Miscarriage Care and Facilities in Scotland: Scoping Report NHS Forth Valley

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 Forth Valley reported that the Early Pregnancy Unit (EPU) at the Royal Hospital is open 8:00 to 16:00 Monday to Friday and closed on Saturday and Sunday (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 Forth Valley reported that Forth Valley Royal 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 Care refers to CMUs as either being freestanding units or alongside units.

NHS Forth Valley reported that there is an alongside Maternity Unit (AMU) at Forth Valley Royal Hospial which is open 24 hours a day seven days a week (Table 8). NHS Forth Valley also reported that they support three Community Midwifery Hubs within the three local authority areas which are open 8:30 to 16:30 seven days a week.

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 Forth Valley reported that there is one Obstetrics and Gynaecology department at Royal Hospital 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 Forth Valley reported that there are no recurrent miscarriage services at Forth Valley Royal Hospital (Table 10).

Infertility services

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

NHS Forth Valley reported they manage a subfertility clinic which is consultant led. Women are reviewed and assessed with primary and secondary infertility. NHS Forth Valley offers infertility investigations and ovulation induction management. Women requiring other assisted techniques are referred to NHS Tayside for tertiary level care.

There is access to this service Monday to Friday between the hours of 8:00-16:00, with planned clinics (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 Forth Valley reported that the Forth Valley Royal Hospital has an A&E facility which is open 24 hours 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.

Sites were asked what would happen if a woman presents at A&E with suspected miscarriage through the night (out of hours) within NHS Forth Valley. In Forth Valley Royal Hospital an initial assessment will be done at A&E. If the women require an immediate review they will be seen in either A&E or on the Gynaecology ward. If they are suitable for review as an outpatient, and are under 14 weeks gestation, this will be arranged by gynaecology staff within 72 hours in the EPU. If they are over 14 weeks gestation they will be reviewed in the maternity unit.