• Trusts facing difficult decisions over use of pregnant staff during covid-19 outbreak
  • National director tells chiefs main risks for pregnant staff are in final trimester
  • Royal college urgently seeking additional guidance for healthcare workers

Local NHS leaders facing difficult decisions over the deployment of pregnant staff during the coronavirus outbreak received further guidance from national leaders on Thursday, warning the main risks arise in the final three months of pregnancy.

On Tuesday last week, NHS England and NHS Improvement said trusts should make adjustments to enable pregnant staff to “stay well and at work wherever possible”, adding these adjustments may include working remotely or moving to a lower risk area.

The Royal College of Obstetricians and Gynaecologists then on Wednesday advised people to discuss their individual circumstances with their occupational health department, but said it was urgently seeking additional guidance for pregnant healthcare workers.

HSJ understands that in a video call with trust bosses on Thursday, Keith Willett, the NHS’ national director for acute care, stressed the available evidence so far suggested the main risks for pregnant staff are in the final trimester.

According to a number of sources who were on the call, he suggested trusts should communicate this and take it into account when making decisions about how and where to allocate staff.

According to one senior leader on the call, Professor Willett said the concern is around anaesthetising pregnant women in the last trimester, and the risks this poses to mother and baby.

He also stressed the importance of having a single, clear message to give to staff.

HSJ has heard some reports of pregnant staff being sent home by their trusts, before being asked to come back into work. Hospitals are desperately trying to ensure they have enough staff to cope with an expected surge of covid-19 cases, especially in critical care.

NHS England and NHS Improvement were contacted for comment on Friday lunchtime, but had not responded at the time of publication.

The RCOG guidance published last week said: “In response to a number of questions received from concerned pregnant healthcare professionals, we acknowledge the anxiety caused by the limitations of available information, especially following the chief medical officer’s advice on Monday 16 March 2020 for all pregnant women to minimise social contact as a precautionary measure.

“To the best of our present knowledge, most pregnant healthcare professionals are no more personally susceptible to catching the virus than their non-pregnant colleagues. However, infection with covid-19 may pose some risks to a pregnant woman’s unborn baby: there is a possible risk of fetal growth restriction and a risk of premature birth for the health of the mother and baby, should the mother become seriously unwell.

“We therefore advise all pregnant healthcare professionals, especially those in high risk areas, to discuss their individual circumstances with their local occupational health department. Further guidance for pregnant healthcare workers is being sought urgently and will be published in our next update to the guidance.”