Maternity and paediatric services at Dr Gray's Hospital: report by CMO Advisory Group

Remit

1. The Chief Medical Officer requested that th1is small expert group provide insight and guidance on the measures proposed by NHS Grampian to maximise the maternity care which can be provided in Dr Gray's Hospital (DGH) following the change in service to a Community Midwifery Unit (CMU) in August 2018. The full Terms of Reference for the group can be found at Annex 1. The CMO asked the Group to look at NHS Grampian's Phase One plan for the improvement of existing provision of Maternity and Paediatric Services at Dr Gray's Hospital and the future plans for the return of obstetric services.

2. As part of our work, the team worked with NHS Grampian Management team and engaged with local clinicians, Maternity Services Liaison Committee (MSLC) and the KeepMUM campaign group to gain a range of views on the existing service and the proposals provided by NHS Grampian. We also spoke with clinicians at NHS Highland (Raigmore).

3. The Chief Medical Officer requested that a short report be provided to include:

1. Exploration of the development areas set out by NHS Grampian and agreed with the Cabinet Secretary. Including the feasibility and likely success of these additional measures and any advice which can be given to ensure success and/or improve upon the plans.

2. Further recommendations to improve the care provided locally for women in DGH in the CMU setting including obstetric emergency triage, antenatal and postnatal care.

3. Review of clinical pathways for the CMU, for transfer (both emergency and elective), and for antenatal care, and comparison with national/professional body standards and experience in other parts of Scotland.

4. Engagement with local clinical staff to allow inclusion of local solutions to break down barriers to different ways of working and to build on communication with NHSG staff in Aberdeen.

5. Engagement with and feedback to NHSG management

6. Exploration of NHS Highland capacity and referral pathways to increase number of women able to travel to Raigmore for antenatal care or birth if this is a shorter journey for them.

Group Members:

Dr Rennie Urquhart - retired Obstetrician, NHS Fife
Justine Craig - Chief midwife, NHS Tayside
Una McFadyen - retired Paediatrician, NHS Forth Valley
Margaret McGuire - Executive Director of nursing NHS Greater Glasgow and Clyde*

*Provided senior input into development of report, but not involved in visits or discussions with staff.