Women & Children. Changes to local health services for.. Inside this edition. Maternity services midwifery led birthing units

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1 Changes to local health services for.. Women & Children Inside this edition Maternity services midwifery led birthing units Children s care less time in hospital, more care at home Women s health - development of gynaecology services Issue one October 2005 A newsletter for patients, NHS staff and the local community

2 Our commitment to you As providers of your local health services we are committed to ensuring patients, the public and our staff are as closely involved and as well informed as possible about any changes being made to improve the care we provide. This newsletter lets you know about some of the changes you will start to see between now and 2010 in the way we care for women and children both in our hospitals and in the local community. These changes will ensure we can continue to provide women and children with services that are of a high standard and modern in their approach. The NHS is continually changing for the better and we want you to be a part of these changes with us. Rose Gibb Chief Executive Maidstone and Tunbridge Wells NHS Trust David Meikle Joint Chief Executive Maidstone Weald Primary Care Trust and South West Kent Primary Care Trust Fiona Henniker Chief Executive Sussex Downs and Weald Primary Care Trust Page 2

3 Contents and timetable Obstetric services pages 4, 5, 6 & 9 Key dates: o Midwifery led birthing unit opens in Maidstone in o All inpatient obstetric services will relocate to the new Pembury Hospital in This will include the development of a midwifery led birthing unit. Children s services pages 5, 6, 7, 8 & 9 Key dates: o o o o Opening of a children s emergency assessment unit at Kent & Sussex Hospital in December 2005/January Relocation of Jacoby children s ward at Pembury Hospital to a different ward on the same site in December 2005/January Opening of a dedicated day case unit for children at Pembury Hospital in December 2005 Relocation of paediatric outpatients and associated therapies at Pembury Hospital in July/August 2006 Gynaecological services pages 5 & 8 Key dates: o o Inpatient gynaecology services moving from Maidstone Hospital to Pembury Hospital in September Creation of a Women s Unit (for emergency gynaecology and gynae oncology) at Maidstone Hospital in December Page 3

4 Future care Obstetric, paediatric and Gynaecological services Obstetric, paediatric and gynaecological Services Health services are evolving quickly with new and modern ways of providing care for women and children. After consulting widely with the public during 2004/05, the local NHS agreed to change and improve the way it provides care for women and children. These changes will ensure it can continue to provide you with the highest standards of care long into the future. There are some key changes that your local NHS will be making between now and 2010 to ensure it is able to provide the very best services possible. Obs and gynae In April of this year the local NHS agreed, after consulting with the public, that by 2010 all high risk obstetric services will move from Maidstone Hospital to the new Pembury Hospital. At the moment all women who are pregnant can have their babies at Maidstone Hospital. In the future, women who require or request a hospital birth will have the choice of the new Pembury hospital, or one of our neighbouring hospitals in Medway or Ashford. Some women will also have the choice to give birth in birthing centres for low risk births currently being developed in Maidstone and Tunbridge Wells. These changes are being made to ensure Maidstone and Tunbridge Wells NHS Trust is able to meet modern standards for health and improve patient care. Services are unsustainable in the long term as they are and will ultimately fail to meet national standards of care, become unsafe and close. Page 4

5 The changes to maternity services include: Providing a centralised High Risk Obstetric Unit delivering 4500 to 5000 babies a year in the area s new 300 million hospital at Pembury Developing a new midwifery led birthing unit in Maidstone for low risk births. This will be separate from Maidstone s main hospital. Developing an integrated midwifery led birthing unit for low risk births at the new Pembury hospital. At the same time we want to develop gynaecological services, which will enable us to develop a women s unit at Maidstone, matching facilities for other women that already exist in Tunbridge Wells. This will also enable us to provide a countywide centre for gynaecological oncology services at Maidstone Hospital, which is already the main centre for specialist cancer services in West Kent. Children s Services We are also developing the way we see and treat children with more care provided in their own homes and on a day case basis, avoiding unnecessary overnight stays in hospital. As part of our consultation, we agreed with you: To provide overnight care for children in the new Pembury hospital. However, the majority of children s care will continue to take place in specialised day units at both Maidstone and Pembury hospitals. To develop a single Neonatal Unit (Special Care Baby Unit) at the new Pembury hospital, which will care for babies from 27 weeks gestation. To further develop children s community nursing teams so that more children can be cared for in their own homes. To continue to maintain a full children s outpatients service at both Maidstone Hospital and the new Pembury hospital. To develop more specialist services locally, reducing the need for children to travel to London for their care. Page 5

6 The need for change The changes we need to make to women and children s services locally will enable us to: Improve the quality of our services for patients Meet modern standards for health Raise our professional standards Make best use of our local resources, money and expertise We believe that to achieve these aims, however, we also need to work closely with patients, the public and members of staff in developing our plans. So far we have working groups looking at the development of midwifery led birthing centres (Birthing Centre Group) and how we provide care for children in the future (Children s Ambulatory Care Group). Both groups include people who have used our services and represent the views of the public. Birthing Centre Group The group looking at midwifery led birthing centres consists of local mothers, clinical staff and local representatives from the National Childbirth Trust, Maternity Service Liaison Committee, Primary Care Trusts and Patient and Public Involvement Forums. They are currently reviewing how women will be referred to the new birthing centres in the future and drawing up guidelines for their use. Part of their work involves visiting other birthing centres across the country and learning from their experiences and sharing best practices. This group meets monthly and its members are planning to visit community groups, GP practices and other local organisations to inform people about their work and listen to people s views. Children s Ambulatory Care Group Local parents also make up an important part of the Children s Ambulatory Care Group. This also meets monthly and along with staff from our local hospitals and community services, our local parents are helping recommend how we provide care for local children in the future. The group is also looking at the development of community children s teams who care for children in their own homes. It also has an important role to play in exploring how we can enhance our services for the new-born. Another major part of the group s work is to redesign the way we treat children with more emphasis on assessing them, treating them and enabling Page 6

7 more of them to go home from hospital on the same day. This is something parents want, is nationally regarded as the best way to treat children and something we want to get better at locally. The work both of these groups are carrying out will not just ensure our services are better for patients, it will also address some of the issues we face locally within the NHS. The new ways of working will help us to: Address our staffing issues Improve the quality and safety of services we provide for patients Further enhance the care we provide in the community with more care in patients homes where they want to be treated Develop our expertise with our staff developing more skills, reducing the need to transfer our youngest patients to other hospitals Make sure our services are led by our clinical experts, our consultants, which means patients being seen in the right place by the right people with the right skills Ensure we can continue to provide a comprehensive service for women and their babies in the future Develop and extend roles for all staff who look after women and babies. Work more closely together as hospital and community teams Page 7

8 Interim Arrangements While some of the major changes will happen in 2010, there are other developments we need to make over the next few years to ensure our services are sustainable and continue to meet the highest standards of care. Many of these changes will be going on behind the scenes but we think it is important to share them with you now. In we need to Fill new consultant posts for paediatrics and obstetrics this will ensure we meet national standards for labour ward cover and ensure we have enough paediatricians (specialist children s doctors) in place until the bigger service changes happen in While recruiting more paediatricians will help maintain a safe level of service for women and children in the short term, there will still not be enough specialist children s doctors at Kent & Sussex Hospital in Tunbridge Wells. To ensure we are able to continue to provide safe, high quality care for all our children, we agreed to move our services for children who require care overnight from Kent & Sussex Hospital to Pembury and Maidstone Hospitals. This will happen after we develop a children s emergency assessment unit at Kent & Sussex Hospital in December this year, to ensure the hospital can still see our youngest patients in an emergency. All children who require overnight care will be seen at the new Pembury hospital when it opens in Move gynaecology services for women who need to stay in hospital overnight from Maidstone Hospital to Pembury Hospital in September. At the same time we will start to develop a new women s unit at Maidstone to include early pregnancy assessment, emergency gynaecology services and further develop our gynaecological cancer services. Appoint a consultant midwife to help with the development of the birthing centres and prepare midwives for their new roles. Page 8

9 Carry out a full review of our Neonatal (special care baby) services to ensure they are able to meet the needs of our children and families until the service moves to the new hospital. At the same time, we have already: Established work groups for the birthing centres and ambulatory care services for children. Set up work groups with the public to finalise plans for moving children s inpatient care from Kent & Sussex Hospital, including ear, nose and throat surgery, to Pembury and Maidstone hospitals at the end of the year. Between we will need to: Open a midwifery led birthing centre in the Maidstone area and start to phase in the transfer of maternity services to Pembury Have developed services so that more children can be seen at home and at hospital without having to stay overnight. Make sure we have the right mix of staff to support our future services. Keeping you involved and informed We value your involvement. Your Views can help shape the excellent services we want to provide patients, before we provide them, whether in our local hospitals, in the community, or in their own homes. Your local NHS is committed to working closely with its staff, patients, the public and other stakeholders to help improve local health services. Page 9

10 To make sure our services are right for you and are of the highest standard, we want to involve as many people as possible over the coming months and years in helping shape the way we provide our women and children s services. As you would expect, our staff have already been closely involved in the early work to plan out these services and the interim arrangements we will soon have in place, as described earlier on. We are working closely with the local Patient and Public Involvement Forums and Overview and Scrutiny Committees on the changes we need to make. At the same time, however, we believe you have important views that will help ensure we can provide even better services in the future. By sharing our plans with you now, we not only hope to keep you informed and aware of what is happening locally within the NHS, but importantly offer you the chance to share your ideas with us. So how do we do that? There are a number of ways that we will be keeping you informed about the changes to women and children s services. Firstly, there are a number of individuals, groups or organisations who represent you and with whom we will be sharing our work. We will be sending out our newsletters to the following stakeholders to share with you: Local MPs Local and county councils Parish councils GP practices Health centres Pharmacies Libraries Voluntary sector Our newsletters will be available to collect from some of the above organisations and they will be on our website too ( We will be sending out newsletters to our own staff and making them available in our hospitals and community clinics as well. Our midwives and health visitors will also be given newsletters so that they can share the latest information with their patients too. Page 10

11 We will also be asking the local media to help explain the changes we need to make to improve women and children s services by carrying stories about the changes, how they affect you and how you can get involved. We also want to be innovative and forward thinking and start planning to inform tomorrow s patients today. We will, for instance, look at how we can work more closely with our local schools so that the changes we are making in the future can start being understood now. We will also look at ways in which we can involve playgroups, nurseries and mother and toddler groups, reaching out to our local parents. Equally, we will also continue to inform our new mums now about the changes happening to women and children s services. We will explore the possibility of asking our new mums if they would like to be kept on a database and sent our newsletters. We will: Be holding open days at our local hospitals for the public to attend, hear more about the changes and give us their views, as we have done in the past Have occasional displays in our local shopping centres Work closely with our local councils to include displays in local public events. We also want to work closely with our local councils to identify and work with ethnic minority and hard to reach groups. We will also be checking with the local Patient and Public Involvement Forums and Overview and Scrutiny Committees to ensure our communication with patients and the public is good. If you would like to know more about the changes to women and children s services, or receive our newsletters, contact: Karen Beesley, Patient and Public Involvement Manager for Maidstone and Tunbridge Wells NHS Trust on or us at mtw.shapingyourlocalhealthservices@nhs.net We will also seek to measure how well we are keeping you informed by asking our staff and patients. Page 11

12 Produced by Maidstone and Tunbridge Wells NHS Trust Communications Department call This newsletter can also be made available in different formats