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

Travel, safety, cost and choice

14. In the short and medium term there are very real and understandable concerns regarding these issues. The temporary change has fallen over the critical winter months creating additional anxiety across all stakeholder groups. Concern about travelling long distances to Aberdeen in bad weather is significant and this must be considered as part of the overall safety picture.

15. We understand that NHSG and NHSH have agreed that women labouring in DGH who require emergency transfer will be taken to Raigmore. However we were told of two occasions where this was declined at the time of transfer and the women diverted to AMH. The extended travel time in emergency cases places women and babies at increased risk.

16. Prior to the change women could opt for care at Raigmore from early in pregnancy, this option has now been discontinued in order to build capacity for emergency transfers during labour from DGH. Removing this choice is a contradiction to the ethos of the Best Start and Realistic Medicine in enabling cross boundary working, choice of place of birth, keeping families together, and enabling and facilitating care as close to home and the local community as possible.

17. For many women in the north-west of the region, transferring their planned care to Raigmore would be beneficial in terms of travel, safety and cost. However it is acknowledged that NHS Highland has capacity issues. Enabling DGH midwives to provide continuity of carer and accompany women who are in their care to Raigmore should be explored using the Memorandum of Understanding between NHSH and NHSG and as an extension of the Best Start 'Early Adopter' scheme.

18. The cost of travel to Aberdeen we were told by both midwives and women was, for some, prohibitive. Staff, service users and DGH management provided differing accounts of the provision of support for transport. It is essential that this is clarified so that staff, including community midwives and GP's, and service users know what support is available and how to access this.

19. We were told by staff that two types of training in neonatal resuscitation are in place, this risks staff confusion and needs to be addressed urgently.