STRUCTURE: A three month public consultation on the future of maternity services in east Kent is expected to begin in October.

The process is expected to see births in future restricted to two hospitals rather than the current four birthing centres.

The NHS Kent and Medway primary care trust cluster and East Kent Hospitals University Foundation NHS Trust have been reviewing maternity services during the spring and summer – prompted by a rising birth rate in east Kent and a change in the pattern of where women are choosing to give birth.

On 9, September, a Maternity Services Review Group – chaired by local GP Dr Sarah Montgomery and including the head of midwifery and a consultant obstetrician – presented a paper to the Health Overview and Scrutiny Committee, outlining a number of options for the long-term future.

There are four options outlined in the paper:

  • Maintain all facilities including births at Canterbury and Dover and open Thanet hospital midwifery-led unit. Cost £2,126,667
  • Maintain all facilities including births at Canterbury. Stop births at Dover. Open Thanet hospital midwifery-led unit. Cost £1,475,241
  • Maintain births at Dover but not at Canterbury. Open Thanet hospital midwifery-led unit, cost £1,355,320.
  • Stop births at Canterbury and Dover open Thanet hospital midwifery-led unit. Cost £700,468.

The review group recommendation is to concentrate resources at two hospitals – the William Harvey at Ashford and the Queen Elizabeth The Queen Mother Hospital at Margate.

Each site will have a co-located midwifery-led unit attached to a consultant-led ward – this will also mean opening the currently idle new midwifery-led unit at Margate. Births would stop at Dover and Canterbury Birth Centres but they would continue to offer all their current day and community services.

Dr Montgomery said: “Offering the choice of giving birth at two hospitals is the safest, fairest and most sustainable option for the long-term future. By changing services in this way, it will be possible to provide every woman with one to one care in labour. The Dover and Canterbury Birth Centres would continue to offer all their current day and community services.”

A three month public consultation, based on the options in the review, will start in October, with a final decision due in January 2012.

The reconfiguration follows a rising birth rate and an increase in the number of women choosing to give birth in Ashford, contrasting with a decline in popularity at Canterbury and Dover, which subsequently sparked the temporary closure of units there.

Dr Montgomery said: “Before the temporary closures at Dover and Canterbury, on average there were five births a week at Dover, seven at Canterbury, 56 at Margate and 70 at the William Harvey. Births at the stand alone units in Canterbury and Dover have been declining for the past five years.“Current evidence suggests that a midwife to birth ratio of 1:28 allows one-to-one care in labour.

“Our midwife to birth ratio varies from 1:9 in the birth units at Dover and Canterbury to 1:40 in the consultant-led unit at Ashford, which deals with the most complex deliveries.

“We want to give all mothers one to one care from a midwife in labour. That is why we had to take the reluctant decisions to temporarily suspend births at Dover and then Canterbury and why we are reviewing our services.”