Miscarriage Care and Facilities in Scotland: Scoping Report NHS Greater Glasgow and Clyde

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 Greater Glasgow and Clyde reported that the Early Pregnancy Units (EPU) at the Royal Alexandra Hospital, Inverclyde Royal Hospital and Vale of Leven are open Monday to Fri 09:00-17:00. The EPU at Princess Royal Maternity Hospital is open 08:30-16:30 Monday to Friday while the Queen Elizabeth University Hospital EPU is open 08:00-16:00 Monday to Friday. Most EPUs are closed on Saturdays and Sundays, however EPU services are provided at the Queen Elizabeth University Hospital on Saturdays 08:30-16:30 and at Princess Royal Maternity Hospital on Sundays 08:30-16:30. While the EPU is deemed the main location that those experiencing miscarriage would be seen, treatment outwith these hours is provided at the obstetrics and gynaecology departments at the Royal Alexandra Hospital, the Queen Elizabeth University Hospital or Princess Royal Maternity Hospital (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 Greater Glasgow and Clyde reported that Royal Alexandra Hospital, Queen Elizabeth University Hospital and Princess Royal Maternity Hospital have Maternity Units which are open 24 hours a day seven days a week. Inverclyde Royal Hospital has a Maternity Unit which is open 08:00-20:00 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 Greater Glasgow and Clyde reported that there are four CMUs at Royal Alexandra Hospital, Inverclyde Royal Hospital, Vale of Leven District General Hospital and Princess Royal Maternity Hospital. The CMUs at Royal Alexandra Hospital and Princess Royal Maternity Hospital are open 24 hours per day seven days a week, while the CMUs at Vale of Leven District General Hospital and Inverclyde Royal Hospital are open 08:00-20:00 7 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 Greater Glasgow and Clyde reported that there are four Obstetrics and Gynaecology departments as detailed in Table 9 below. The departments at Royal Alexandra Hospital, Queen Elizabeth University Hospital and Princess Royal Maternity Hospital are open 24 hours a day 7 days a week. The department at Inverclyde Royal Hospital is open 09:00-17:00 Monday-Friday for obstetric outreach clinics and antenatal appointments and closed on Saturdays and Sundays.

Recurrent miscarriage services

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

NHS Greater Glasgow and Clyde reported that Recurrent Miscarriage Clinics are operated from Princess Royal Maternity Hospital and the Queen Elizabeth University Hospital. Princess Royal Maternity Hospital runs recurrent miscarriage clinics 09:00-12:00 on Monday and Tuesdays and 13:00-16:00 on Thursdays. Queen Elizabeth University Hospital runs recurrent miscarriage clinics Monday to Friday 09:00-17:00 (Table 10).

Infertility services

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

NHS Greater Glasgow and Clyde reported that infertility services are operated in Royal Alexandra Hospital on Thursdays 14:00-16:00 and in Princess Royal Maternity Hospital Monday – Friday 09:00-17:00 (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 Greater Glasgow and Clyde reported that the Royal Alexandra Hospital, Inverclyde Royal Hospital, Queen Elizabeth University Hospital and Princess Royal Maternity Hospital have an A&E facility that is open 24 hours seven days a week. There is no A&E department at the Valley of Leven District General Hospital.

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 Greater Glasgow and Clyde. All sites reported that if a woman presents at A&E with suspected miscarriage through the night (out of hours) staff would triage the patient. If clinically stable, A&E staff would make a referral for the patient to be seen at the EPU at their site the following day within opening hours. If the patient is unstable the patient would be transferred to the obstetric and gynaecology team. If a women presents at Inverclyde Royal Hospital and is unstable, they would be transferred to the obstetrics and gynaecology team at the Royal Alexandra Hospital.