Miscarriage Care and Facilities in Scotland: Scoping Report NHS Ayrshire and Arran

Opening hours of miscarriage care services

Early Pregnancy Units

The Lancet series on Miscarriage Matters recommended that healthcare funders and providers invest in early pregnancy care, with specific focus on training for clinical nurse specialists and doctors to provide comprehensive miscarriage care within the setting of dedicated Early Pregnancy Units.

17 of the 44 sites reported that they have a dedicated Early Pregnancy Unit (EPU). This was across 10 Health Board areas (Table 2).

NHS Ayrshire and Arran reported that the Early Pregnancy Unit (EPU) is situated at University Hospital Crosshouse and is open 8:00-18:00 Monday to Friday, 08:00-16:00 on Saturday and is closed on Sundays. While the EPU was deemed the main location that those experiencing miscarriage would be seen, treatment outwith these hours would be at the maternity unit within University Hospital Crosshouse, which is open 24 hours a day 7 days a week.

Maternity Units

19 sites of the 44 sites reported that they have a Maternity Unit that is currently open. This was across all 14 Health Board areas.

NHS Ayrshire and Arran reported that University Hospital Crosshouse has a maternity unit that is open 24 hours a day seven days a week (Table 7).

Community Maternity Units

21 of the 44 sites said that they have a Community Maternity Unit (CMU). This was across 7 Health Board areas. The Best Start: A five year plan for Maternity and Neonatal Care refers to CMUs as either being freestanding units or alongside units.

NHS Ayrshire and Arran reported that there are two community maternity units, one at University Hospital Crosshouse and one at Arran War Memorial Hospital, they are both open 24 hours per day seven days a week (Table 8).

Obstetrics and Gynaecology

21 of the 44 sites said they had an Obstetrics and Gynaecology department. This was across all 14 Health Boards areas.

NHS Ayrshire and Arran reported that there is one Obstetrics and Gynaecology department at University Hospital Crosshouse which is open 24 hours a day, seven days a week (Table 9).

Recurrent miscarriage services

13 of the 44 sites said they have recurrent miscarriage services. This was across 11 Health Board areas.

NHS Ayrshire and Arran reported that recurrent miscarriage services are operated from University Hospital Crosshouse and are available two days a week on Mondays 14:00-17:00 and Tuesdays 14:00-17:00, with one clinic on Mondays and two clinics running in tandem on Tuesdays.

Infertility services

14 of the 44 sites said they have infertility services. This was across 12 Health Board areas.

NHS Ayrshire and Arran reported that infertility services run from 09:00 – 12:30 on Monday to Fridays and are closed on the weekends (Table 11).

Accident and Emergency

37 of the 44 sites said they have a Accident and Emergency (A&E) department. This was across all 14 Health Board areas. All A&E sites said they were open 24 hours every day including weekends in all Health Board areas.

NHS Ayrshire and Arran reported that all three sites have an A&E facility that are all open 24 hours a day, seven days a week.

Out of Hours care

If a woman presents at A&E with suspected miscarriage through the night (out of hours) in Scotland, the reported processes vary both within and between Health Boards.

In NHS Ayrshire and Arran sites were asked what would happen if a woman presents at A&E with suspected miscarriage through the night (out of hours). University Hospital Ayr reported that women who present at their site would be transferred to University Hospital Crosshouse which is approximately 16 miles away. Arran War Memorial Hospital reported that if a woman presents at Arran War Memorial Hospital during this time, the midwife on call for Arran community maternity unit would be telephoned or University Hospital Crosshouse would be contacted for advice.

University Hospital Crosshouse reported that they would transfer women from A&E to the Maternity Assessment Unit or labour ward if the patient was in clinical need of immediate/urgent management through the night (out of hours). If there was no immediate clinical need, the patient would be referred to the EPU during opening hours to discuss management options.