Falling birth rates and maternity facilities under threat in the NHS area of ​​central North London

Falling birth rates, low staff morale and confidence in the NHS in central North London have raised concerns among councillors.

During a joint North Central London health review and review panel on Friday 31 May, councilors discussed the statistics with NHS leaders in North Central London.

Committee member Cllr Tricia Clarke from Islington asked about the falling birth rate, which has led to a proposal to cut maternity units, with services at the Whittington and Royal Free hospitals under threat.

Gillian Smith, chief medical officer at the Royal Free London NHS Foundation Trust, would not confirm which unit would close, but acknowledged the need for the closure.

She said: “We know that in north central London the birth rate is falling and as a result we have seen a reduction in the number of births taking place across the area.

“The quality of services is good and the patient feedback is good, but we know that if we continue with the number of units we have, we will not be able to sustain these services in the long term.

“The birth rate is falling, this is one of the main drivers of change in the ‘Start Right’ process.”

The Start Well program is a partnership program in central North London which has been running for a year and is undergoing an ‘options assessment process’ for maternity, newborn and pediatric surgical services in the area. The trial is due to conclude in the summer.

On Whittington Health NHS Trust, committee chair Cllr Pippa Connor from Haringey asked about a 2023 staff survey which showed 30% of staff at the trust would not feel safe “raising concerns about clinical practice unsafe’, which could lead to a ‘serious incident’. .

Sarah Wilding, chief nurse at Whittington Health NHS Trust, said they did not have a high proportion of staff reporting concerns anonymously, which was “very unusual”, stressing that this showed they had a culture that considered “responsible”.

She then described the “multiple ways” staff can speak up, including through line managers, occupational health services and human resources.

In the maternity wards there were also ‘safety champions’ positioned to field questions from staff.

As for North Middlesex University Hospital NHS Trust, Cllr Connor said the trust’s report did not contain enough data, particularly about “staffing, patient complaints and concerns about the merger (with Royal Free London)”.

Cllr Connor said: “You have a huge amount of information in your head that you can come up with and tell us, but I just can’t see it on paper in front of me.”

Lenny Byrne, acting chief medical officer at North Middlesex University Hospital NHS Trust, said a “huge” amount of data was collected and sometimes he didn’t know “how much or how little” to include.

For example, he said there was a 120-point improvement plan for maternity hospitals, but it was not included.

Victoria Jones, chief medical officer at North Middlesex, said “pockets” of poor staff culture were a top priority for the trust.

She said: “The vast majority of our staff are fantastic but we want our residents to feel confident that when they come to North Middlesex they will be treated by someone who treats them with kindness, respect and has the right training to give them. the care we want.

“I think the work we’re doing, where we know issues have been identified, we’re doing it in a timely manner and making sure it doesn’t affect the wider staff.”

JHOSC – NHS Quality Accounts Special Meeting, North Central London Joint Health Overview and Scrutiny Committee, 10.00am, Friday 31 May 2024.

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