Raigmore staff voice concerns over maternity services in letter to Humza Yousaf

Healthcare staff have written to the health secretary raising concerns over patient safety and the delivery of new models of care across NHS Grampian and Highland health boards.

Health Secretary Humza Yousaf will give a statement on the maternity care issues in Moray on Tuesday (Photo: Andrew Milligan).

In a letter to Humza Yousaf, a group of 22 maternity staff from Raigmore Hospital in Inverness state patient safety concerns have not been acknowledged and a proposed model of care is “fundamentally flawed”.

Their concerns come after maternity services were downgraded at Dr Gray's Hospital in Elgin in 2018 due to staff shortages.

Following the downgrading of services three years ago due to the continued staffing crisis, almost three quarters of births have been referred to Aberdeen or Inverness.

The move left most pregnant women facing either a 90-minute trip to Aberdeen or a 60-minute trip to Inverness to give birth, depending on conditions.

The Scottish government commissioned a review to examine whether a consultant-led service could be reinstated.

However, its report, published in December, outlined a model (model 4) which would see women being given the choice of delivering their baby at either Dr Gray's - if they are classed as low risk - Aberdeen or Raigmore, with antenatal care provided at Dr Gray's.

The staff in the letter state this model is “fundamentally flawed due to its intentional discontinuity of care for pregnant women, not just between clinical teams but between health boards”.

The staff also raise issues with proposals from senior health board management spending £5 million on a “clinically disruptive refurbishment of the maternity unit” which adds “not one single bed to its capacity”.The letter states a business case drawn up by NHS Highland contains “numerous factual errors and baseless assumptions” on areas such as the number of deliveries at Raigmore Hospital in Inverness per year. The case states the estimated number of additional Raigmore deliveries per year under the model is 190. However, the staff said evidence suggests the numbers would be more along the lines of 650-900, representing a 32-45 per cent increase in the Raigmore birth rate.

A new maternity unit has been proposed by the staff, to permit the care – under any model – of any "significant additional number” of pregnant women.

The letter states: “Model 4 must therefore be rejected and the consultant-led service at Dr Gray's Hospital re-established as a matter of urgency. In order to deliver safe and sustainable maternity care to the women of the Highlands, we ask for your urgent help with regard to our midwifery staffing crisis, our middle grade medical staffing crisis and our need for a new maternity/gynaecology/neonatal unit.”

Delivering a statement on the issue at Holyrood on Tuesday, Mr Yousaf reiterated his "absolute commitment" to ensure a full consultant-led maternity unit at Dr Gray’s is re-established.

However, he rejected calls to change the model criticised by healthcare staff, naming it an “important step” and “interim solution” in improving care for pregnant women in the impacted area.

Mr Yousaf said: "Model 4 will provide obstetric maternity care closer to home for Moray women while NHS Grampian put plans in place to return to consultant-led services at Dr Gray’s.

“Having met with local campaign groups and the relevant Health Boards this week, before giving approval to the Model 4 plans I am very clear that further work is required, and there are elements to be worked through locally and nationally to deliver for families in Moray. I have also heard very clearly the concerns raised by Clinicians and have asked our External Assurance Panel to provide me with a level of reassurance around assumptions in Model 4 plans.

“At a local level, clinical teams in Highland and Grampian need to develop the safe pathways of care to bring reassurance to both the women and clinicians. At a national level we are determined to address the ongoing challenge of recruitment in rural areas.”

Mr Yousaf said he expected to receive the next phase of the plan for improvements by the end of December and will keep Parliament updated.

However, Scottish Conservative leader and MP for Moray, Douglas Ross, said he cannot thank Mr Yousaf for his statement on the issue and ‘pleaded’ for the health secretary to reject the model healthcare staff have raised concerns over.

Mr Ross said: “I share the anger, disappointment and frustration that we are no further forward months after the cabinet secretary previously came to this chamber and said he would make this a priority. There is nothing of comfort for Moray mums and Moray families in that statement because the agonising worry and concern about being transferred in labor is still there, be that Inverness or Aberdeen, is still there and shows no signs of ending.”

Labour’s Carol Mochan also raised the question of when the chamber could expect a women’s health champion after the Scottish Government previously announced such a champion would be announced over the summer this year. Mr Yousaf accepted this announcement has been delayed, however, committed to the position being announced “imminently”, giving no further details on a timescale.