In their Equality Impact Analysis Report into the Clinical Services Review of July 2017, Dorset CCG say the Clinical Services Review will create ‘A significant risk during labour and childbirth’ and ‘A significant risk for children requiring acute paediatric services’.
“A proportion of residents in Dorset live in a rural or deprived areas of Dorset, some whom may not have access to care. Travel time for intrapartum care (care during labour and childbirth) is perceived as a significant risk.
A large proportion of residents in Dorset (41%) live in rural communities
(State of Dorset report). The most rural localities tend to be in North Dorset and West Dorset. Approximately 18% of households in Dorset do not have a van or car (2011 census). Travel time for intrapartum care (care during labour and childbirth) and children requiring acute paediatric services is perceived as a significant risk.”
So far Dorset CCG has only carried out a limited risk assessment of mums-to-be and child emergencies who arrived by ambulance at Poole Hospital January-April 2017, and who would have faced longer journeys to Hospital had Specialist Maternity and Paediatric services not been available at Poole.
This identified just 3 mums and 4 children at likely increased risk, however the cases relied on Ambulance Trust report data, some of which was incorrect.
However, a Freedom of Information Act request showed that of the 590 maternity emergencies treated at Poole in 2017, less than a quarter came by ambulance. No risk assessment has been carried out for the 454 mums facing maternity emergency who did not arrive at Poole by ambulance.
Expert opinion, cited in the High Court, says the majority of child emergencies do not come to Hospital by Ambulance either, and no risk assessment has been carried out for these children.
Only considering ambulance cases means that the CCG have carried out NO RISK ASSESSMENT AT ALL for the majority of maternity and child emergencies – the very cases the CCG admits face significant risk due to increased travel times.
A second Freedom of Information Act request to Poole Hospital showed that 251 newborn babies received intensive, or high dependency, care at Poole in 2017/8, and that a further 195 newborns needed special care.
The mums of very premature babies, and the mums of the babies needing intensive, and high dependency care, come from all over the County to Poole Hospital, as Poole is the only Dorset Maternity Unit offering this level of care.
Moving the Specialist Maternity Unit to Royal Bournemouth Hospital, in the far east of the County, will mean longer journeys for many to these mums-to-be.
The risk this poses to vulnerable mums and newborns is of great concern.
We call for a full independent review of what the likely impact of would have been on each of the mums-to-be, on each of the newborns, and on each of the child emergencies who have been treated at Poole Hospital over the last year, who would have faced longer journeys to Hospital under the plans, with realistic assessment of what their new total journey times would be, given that the majority of these maternity and child emergencies did not come by Ambulance.
The review should be carried out by a reputable organisation that does not rely on Dorset Clinical Commissioning Group for its funding.
We will also be calling for an independent and full review of the adult emergency cases, as the review that has been carried out to date has been wholly inadequate. Some of the data reviewed was inaccurate, the sample studied was small and unrepresentative, and no attempt was made to identify and review the cases most severely affected by the changes.