Miscarriage Care and Facilities in Scotland: Scoping Report NHS Western Isles

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 Western Isles reported that there are no EPUs in the Health Board area. Miscarriage care is provided within the Maternity Unit at Western Isles Hospital and the Community Maternity Unit at Uist and Barra Hospital.

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 Western Isles reported that Western Isles Hospital has a maternity unit that is open 24 hours a day seven days a week (Table 6).

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 Western Isles reported that there is one CMU at Uist and Barra Hospital, supported by a midwife who works 9:00 to 17:00 Monday to Friday and is available for any emergencies outwith these times supported by a GP and nurse (Table 7).

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 Western Isles reported that there is one Obstetrics and Gynaecology department at Western Isles Hospital, and it is open 24 hours a day seven days a week (Table 8).

Recurrent miscarriage services

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

There is no recurrent miscarriage service in NHS Western Isles.

Infertility services

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

In NHS Western Isles there is no infertility service.

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.

In NHS Western Isles all three sites have an A&E facility and all were 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.

The secondary care sites identified in NHS Western Isles were asked what would happen if a woman presents at A&E with suspected miscarriage through the night (out of hours). If a woman presents at Barra Community Hospital A&E with suspected miscarriage through the night (out of hours), Western Isles Hospital would be contacted for advice and the woman would then be transferred for treatment. If a woman presents at Uist and Barra Hospital they would be assessed, a full history of symptoms taken, and a midwife would be called who would then assess the situation, and then transfer to Western Isles Hospital if intervention is required. If a woman presents at Western Isles Hospital with miscarriage through the night, A&E staff contact the Obstetrics and Gynaecology consultant and transfer the woman to Maternity services.