Miscarriage Care and Facilities in Scotland: Scoping Report NHS Fife

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 Fife reported that the Early Pregnancy Unit in Victoria Hospital is open 09:00-13:00 Monday to Friday and 09:00-15:00 on Saturdays and Sundays with 24 hour cover provided for emergency advice. The EPU is the main location that those experiencing miscarriage would be seen in NHS Fife (Table 6).

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 Fife reported that Victoria Hospital 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 Care⁶ refers to CMUs as either being freestanding units or alongside units.

In NHS Fife reported that there is no community maternity unit at Victoria Hospital (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 Fife reported that there is an Obstetrics and Gynaecology department at Victoria Hospital which is open 09.00-17.00 and on call 17.00-09.00 Monday to Friday, with emergency services only provided on Saturdays and Sundays (Table 9).

Recurrent miscarriage services

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

NHS Fife reported that recurrent miscarriage services operate from Victoria Hospital and is available 9:00-16:00 Mondays, Wednesdays and Thursdays and 9:00-12:00 every second Tuesday (Table 10).

Infertility services

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

NHS Fife reported that infertility services run 9:00-17:00 Monday, 9:00-16:00 Tuesday & Thursday, 9:00-12:00 Wednesday and on every second Wednesday 13:00-17:00 a clinic is run by a consultant (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 Fife reported that they have an accident and emergency facility which is 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 varied both within and between Health Boards.

Sites were asked what would happen if a woman presents at A&E with suspected miscarriage through the night (out of hours) within NHS Fife. Victoria Hospital reported that when a woman presents at their site the patient's history would be taken and their clinical condition assessed to see if she required stabilisation. An appropriate referral would be made to the emergency obstetrics and gynaecology team and the woman would be transferred to the emergency gynaecology area, where she would be supported by the nursing staff and observations would be taken, a gynaecological examination would be carried out and analgesia given if required.