ERI shut to pregnant women 107 times a year

The vital Edinburgh Royal Infirmary unit cannot cope and closes to mums every three days – forcing bewildered pregnant women to be seen elsewhere.

New figures have shown that the birthing unit at the Royal Infirmary was placed “on divert” on 107 occasions last year, meaning mums in labour had no option but to have their babies more than 20 miles away at St John’s Hospital in Livingston.

On each occasion the unit, where a new £2.8 million birthing suite was opened just 15 months ago, was closed to non-complex births for between 30 minutes and 12 hours due to a lack of staff or capacity.

The startling scenario is made all the worse when offset against the region’s exploding birth rate and lifestyle changes which mean the average age of a first-time mum is now 29.

With the number of births in the region now standing at up to 9500 a year, and the proven likelihood of mature mums being more likely to suffer from birthing complications, critics have been quick to label the “part-time” ERI unit a “scandal”. One doctor told us: “Mums deserve better treatment than this.”

The damning figures were revealed as it was warned that a staffing crisis which has threatened the children’s ward at St John’s Hospital could spread to hit vital neonatal and paediatric services in the Capital.

NHS Lothian said that the number of births being diverted away from the Royal Infirmary had remained stable in recent years, but the only previously publicised figures suggested the problem is  deepening.

In the first seven months of 2010, the unit shut 51 times, meaning it would have closed on 87 occasions had the same pattern been repeated throughout the year.

The Scottish Conservatives, who obtained the figures through the Freedom of Information Act, said that in the rest of Scotland diverting mothers from hospitals had only occurred on “a handful” of occasions, yet the process had potentially disrupted hundreds of Lothian mothers at a vital stage of their pregnancy.

The party’s health spokesperson, Jackson Carlaw, said: “These findings are alarming, and frankly families across the Lothians deserve better than this. The health board and the Scottish Government must get together urgently and work out how to stop this happening.

“Birth rates since it opened haven’t increased, so why is this continuing to happen?”

It is understood that staffing levels in the maternity department, which is the busiest in Scotland, have not been cut in recent years, and parents are warned in the run-up to the birth that they may be sent to an alternative hospital.

But the department has seen a higher number of complex or high risk births, largely due to women giving birth later in life and a higher proportion falling pregnant with underlying medical conditions.

Areas of the Simpson Centre are often kept open in case of a complex birth, while the new birthing suite is only used for women unlikely to require medical intervention.

But one GP, who works at a busy city practice, slammed the practice of turning people away from their local unit and branded the new birthing suite a “white elephant”. She said: “This is absolutely appalling. The place is clearly not fit for purpose.”

Maternity services at St John’s Hospital were placed on divert on 14 occasions in 2012.

Independent MSP Margo MacDonald said that while the most pressing concern was that babies are delivered safely, she understood why mothers would be upset at having plans changed at the last minute.

She said: “Particularly for first-time mothers, they deliver the baby 100 times in their head before they go into hospital, and may have got to know staff. ”

NHS Lothian said that its new birthing unit, which has six delivery rooms, all with en-suite facilities and a birthing pool, had been an “overwhelming success” and that feedback had been “extremely positive”.

Maria Wilson, chief midwife, said: “During extremely busy periods the maternity suites at the Simpson Centre for Reproductive Health and St John’s Hospital are used flexibly and the options available will be discussed with women as part of the triage process.”

Meanwhile, the strain NHS Lothian was further underlined when fears were raised over neonatal services for sick and premature babies at the Simpson Centre and the Intensive Care unit at the Sick Kids  hospital. A cut in paediatric and neo-natal trainee numbers from next month has cast the future of the inpatient ward at  St John’s Hospital into doubt.

Dr David Farquharson, the health board’s medical director, said that staffing issues at the Edinburgh sites were of even greater concern.

“As medical director the main areas of concern are the neonatal unit at the Simpson and PICU [paediatric intensive care unit] at the Sick Kids, rather than St John’s. It’s going to be an ongoing problem,” he said.

A worldwide recruitment drive to attract new staff to fill gaps in the workforce is already under way, with interest received from countries including China, Romania, the Netherlands and Burma. Five applications and 11 expressions of interest have been received.

The Scottish Government has said it will fast track the immigration process to get incoming doctors on to Lothian’s wards quicker.

Baby boom puts strain on services

THE population in Lothian has exploded in recent years, inevitably putting increased strain on maternity services as more babies are delivered.

There are currently almost 10,000 births every year in the region, and with the population due to increase by ten per cent in the next decade, that figure is only likely to grow.

And the Capital’s population in particular is soaring, with the total number of residents expected to top half a million for the first time this year.

In 1998, there were 8923 births in Lothian, with the numbers then declining steadily in subsequent years. In 2000, 8579 babies were born and by 2003 it had fallen to 7971.

But the number of births then began to surge, hitting 8413 in the following year and 9560 in 2009.

In 2011, NHS Scotland’s Information Services Division said that there were 9368 births in Lothian. In the city of Edinburgh area in 2011, the number of live births hit an all-time high at 5885, rising from 4506 a decade earlier.

There were 806 births in East Lothian and 1904 in West Lothian. But in Midlothian in 2011 there were fewer babies born than in any period recorded since 1998, with just 780 births, compared to 955 in 1999 and 971 just five years ago.

The age of mums is also increasing. In 2011, 391 mums gave birth to a child while aged 40 or above, while there were just 159 in the age group in 1999. There was also a significant rise in the 35 to 40 age group.

Meanwhile, teen mums have decreased. The total peaked in 2000, when there were 702, but fell to 476 last year.