Maternity unit to be closed despite safety fears

North Central London Integrated Care Board yesterday announced plans to close the maternity unit at Royal Free Hospital in north London.

The move will have to be approved at the ICB’s board meeting next week and by NHS England. The ICB has said it wants to close the service in the face of stretched staffing and reduced demand.

But the plans have proved controversial among some clinicians. Last year, the clinical leaders of the Royal Free’s maternity services wrote to their chief executive saying the closure could increase maternal mortality.

NCL ICB medical director Jo Sauvage said: “We have a declining birth rate in our area, and the need for more complex support for mothers, pregnant people and their babies is growing.

“Our services are not currently set up to meet the needs of everyone that uses them. Doing nothing is not an option and we have carried out extensive work to make sure we are able to make the right decision for local families.”

The ICB had been weighing up whether to close the maternity unit at Royal Free or the one at the neighbouring Whittington Hospital in Islington.

The other three units at North Middlesex, University College London Hospital and Barnet Hospital will remain as they are.

In a joint statement accompanying its decision-making business case, the chief executives of the three acute trusts on the patch said: “We recognise that this is a difficult decision to make. These services are highly valued by local communities and no change is without impact.

“We recognise that the outlined proposal will impact staff and together we are committed to supporting staff regardless of the outcome of the decision.”

The business case said the number of admissions into the Royal Free’s unit had been declining by four per cent every year since 2018-19 and occupancy in 2023-24 was only at 51 per cent.

It said this meant that the volumes going through it were not enough to meet the training standards set out by the British Association of Perinatal Medicine.

The ICB said the consultation responses had seen keeping provision at the Whittington as “the least disruptive”, citing “the established multi-disciplinary team/effective use of allied healthcare professionals (AHPs); that “Whittington Hospital already has a level two [neonatal unit], managing more births than Royal Free”, plus “concern as to feasibility of uplifting Royal Free Hospital to a level two unit”.

It also stressed the importance of co-location with paediatrics, haemoglobinopathy, sickle cell, and female genital mutilation teams, and the younger and more deprived population served by the Whittington.

Meanwhile, respondents to the consultation favouring the Royal Free cited its co-location with haematology, renal and HIV services.