, social isolation, limited
public transport and a high teenage pregnancy rate that pose particular
challenges to our services.
STAFFING
Midwives:
The Midwifery Service is fully integrated. All
midwives are appointed to work within the Shropshire Maternity
Services rather than any specific Unit, Ward or Department. Midwives
work a variety of shift patterns within a four week rota and rotate
throughout the county on a four month to two year basis depending
on their professional development needs. Shropshire has appointed
13 Supervisors of Midwives linked to the West Midlands Local Supervising
Authority.
156.72 whole time equivalent midwives work within
the Service. These midwives not only provide midwifery care but
also staff the Midwifery Ultrasound Department and staff the theatre
and recovery area within the Consultant Unit. They also provide
a postnatal debriefing service for patients.
Consultants:
There are now 8 Obstetrician/Gynaecologists
working within Shropshire.
Their speciality areas include:
— Mr David Redford Clinical Director
Consultant Obstetrician & Gynaecologist (Feto-maternal medicine—Diabetes,
HIV).
— Mr B Bentick Consultant Obstetrician
& Gynaecologist (Infertility Specialist).
— Mr A Gornall Consultant Obstetrician
& Gynaecologist (Feto-maternal medicine).
— Dr M Mohajer Consultant Obstetrician
& Gynaecologist (Feto-maternal medicine).
— Dr S Oates Consultant Obstetrician
& Gynaecologist (Oncology and Psycho-sexual counsellor).
— Dr J Pannikar Consultant Obstetrician
& Gynaecologist (Medical education, Colposcopy).
— Mr N Reed Consultant Obstetrician
& Gynaecologist (Minimal Access Surgery, Medical education
and Colposcopy).
— Mr A Tapp Consultant Obstetrician
& Gynaecologist (Urodynamic and Cystoscopy Specialist, Lead
Gynaecology Consultant).
Middle Grade Medical Staff:
Currently in post we have one Associate Specialist,
one Staff Grade and five Senior Registrars.
Junior Doctors:
In post we have seven Senior House Officers
and in addition we offer medical students clinical placements.
Service Location:
One consultant maternity unit and five general
practitioner/Midwife led units based at:
— In addition there are three GP/Midwife
Led Units in Powys that refer all their high-risk patients to
the Consultant Unit at Shrewsbury.
CONSULTANT UNIT
— Situated on the main RSH site. This
unit has the only consultant labour suite in the county and also
cares for approx. 500 Powys women per year.
The unit facilities include:
— Inpatient antenatal beds
— Labour suite (11 delivery beds, one
obstetric theatre and recovery)
— Inpatient postnatal beds
— Transitional Care facilities
— Family/bereavement rooms
— * On-site 22 cot Neonatal Intensive
and Special Care Unit
* Managed by Children's Care Group
OUTLYING UNITS
Shrewsbury GPU:
During most of 2002 the GPU was closed due to
staff shortage, and intrapartum low-risk, midwife-led care was
provided on the Consultant Unit Labour Ward. The statistical data
is fragmented except for certain key points.
— Two labour rooms, one pool room;
16 postnatal beds
| 2002 |
| Deliveries at Shrewsbury GPU | 281
|
| Home Births | 38 |
| Day Attenders | — |
| CTG performed | — |
| Attendance at Midwives Clinics at GP Surgery
| 4,808 |
| Attendance at Midwife Led Clinics | —
|
| Antenatal Bookings in the home | 1,158
|
| Antenatal Visits | 3,109 |
| Postnatal Visits | 5,257 |
Bridgnorth Maternity Unit:
Bridgnorth is a small Midwife Led Unit. It is able to offer
a diverse range of care from pre-conception advice to postpartum.
Its location ensures that there is 24 hour midwifery support within
this rural setting.
— One labour room; four postnatal beds
| 2002 |
| Deliveries at Bridgnorth | 85
|
| Home Births | 3 |
| Day Attenders | 960 |
| CTG performed | 168 |
| Attendance at Midwives Clinics at GP Surgery
| 432 |
| Attendance at Midwife Led Clinics | 1,650
|
| Antenatal Bookings in the home | 414
|
| Antenatal Visits | 798 |
| Postnatal Visits | 1,702 |
Ludlow Maternity Unit:
Ludlow Maternity Unit has a central location and as such
has an important role within the Community, providing localised
accessible midwifery care.
— One labour room; eight postnatal beds
2002
Deliveries at Ludlow 92
Home Births 1
Day Attenders 1,595
CTG performed 402
Attendance at Midwives Clinics at GP Surgery 1,047
Attendance at Consultant Clinic 57
Antenatal Bookings in the home 0
Antenatal Visits 452
Postnatal Visits 1,091
Oswestry Maternity Unit:
The Unit provides a small, friendly and varied service for
the pregnant women of North Shropshire.
— One labour room; one pool room; seven postnatal
beds
| 2002 |
| Deliveries at Oswestry | 91
|
| Home Births | 5 |
| Day Attenders | 2,197 |
| CTG performed | 237 |
| Attendance at Midwives Clinics at GP Surgery
| 2,172 |
| Attendance at Consultant Clinics | 96
|
| Antenatal Bookings in the home | 1,465
|
| Antenatal Visits | 177 |
| Postnatal Visits | 8 |
Wrekin Maternity Unit:
The Wrekin Unit is situated within the Princess Royal Hospital.
Its central location has promoted accessible maternity care, in
this part of the county.
— Three labour rooms (one in a pool room); 14 postnatal
beds.
| 2002 |
| Deliveries at Wrekin | 474 |
| Home Births | 23 |
| Day Attenders | 780 |
| Attendance at Midwives Clinics at GP Surgery
| 1,318 |
| Attendance at Consultant Clinics | 1,371
|
| Antenatal Bookings in the home | 1,869
|
| Antenatal Visits | 3,045 |
| Postnatal Visits | 17,982 |
DELIVERY DATA
DELIVERIES
| January-December 02
| January-December 01 |
| RSH Consultant Unit | 3,634
| 3,465 |
| RSH GP Unit | 281 | 376
|
| Wrekin | 474 | 451
|
| Bridgnorth | 85 | 62
|
| Oswestry | 91 | 92
|
| Ludlow | 92 | 93
|
| Home/Community Birth | 81 |
65 |
| SHROPSHIRE TOTAL | 4,738 |
4,604 |
| POWYS UNITS | |
|
| Welshpool | 74 | 92
|
| Newtown | 49 | 65
|
| Llanidloes | 33 | 32
|
| CATCHMENT TOTAL | 4,894 |
4,793 |
PERINATAL & RELATED LOSSES
| January-December 02
| January-December 01 |
| Perinatal Death Rate Unadjusted by place of domicile
| 42 | 50 |
| 8.8% | 10.8%
|
| 8.5% | 10.4%
|
CONSULTANT DELIVERY DATA
| January-December 02
| | | | January-December 01
|
| No | % CU
| % Total | % CU
| % Total |
| Instrumental Deliveries | 429
| 11.8 | 8.8 | 14.5
| 10.4 |
| C/S 581 | 15.9 | 11.8
| 14.4 | 10.4 |
|
| BR (Vaginal) | 66 | 1.8
| 1.3 | 2.0 | 1.4
|
| TWINS | 67 | 1.8
| 1.3 | 2.0 | 1.4
|
| 1,500g | 48 | 1.3
| 0.9 | 1.8 | 1.3
|
| 2,500g | 311 | 8.5
| 6.3 | 9.4 | 6.8
|
| 4,500g | 85 | 2.3
| 1.7 | 2.3 | 1.6
|
| APGAR at 5 | 41 | 1.1
| 0.8 | 1.2 | 0.8
|
Day Assessment Units are well established in Shrewsbury and
Telford, and newly opened in Oswestry.
DAY ASSESSMENT STATISTICS 2002
| Total Episodes of care | 8,133
|
|
