Maternity unit closures likely as birth rates fall

Maternity services at the Royal Free and Whittington hospitals are under threat due to falling birth rates

Concerns have been raised by councillors over falling birth rates, low staff morale and patient complaints across NHS services in north London.

During a North Central London joint health overview and scrutiny committee councillors discussed concerning statistics with North Central London NHS leads.

The NHS admitted there would be a maternity unit closure but did not specify whether the services at Whittington or Royal Free hospitals would close.

One trust's staff survey found 30% of workers did not feel secure raising concerns about unsafe clinical practice but health bosses said measures such as having "safety champions" were available on wards to improve confidence.

Birth rate 'driver of change'

On Friday, committee member Tricia Clarke asked about the declining birth rate in north London which has led to a proposed cut to maternity units, with services at Whittington and Royal Free hospitals under threat.

Gillian Smith, chief medical officer at Royal Free London NHS Foundation Trust, did not confirm which unit would close but acknowledged the need for closure.

She said: "The birth rate is falling, that’s one of the main drivers of change in the 'Start Well' process."

Start Well is a North Central London partnership programme that is appraising maternity, neonates and paediatric surgical services in the area. The process is due to be concluded in summer.

"The quality of the services is good, and the patient feedback is good, but we know if we continue with the number of units that we have we won’t be able to sustain those services in the longer term," Ms Smith added.

One trust spokesperson said they want patients to feel to feel "confident" they’ll be treated with "kindness" by staff who have "appropriate training"

Committee chairwoman Pippa Connor, noted a 2023 staff survey for Whittington Health NHS Trust showed 30% of staff would not feel secure "raising concerns about unsafe clinical practice" which could lead to a "serious incident".

Responding for the trust, chief nurse Sarah Wilding said it was "very unusual" there wasn't a high proportion of staff reporting concerns anonymously, but claimed this showed the trust had a culture which held itself "accountable".

She then signposted the "multiple ways" staff could speak up, including via line managers, occupational health services, and human resources as well as ward "safety champions" trained to receive questions from staff.

Meanwhile Ms Connor said a report from North Middlesex University Hospital NHS Trust didn’t contain enough data on "staffing, patient complaints and concerns around the merger [with Royal Free London]".

Responding for this trust, medical director Victoria Jones said the "pockets" of poor staff culture were a top priority for the trust and they were working on improvements.

"The vast majority of our staff are fantastic, but we would want our residents to feel confident that when they come to North Middlesex they’ll be treated by someone who treats them with kindness, respect and has the appropriate training to deliver the care that we want," she explained.

"I think the work that we’re doing, where we know there’s been problems identified, we’re doing in a timely fashion and making sure it doesn’t affect wider staffing."

The North London Joint Health Overview and Scrutiny Committee is made up of members of the Health Overview and Scrutiny Committees from five London boroughs: Barnet, Camden, Enfield, Haringey and Islington.

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