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

Staff morale, inclusion, training and communication

20. We were impressed with the new management and leadership structure that is now in place in DGH. We think this is very positive and a good step forward, and were encouraged by the proactive attitude demonstrated and the good grasp of what was needed locally.

21. It is our perception, from our discussions with medical, midwifery and paediatric staff at DGH that morale is low. Staff also told us that communication has been poor and that the current crisis is not unexpected and that plans should have been in place at a much earlier juncture. Some staff feel patronised and told us that they felt that the issues they have raised were not being treated seriously.

22. Staff also told us that they want to see a firm clear plan with a timescales for the restoration of obstetric and paediatric services. They are concerned that they will become deskilled and worry about the security of their jobs under the current arrangements.

23. We got a strong sense that staff are willing to adapt and explore options, however they feel discouraged and disempowered. Midwives told us that they are keen to accompany women who are transferred to Raigmore and continue to look after them there. However they perceive existing red tape is making this difficult and they don't feel encouraged to do so due to uncertainty about their role, their contracts and differing NHS Board procedures.

24. We heard some innovative ideas about the future of paediatrics and maternity services at DGH from staff. The ideas proposed included changing models of care and training opportunities, increased use of telemedicine, and introduction of a Service Level Agreement to allow NHSG midwives to continue care into NHS Highland.

25. There is a perception by staff that NHS Grampian sees DGH as an 'add-on' to the main service in AMH with concerns raised about the level of commitment from NHSG management to restoration of the service at DGH. Staff were also of the view that the priority for staffing is focussed on AMH, and posts in DGH are a secondary and lesser concern for recruitment. There was also a perception that AMH would not be willing to share or rotate staffing because of impact on AMH capacity.

26. Paediatric staff feel that too much of the shift and focus was on restoring the maternity and obstetric service with little consideration given to paediatric staff or services in DGH