Miscarriage Care and Facilities in Scotland: Scoping Report NHS Highland

Miscarriage management and information

The Lancet series on Miscarriage Matters stated that women should be presented with the available evidence about miscarriage management and be free to choose the management approach that suits their needs and preferences.

Choice of management option

All Health Boards in Scotland reported that they ensure that women can choose their preferred method of management of miscarriage. However, the geography in Scotland has implications for women in terms of how they can access their chosen approach.

Sites in NHS Highland reported different processes of offering management options within the Health Board. Sites in Argyll and Bute reported that their services are provided via service level agreement with NHS Greater Glasgow and Clyde where women are referred for all management options. Belford Hospital reported that women are referred to Raigmore Hospital for all treatment which is 67 miles away. Both Caithness General Hospital and Dr MacKinnon Memorial Hospital said that they provide expectant management on site and refer women for all other management options to Raigmore Hospital. Caithness General Hospital is approximately 105 miles from Raigmore Hospital and Dr Mackinnon Memorial Hospital is approximately 89 miles away.

Written information

All Health Boards in Scotland said that they provide written information about the treatment options for the management of miscarriage and what to expect in terms of miscarriage care. However, not all sites where women may present for miscarriage care said that they provide written information on treatment options or what to expect.

In NHS Highland Raigmore Hospital stated that the same pathway of care for miscarriage treatment is used across all available departments within the site. Across NHS Highland there is some variation in what is provided by each site in terms of information provision.

Raigmore Hospital, Dr MacKinnon Memorial Hospital and Caithness General Hospital all responded that written information about treatment options and what to expect is provided at their sites. Belford Hospital and Nairn Town and County Hospital reported that written information about management of miscarriage or what to expect next is not provided on site, however, Belford Hospital noted that this information would be provided by staff at Raigmore Hospital once a patient had been transferred. Sites within Argyll and Bute reported that they provide information on treatment options for the management of miscarriage, but do not provide information about what to expect next in terms of miscarriage care as all women are referred to sites within NHS Greater Glasgow and Clyde for treatment, where this information would be provided.

Information about management options

As well as written information, Raigmore Hospital, Dr MacKinnon Memorial Hospital and Caithness General Hospital all either agreed or strongly agreed that what will happen during and after the chosen method of management of miscarriage, and what happens in terms of follow-up after the management of miscarriage, is fully explained to women. Belford Hospital stated that this information would be provided at Raigmore Hospital. Sites within Argyll and Bute neither agreed nor disagreed with these statements as information is provided once the pathway of care for the Health Board had been followed and the patient is at the site that would offer treatment for miscarriage, which in this case is delivered by NHS Greater Glasgow and Clyde.