Tag: maternity

Liverpool Women’s Hospital. Great work and great problems.
This banner in Liverpool Life museum is from one of the campaign groups for women’s health in the early twentieth century

Women and babies in Liverpool are entitled to the highest standard of healthcare. Our grandparents and great grandparents fought to found the NHS and left us this as their legacy. The NHS was a national service providing excellent healthcare, publicly provided and government funded. The new NHS did magnificent work for infant and maternal mortality.

In the last twenty years though, there have been years of cuts and privatisation in healthcare and years of poverty and subsequent ill health in Liverpool. A report to Liverpool city council this year said that, without change, “The life expectancy of women will fall by one year, and they will be in good health for 4.1 fewer years than they are currently.”

It is time to demand better.

Campaigning for the whole NHS

We are campaigning to Save Liverpool Women’s Hospital and to restore and repair the NHS. We want to see improved funding and staffing and to see the whole NHS move back to its original model of a national public service, publicly provided, providing universal comprehensive and timely care for everyone free at the point of need and funded by Government. If you have not yet signed our petition please do so.

Healthcare staff have worked way beyond what should have been needed to keep some good services going. Every day people are grateful for their work, their kindness and humour but sheer human effort cannot compensate for inadequate funding and too few staff.

Liverpool Women’s Hospital provides some excellent services but it has some serious difficulties too.

The Liverpool Women’s Hospital board meeting on 9/05/2024 reported some excellent staff work, including improved methods of helping premature and very premature babies survive and thrive. It also reported the success of moving early pregnancy loss to its own area, a development much valued by the mothers involved. Previous meetings have seen patients reporting their experiences too. In April there was a very positive report from a patient about her experience of the care she received from the Rainbow Clinic as a previously bereaved mum. We have also seen excellent presentations about the pioneering work on endometriosis and menopause at different meetings. The Hospital website says Every day on average, 24 babies are born in Liverpool Women’s Maternity Unit and another three babies are born prematurely and cared for in our Neonatal Unit.  Most of Liverpool’s babies are born at Liverpool Women’s Hospital and sick and tiny babies are cared for in the beautiful new NICU ( Neo Natal Intensive Care Unit)

Entrance to the NICU

The Liverpool Women’s Hospital is undertaking a major anti-racism drive to improve outcomes for patients and staff. We very much welcome this initiative. It is essential to save lives.

The core problem for Liverpool Women’s Hospital is under funding. This underfunding stems from the national underfunding of maternity as well as the general under funding of the NHS. This longterm underfunding has meant years of cuts. The NHS organisational changes from 2012 to create Trusts and Foundation Trusts also wasted many resources that should have gone to patient care.

Liverpool Women’s Hospital also has a long waiting list for cancer patients and waiting lists for gynaecology appointments. Some more staff have been appointed and hopefully the list will be dramatically reduced.These waits cost lives and health. The Chief executive reported that

“NHS England’s tiering process for cancer performance is designed to provide accountability and additional central support for trusts that are most at risk of missing national cancer targets. Trusts are categorised into tiers based on their performance, with Tier 1 being the most challenged and requiring the most support. Trusts may move between tiers based on their performance improvements or deteriorations.
In a letter received on 26 April 2024 from NHS England, it was confirmed that following a review of cancer performance, and in agreement with the regional team, the Trust will be in Tier 1 for Cancer from the week commencing 29 April 2024. The move to Tier 1 will involve regular meetings to discuss delivery progress and any required support from the relevant parts of NHS England.

Last year the hospital had a poor Care Quality Commission report for maternity and it has taken work to improve on this.New management is in place and they have plans to ensure that improvements are happening.

Our babies, our mothers, deserve much more.Every mother every baby treated at Liverpool women’s deserves the very best. Poverty from low wages, low benefits and poor housing is costing lives, and causing long term ill health. Inadequate health services are part of this.The Care Quality Commision report last year showed how much harm has been done by this underfunding and under staffing. The management must also be responsible for some of the damage mentioned in the Care Quality Commission reports.

The funding issues at Liverpool Women’s means that to meet the current level of service it needs twenty five percent more funding. Money is spent very carefully but for basic safety to be met, that extra spending is essential. At present the required money is being spent and temporary support funding has been made available, by the ICB or national NHS. However this situation puts the hospital into whats called Level 3 of the National Oversight Framework which could bring in management decisions not based on the needs of staff and patients, as the government clamps down on public spending.

Many studies show that money spent on good healthcare repays for itself many times over. At birth this is especially so as bth injuries can last a lifetime.

Neither merging the hospital nor dispersing its services will change that fundamental financial situation. Only an improvement of maternity funding will make a real difference.

Screen shot from page 52 of the LWH Board meeting 9 05 24

The underfunding of maternity leads to staff overwork and reduced services. Government safety figures for staffing are met but we say these safety figures are inadequate. The Government funding does not provide sufficient staff to deliver the kind of service patients and staff require. yet money is squandered on private companies and financial consultants.

There are national problems with maternity services described in many prestigious reports, as well as the Ockendon and Kirkup reports. No report has yet managed to shift the Government’s policies. We believe we need a huge campaign to win back the NHS.

A large part of Liverpool Women’s Hospital Maternity spend is on the maternity Incentive scheme, a government owned insurance system, run on a business model. Liverpool Women’s Hospital meets all the requirements of this scheme and so gets a refund from hospitals that do not meet all the safety requirements. This is an unbelievable situation..

Payouts from the fund are higher than the funding for maternity.If maternity were well funded fewer babies would be damaged and have to claim through the courts from this insurance fund.

In this crazy situation the hospital is still expected to make cuts (CIPs).

Our demonstration last October.

We have written before about how planned Cheshire and Merseyside ICB funding will not repair the situation patients experienced last winter. This poor experience was seen in many aspects, including A and E, care in corridors, access to GPs, access to NHS dentistry, and inadequate mental health provision. It will be worse next winter.

It was no surprise to hear there will be no new Hospital built in the next decade, nor does Liverpool Women’s require a new building. we believe that the new building idea was floated to make the idea of merging Liverpool Women’s Hospital into the big acute hospital more palatable. The existing building is less than thirty years old.However the drive to make fundamental changes remains, with merger or dispersal being the most likely recommendations. WE want to keep a distinct women’s hospital.

In the April Board meeting of Liverpool Women’s Hospital it was reported that work is in progress for major changes.

“the Women’s Hospital Services in Liverpool Programme. As part of the roadmap, the initial phase of the programme had been outlined, with an emphasis on the importance of openness, transparency, and continuous engagement with the public.
The development of a clinical case for change was scheduled for the spring and summer of 2024, with publication expected later in the same year. Feedback from this engagement phase, gathered during the winter of 2024/25, would then inform the approach to designing future services, with further development of potential options anticipated to commence in early 2025.” So the threats to Liverpool Women’s Hospital are still very real.

A meeting has been held with other Liverpool hospitals about the future for Liverpool Women’s Hospital and women’s health in the other hospitals in Liverpool.We have not yet been able to see which issues the other hospitals raised. Public consultation is promised this year.

No hospital can exist in a vacuum. Every hospital should be working in a mutually supportive system. The NHS was founded to be a national service, not a collection of competing hospitals. System working was damaged by the 2012 Act and the drive to privatisation. Cooperation and system working is required for the future of the other specialist hospitals in Liverpool, like the Heart and Chest and the Walton Centre.

Our campaign to Save Liverpool Women’s Hospital and to restore and repair the NHS has huge public support and is growing steadily.

The Future of Liverpool Women’s Hospital, Spring 2024

Save Liverpool Women’s Hospital.

The future of Liverpool Women’s Hospital has been under threat for nine years now. The petition which is at the heart of the Save Liverpool Women’s Hospital Campaign says “No closure. No privatisation. No cuts. No merger. Reorganise the funding structures not the hospital. Our babies and mothers our sick women deserve the very best.

In the Liverpool Women’s Hospital Board papers 11.04. 2024, it was announced that “An indicative programme plan had been developed and this reflected the unlikelihood that a new hospital building, co-located with an adult acute site, would be built within a five-to-ten-year timescale.

( In plain English this means they will not get a new Hospital)

 And that

 “… discussions were held on alternative solutions for citywide women’s healthcare.

Our opponents promised the public that a new smaller hospital on the Royal site would improve services. We always said that such a plan was magical thinking and that even if they got the money for a new building the existing problems would still be there. We said moving the Liverpool Women’s Hospital from the Crown Street site would be bad for women and babies.

Now we are in the horrible position that the bribe of a new hospital has evaporated but the core financial and organisational problems remain. We well remember the Panorama programme many years ago when it was announced that they wanted to close one hospital in Liverpool, and that clearly was Liverpool Women’s Hospital.

There are serious problems for Liverpool Women’s Hospital not to do with the Hospital site.

The Board of Liverpool Women’s Hospital has made it clear that safe services require extra funding. We demand that this money be provided.

Liverpool Women’s Hospital has a grave shortage of funds for crucial services. The fault for this lies with the last four governments but especially the current government who are very much aware of the damage they are doing to maternity care. There have been numerous high-profile reports on this, not least of these reports, being the work of Donna Ockendon. Donna Ockendon is now working on another maternity report, this time from Nottingham.

There are five reasons this national problem impacts on Liverpool Women’s Hospital

  1. Healthcare in the UK is badly funded and badly organised, wasting money and resources on privatisation.
  2. Eighty per cent of Liverpool Women’s Hospital’s budget comes through maternity funding, mainly the Maternity Tariff. The maternity tariff nationally is inadequate. No other hospital relies quite as much on maternity funding as the Liverpool Women’s Hospital does.
  3. The costs of the Clinical Negligence Scheme weigh particularly hard on this, the largest maternity hospital. The Government scandalously spends more on compensation than it does for the whole maternity service.
  4. The hospital is a Foundation Trust, which is an expensive management model for a small hospital.
  5. The model of healthcare from this, and some earlier governments, saw hospitals as competing businesses rather than a cooperating system. A small hospital could not thrive in such a scenario. This model is changing but the new ICB model also poses serious problems. We call for a return to the original Bevan model of the NHS, where a fully funded national, publicly owned and delivered health system based on cooperation not competition, sees ongoing improvement in maternity services.

Liverpool Women’s Hospital lacks crucial services because of these funding issues.

Our petition, now with more than 40,000 signatures online and more than 20,000 on paper, says “Save the Liverpool Women’s Hospital. No closure. No privatisation. No cuts. No merger. Reorganise the funding structures not the hospital. Our babies and mothers our sick women deserve the very best.”

Our campaign wants to improve the whole maternity journey for women and babies, every aspect of it, safety, respect and celebration of birth. We campaign for maternity everywhere in the UK. It is not possible to solve the fundamental problems of Liverpool Women’s Hospital without solving national funding and staffing issues but we can stop projects that make things worse. There are many and detailed reports about how the experience of maternity has worsened in recent years.

Our campaign wants midwives, nurses, obstetricians, CSWs and other staff to feel safe, and respected at work, free from undue stress, with access to ongoing education and training and with the opportunity to eat well, go to the toilet and have proper breaks at work, both day and night.

Our campaign wants to see maternity well-funded and protected from privatisation and protected from trendy, untried innovations.

We want those running maternity services to remember that as medics they have a duty of candour, to tell the truth about funding and staffing issues.

Since 2010 there has been damage done to all maternity and women’s health services nationally, and Liverpool Women’s Hospital has not escaped that damage. Underfunding, understaffing, and lack of key equipment and services have all had an effect.

We campaign for the whole of the NHS, not just maternity

Why do we want a women’s hospital?

We want excellent healthcare for women and babies. Our babies, our mothers, deserve the best. It is that simple.

However, that is not what this and previous governments have provided. We want to keep the focus on the needs of women and their babies. The scale and depth of the maternity scandals in other big multi-site, multi-specialism hospitals is a testament to how important this is. There have been many prestigious reports published about how bad the damage has been to Maternity and to women’s health. One in seven maternity units have closed during the period of cuts and this wave of closures has not stopped.

Cuts in NHS funding are part of the Austerity project. Austerity cuts have hit women and children and the working class very badly whilst the rich get ever richer. In this situation, we must protect what we have and not let it go. Maternity in England has suffered grievously under austerity. Maternal deaths are the highest in 20 years.

Ockendon’s reports have painted a grim picture of the failings of the system. Our campaign has fought hard for national as well as local funding and held two conferences on this matter. None of these hospitals involved in the big maternity scandals were standalone  Women’s Hospitals like Liverpool Women’s Hospital and their failings were not blamed on being a standalone Women’s Hospital. Yet the standalone character of Liverpool Women’s Hospital was what all the case for change was based on.

When Donna Ockendon did her first report on the Shrewsbury baby deaths it was revealed that many hospitals providing maternity care did not even have a member of their board charged with Maternity care, so board papers could go with nary a mention of maternity. Bad Care Quality reports were not given due consideration by the Shrewsbury board.

  • “The Trust board did not have oversight or a full understanding of issues and concerns within the maternity service, resulting in neither strategic direction and effective change, nor the development of accountable implementation plans.“

Most of Liverpool’s babies are delivered at Liverpool Women’s Hospital. The hospital delivers roughly 8,000 births per year. The Hospital also provides maternity care from a wider region for complex pregnancies and very premature or very sick newborn babies. It is a Maternal Medicine Centre, one of three within the Northwest Maternal Medicine Network. The Hospital also provides Gynaecological treatments,  Fertility services, Genetics services, Cancer care and termination of pregnancy, when that requires surgical intervention. The hospital also has a reputation as being a safe and caring place for women (though that has faltered a little in recent years). For all these reasons,  Liverpool Women’s Hospital is considered to be especially important by the people of Liverpool and beyond, but not considered so important by the Government or NHS England. For the last nine years, the future of Liverpool Women’s Hospital has been under ongoing threat.

We ask the people of Liverpool to continue to support our campaign for a fully funded, fully staffed, fully equipped hospital on the Liverpool Women’s Hospital Crown Street Site and for a fully funded, fully staffed, publicly owned and delivered national health service.