Our campaign has worked since 2015 to secure a future for Liverpool Women’s Hospital. We want no loss of services, no loss of beds, no privatisation. We want a continued and enhanced focus on the health of women and babies. We do not want relocation to the crowded, crisis ridden site of the Royal Liverpool Hospital. We want to preserve the site at Crown Street. We want no part in PFI. Tens of thousand have signed our petitions, in the streets and on line.

We have roundly condemned the plans previously put forward by the CCG and the Trust. We dismiss the description of the Crown Street site as “isolated”, it is far closer to the Royal than either the Aintree or Broadgreen sites of the new combined trust. With the demise of the PFI system and the huge scandal at the Liverpool Royal Carillion site, these initial plans have fizzled out, at least for now.

Some interesting new discussions have now begun. We are sharing these discussiosns from the hospital board meetings here for our supporters to read and consider. We will hold a meeting to discuss them in more detail when people have had a chance to consider them. We are posting key sections from the report for our supporters to read, not to endorse it.

The discussions from the board are in four sections;

Networked Maternal Medicine Services (which is the subject of this blog post). This means Liverpool Women’s hospital will be working with the Manchester Hospitals, with one of the Manchester hospitals being the lead on maternity, with LWH as a subsidiary hub. Some Liverpool women with the most complex needs, will have to travel to Manchester for their care. Often these women are the least able to travel longer distances.

Sections on Gynaecological Oncology, The Age Profile of Consultant at LWH, and Working in partnership with other hospitals in Liverpool, will be posted in other blog posts.

We are posting these papers as four blog posts so the lay person can more easily understand them. Anyone who wants them in their original form can find them here, these are public documents.

Introduction from the Board

“Liverpool Women’s NHS FT (LWH) has previously set out the challenges it faces in delivering the highest quality of healthcare on its isolated Crown Street site. Clinicians at LWH have concluded that to sustain the services of the trust into the future, relocation onto an adult acute site would be required. These conclusions have been articulated in the trust’s Future Generations strategy, confirmed through a rigorous options appraisal process run by Liverpool CCG and supported in a Clinical Senate report from independent experts under the umbrella of NHSE.

To date, the DHSC has not given the trust permission to raise the capital required for the construction of a new hospital. Even if this was now achieved, services will continue to be run from the Crown Street site for several years to come. Given these facts, it is important that the trust revisits its clinical position periodically so that relevant and up to date information firstly can be used internally to counteract the clinical threat and secondly can be shared externally so that the need for relocation remains a visible priority for the system. To this end, a Clinical Summit was held in the Trust on 11th June 2019, to which all key stakeholders were invited and at which, a set of key clinical questions was asked.

Networked Maternal Medicine Services (My link)

NHSE/I have committed to ensure that all women in England have access to a level of expert clinical care before, during and after pregnancy that is commensurate with their clinical condition, if a significant medical problem isencountered. The national plan is to achieve this by establishing new Networked Maternal Medicine Services (NMMS), each with a Maternal Medicine Centre (MMC) at its heart.

Each MMC will be staffed by an experienced multidisciplinary team including an obstetrician with sub-specialty training in maternal medicine (or equivalent) and an obstetric physician (or equivalent) along with input from all relevant other medical specialists and support from specialist midwives. For the delivery of maternal medicine services within a given footprint, the MMCs will:

  Provide a leadership role

  Liaise with the other providers of maternity care in its footprint

  Agree pathways of care and patterns of referral

 Ensure that women are cared for by clinicians with an appropriate level of expertise.

Peripheral units will provide much of the maternal medical care required for women of low to medium complexity. The referral of some high risk or complex cases from across any given NMMS footprint into its MMC for the delivery of care is, however, inevitable.

To become an MMC, a trust must comply with a nationally determined service specification with its range of associated standards.

An assessment against that service specification has been carried out by the Clinical Director for Maternity at LWH and this has been included as an Appendix to this paper. The trust can demonstrate compliance against most of required elements but it is not co-located with other adult acute specialties, so full compliance has not been achieved.

In view of these constraints, earlier this year, the trust submitted a joint bid with other partners across the North West, outlining a proposal to develop an NMMS which will cover three LMS areas; Greater Manchester and Eastern Cheshire, Cheshire and Mersey and Lancashire and South Cumbria. In this proposal:

 · An MMC will be established at Saint Mary’s Hospital at Manchester University NHS Foundation Trust (MFT). This centre can comply in full with the service specification as its women’s services are co-located with other adult acute services

 · Two sub-centres will be developed including one at LWH, allowing most but not all women to be treated closer to home. Referral from Cheshire and Merseyside into MFT will be required for some women with severe medical problems: around ten per year will receive most of their care at MFT and a higher number will attend MFT for one or more outpatient reviews.

 Establishing LWH as a sub-centre for maternal medicine will require the appointment of an obstetric physician in Liverpool. The Clinical Director for Maternity is presently working with partners at LUH to identify an appropriate clinician for this role. He is also writing to colleagues across Cheshire and Merseyside in order to formalise existing referral pathways for patients.

These are serious issues for Liverpool women. It would be better to have a self contained Merseyside and Cheshire service. Your comments are welcome.

The following posts will discuss the other issues raised.