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Elgin maternity unit changes due to lack of paediatric support

Dr Gray's Hospital, Elgin.
Dr Gray's Hospital, Elgin.

A new report has laid bare the difficulties staff have been facing at Dr Gray’s Hospital due to the ongoing recruitment crisis.

NHS Grampian revealed that there was not enough staff both at trainee and senior level working in the paediatric service to “safely continue” running the service as normal.

Bosses revealed that staff problems in the department would “directly affect” the local obstetric service and would “reduce the number of births that can be safely carried out”.

There have been four unsuccessful attempts to recruitment consultants since June 2016 with a further process ongoing with “no success to date”.

Two new consultants employed between 2015 and 2017 quit their posts in July and August last year citing the “unsustainable nature of the roles, and the overall difficulty of maintaining a safe service”.

The report revealed that the out-of-hours on-call service had been operated by two consultants with the support of a community paediatrician on a short-term basis. However, it emerged that service will no longer be in operation from the end of this month due to staff concerns.

The report said: “It should be noted that the burden of the on-call rota frequency has been highlighted as a high risk in relation to the health and wellbeing of the small team involved, and it is agreed that the out-of-hours on-call service will cease from Tuesday 31st July.”

The paediatric service was downgraded at the hospital last year due to staff shortages with the unit closed to new admissions overnight.

Eight junior doctors are needed to support the service, but only two have been employed, and a consultant paediatric vacancy still needs to be filled.

Senior clinical experts have advised that medium and high risk pregnancies would have an “increased risk of adverse outcomes for the baby if they are delivered without immediate paediatric specialist input”.

The risk assessment report said: “This senior expert clinical advice indicates that the continuation of a consultant led obstetric service, without the necessary consultant paediatrician support, would result in a service which, in risk terms, would have an almost certain likelihood of an extreme consequence.”

It also acknowledged that while Moray women and their families had put forward valid concerns, transferring high risk pregnancy mums was the “safest option for women and their babies.”

Sue Swift, Divisional General Manager for Women and Children, said that the report was published to reassure people that the maternity unit will still be safe to use.

“We want to be as open as possible about the challenges we face as well as giving people easy access to the information they need on the safety of the Community Midwifery Model that we’ve put in place,” she said.

“This is an evolving situation and we’ve worked hard to try and reduce the impact where we can. We will continue to listen to patients to identify anything else we can do to support them over the coming days and weeks but we also completely understand that people are very disappointed that we have had to make these changes.”

However, campaign group Keep Mum hit out at the transfer plans.

A spokeswoman for the group said: “NHS Grampian describes the new arrangements as ‘safe’. We totally refute this claim. Of course, a midwifery led unit would be ‘safe’ if it was in close proximity to a full specialist unit but we do not have that. However careful the assessment of women in labour, it is not possible to predict outcomes, even in low risk women.”

Moray MSP Richard Lochhead was critical of the time it took the health board to publish the report.

He said: “It’s been a real source of frustration for campaigners that it has taken a number of weeks since NHS Grampian’s announcement for them to publish their risk assessment report.

“I’m asking the Scottish Government to establish a team to help Dr Gray’s with recruitment and to address key points of pressure in the NHS particularly in the north of Scotland.”