PLANS to reduce midwife care at Withybush hospital to a daytime service - as exclusively revealed by the Western Telegraph - are now being formally discussed with staff.

At first, Hywel Dda University Health Board denied it had plans to change to the way Withybush’s maternity unit is staffed, before  later admitting that some changes were being considered.

And a confidential letter obtained by the Western Telegraph has now confirmed the final plans.

The letter and an attached briefing document says that the health board plans to change the model of care used by the Midwifery Led Unit, reducing the current 24/7 staffed service at the hospital to a model where staff work on an on-call basis outside normal working hours.

Western Telegraph:

In the letter, the health board claims there will be no change in the provision of service, describing it as still being a 24/7 service, as midwives and support staff will still be available at all hours.

But the changes would mean that midwives and health care support workers would not continue to work from the maternity unit after hours as they currently do.

“Outside of normal working hours women would be able to access the MLU via their on-call community midwife who would be available to maintain the MLU provision of care,” the letter says.

Under the plans, anyone going into labour during daytime hours would be able to go to Withybush Hospital to have their baby delivered.

But outside of daytime hours, a woman in labour would need to contact their on-call midwife, who would meet them at the hospital.

There are also plans for three community midwife teams based in north, south and mid-Pembrokeshire.

The briefing document says the service is being considered for change due to a drop in numbers of babies being born in Pembrokeshire since the Midwifery Led Unit was opened at Withybush in 2014.

At the same time as the unit opened, maternity care led by consultants was moved wholesale to Glangwili Hospital in Carmarthen.

The briefing claims that in 2018, a total of 3,165 babies were delivered across the health board, with 142 of those being delivered at Withybush MLU.

This was a reduction from the 189 babies delivered at the unit in 2016, and the 160 babies delivered there in 2017.

Western Telegraph:

In 2018, 90 women from Pembrokeshire postcodes chose to have their babies delivered in Glangwili’s maternity unit.

In March, Wales' First Minister Mark Drakeford and Health Minister Vaughan Gething both denied any changes were being made to midwifery services at Withybush when asked by Paul Davies AM and Joyce Watson AM respectively.

What Hywel Dda has said

The Western Telegraph asked Hywel Dda University Health Board:

  • Why the new model was not considered a reduction of midwifery services at Withybush Hospital
  • What work had been done to make sure the new model was as safe as the current one
  • What would happen if someone arrived at Withybush outside normal working hours without having contacted the on-call midwife

Keith Jones, Assistant Director of Acute Services at Hywel Dda University Health Board said the proposals did not “represent a reduction in the service available to women and that the Midwife Led Unit at Withybush Hospital will continue to be available to women 24/7 as at present.

He added: “Our proposals will allow us to deploy our midwives and support staff as effectively as possible, as the midwives currently based in the MLU will be expanded into an integrated community midwifery team.

“This will lead to improved continuity of care for women and their families throughout pregnancy, labour and the postnatal period and ensure that midwives’ time is fully utilised and matched with womens’ needs.”

When asked about whether the on-call system would be as safe as the current model, Mr Jones said: “Any women booked for Midwifery Led Care are continually risk assessed during their pregnancy and follow the All Wales Midwifery Led Care Guidelines and Pathways.

“The proposed model of care is well established throughout the UK both in rural and urban areas.

“Individual pathways of care are discussed with women during their pregnancy and issues such as geographical location, drive times and communications access are all considered.”

Western Telegraph:

When asked what would happen if someone in labour arrived at Withybush out-of-hours without having called ahead to alert an on-call midwife, Mr Jones said: “It is important to note that only women deemed suitable for Midwifery Led Care would access the MLU at Withybush General Hospital and receive consistent advice during their pregnancy how to contact their midwife during the early stages of labour.

“The proposed model of care would facilitate an increase in the availability of home assessments to help avoid unnecessary travel when women suspect they may be in labour.”

Staff are being consulted about the proposals until the end of July.

According letter shown to the Western Telegraph, the health board plans to have the new model in place by November 4 at the latest.