Miscarriage Care and Facilities in Scotland: Scoping Report NHS Lanarkshire

Opening hours of miscarriage care services

Early Pregnancy Unit

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 Lanarkshire has two Early Pregnancy Units (EPU). The EPU at University Hospital Wishaw is open 09:00-17:00 Monday-Friday, 09:00-13:00 on Saturdays and closed on Sundays. University Hospital Wishaw reported that the EPU is open on Saturdays for early pregnancy ultrasound scans only. The EPU at University Hospital Hairmyres is open 08:00-16:00 Monday-Friday and closed on both Saturday and Sunday.

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 Lanarkshire reported that University Hospital Wishaw has a maternity unit that is open 24 hours a day seven days a week.

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.

NHS Lanarkshire reported that there is one Community Maternity Unit (CMU) at University Hospital Hairmyres which is open 08:30-16:30 Monday to Friday and closed on Saturdays and Sundays (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 Lanarkshire reported that there are two Obstetrics and Gynaecology departments, one at University Hospital Wishaw and one at University Hospital Hairmyres. The department at University Hospital Wishaw is open 24 hours a day seven days a week, while the department at University Hospital Hairmyres only delivers outpatient services and is open 09:00-17:00 Monday-Friday and closed 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.

In NHS Lanarkshire, University Hospital Wishaw runs a recurrent miscarriage clinic 09:00-12:00 on Mondays and 10:00-12:00 on Fridays (Table 10).

Infertility services

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

NHS Lanarkshire reported that infertility services are operated in University Hospital Monklands 08:00-16:00 Monday to Friday and are closed on Saturdays and Sundays.

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 Lanarkshire reported that all three sites have an accident and emergency (A&E) facility which 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.

Sites were asked what would happen if a woman presents at A&E with suspected miscarriage through the night (out of hours) within NHS Lanarkshire. All sites reported that if a woman presents at A&E with suspected miscarriage through the night (out of hours) at their site A&E would triage the patient. If clinically stable A&E would make a referral for the patient to be seen at the EPU at the patients local site the following day within opening hours. If the patient presents at University Hospital Wishaw and is unstable they would be transferred to the obstetric and gynaecology team or the gynaecology team on call would be asked to attend A&E. If a women presents at University Hospital Monklands or University Hospital Hairmyres and are unstable, they will be transferred to the Obstetrics and Gynaecology team at the University Hospital Wishaw.