Clinical commissioning groups have been asked about their arrangements for ensuring women and their babies have access to fetal medicine services, after an HSJ investigation raised concerns babies were “dying unnecessarily” because of a flawed funding system.


fetal ultrasound pregnancy monitoring

Fetal medicine is a highly specialised area of medicine involving the diagnosis and treatment of complications that may arise in unborn babies.

In June, HSJ revealed that senior doctors had warned that babies were “dying unnecessarily” because local hospitals had a perverse financial incentive to “hold on” to patients rather than make a referral to a specialist unit.

The warning was set out in letter by leading consultants at London’s specialist fetal medicine units, which included anonymised cases of patients being mismanaged and in some circumstances experiencing harm as a result.

In response to HSJ’s investigation, the London maternity clinical network sent a letter to the capital’s CCGs on 30 June asking for their “help in ensuring that all women and their babies have access to specialist fetal medicine units if the need should arise during pregnancy”.

The network said a service specification circulated in late 2015 made “it clear that referral pathways need to be in place to ensure timely access to such services [and] that funding for the activity in fetal medicine units would come via service level agreements between maternity providers”.

The letter added: “An article published on 15 June 2016 in Health Service Journal… suggests that harm may be being caused by late referrals to fetal medicine units due to funding issues.

“It is worth pointing out that the letter referred to is over a year old and the evidence is anecdotal.

“However, these are serious issues and we are asking if you could respond to this letter letting us know your experience of ensuring that women in your area have ready access to these services.

“In particular it would be helpful to know if your local unit(s) have [service level agreements] in place for this activity.”