Moray Maternity Services Review: report

Appendix A: Commission Brief (including Terms of Reference)

Review of Maternity Services for the women and families of Moray.

Description

To work with NHS Grampian, NHS Highland and stakeholders with an interest in local maternity services to describe the best obstetric model that will provide safe, deliverable, sustainable and high quality maternity services for the women and families of Moray in line with the Scottish Government ambition described in 'The Best Start: A Five Year Plan for Maternity and Neonatal care (2017)'.

Terms of Reference

• It should examine the requirements for establishing a safe and sustainable consultant-led intrapartum obstetric service at Dr Gray's Hospital.
• It should examine the requirements for establishing a safe and sustainable midwife-led intrapartum service at Dr Gray's Hospital.
• It should involve services in Raigmore Hospital (NHSH) and Aberdeen Maternity Hospital (NHSG) as well as Dr Gray's Hospital Elgin.
• It should consider rurality, transport and local support whilst aiming to provide services as close to home as possible.
• It should be deliverable and sustainable in the context of other health and social care services in Moray, with reference to the local healthcare landscape and economy.
• It must be carried out in partnership with local stakeholders with an interest in maternity services that would be affected by the recommendations.
• In will involve NHS Grampian and NHS Highland staff including the respective leadership teams, Obstetric specialists (Medical and Midwifery), Paediatric Specialists (General and Neonatal, Medical and Nursing), Anaesthetics Specialists (General and Specialist) and Scottish Ambulance Service.
• It should reference national standards and guidelines for maternity service provision to ensure the recommended option is safe and of high quality.
• Recommendations should reflect the provision of choice for women in line with 'The Best Start: A Five-Year Forward Plan for Maternity and Neonatal Care (2017)'.
• It should examine and review the chronology of events to stabilise services since July 2018 and offer reflection on what can be learnt from this.

Expected Outcome

A report detailing the best service model or options that offer deliverable, sustainable, safe and high quality maternity care for the women and families of Moray. The report should also offer a recommended action plan that takes the service from its current position through a series of safe interim steps before reaching its final configuration.

Principles

The review process and final report should take account of the operating principles for invited reviews in health care as recommended by the Academy of Royal Colleges, 2016.

These include:

• The primary focus should be on patient safety and patient care;
• The review will be advisory in nature;
• The accountable organisations will indemnify the review team;
• The review must be independent, objective, open, transparent and impartial;
• It will be conducted by experts with reference to nationally recognised standards and guidelines, relevant to the area of interest;
• It will be carried out in partnership with staff, women, families and the public;
• It will be conducted on a confidential basis in a respectful and sensitive manner;
• It will follow a recognised structured process to be agreed prior to the review;
• The review report will be structured setting out the reasons for review, its Terms of Reference, the information gathered by the reviewers, their conclusions and recommendations;
• Any patient safety issues identified, during the review, will be immediately addressed by NHS Grampian and NHS Highland;
• There will be a clear process for receiving feedback associated with the review process.

Review Group

The review process should be led by an experienced NHS Scotland Chief Executive. The Chief Executive, and where possible members of the review group, should have experience of delivering services in a similar population context, and where possible, experience of service review. The review group should be independent of the NHSG and NHSH Boards and include:

• Obstetric Medical Specialist
• Midwifery Lead with experience of both midwifery-led and consultant-led delivery units

• Obstetric Anaesthetic specialist
• Administrative support
• National NHS planner with expertise in service development
• Paediatric Medical Specialist with experience of service review

Timescale

To produce a report for the consideration by the Cabinet Secretary for Health and Sport by the end of June 2021.

Scottish Government

March 2021