Agenda item

9.1  Note: the sub-committee agreed to a change of the agenda sequence so that this deputation followed item 5.

9.2  Emma Beamish, a founder of the Albany Action Group of parents who had used the Albany Midwifery Practice, was invited to address the sub-committee as the deputation’s key speaker. She outlined the reasons for the deputation and explained features of the practice that had been particularly valued: when an expectant mother booked in, for example, she was appointed a midwife to care for her throughout her pregnancy, as well as throughout labour and for 30 days after the child’s birth. Regarding the closure of the practice, she commented that when King’s College Hospital (KCH) had terminated the practice’s contract it was stated that this was necessary for safety reasons. She added that the KCH risk assessors had not raised problems with the midwifery and that to date the Action Group felt that the hospital had not sufficiently explained what the problems were.

9.3  Ms Beamish further stated that KCH had commissioned a report from the Centre for Maternal and Child Enquiries (CMACE) with recommendations, but that the report did not recommend that the practice be closed. She added that because safety reasons were used, this meant that there was no need to consult with local parents; that the practice was therefore terminated very quickly; and that parents have not in the meantime had access to any service comparable to that provided by the Albany midwifery. She requested that the sub-committee look at the process used by KCH to reach their decisions about closing the practice.

9.4  Ann Fox from the National Childbirth Trust (NCT) explained that the NCT would not normally become involved in local decisions, but was doing so in this case as the Albany Practice had received national and international awards and had used a model that was about to be copied across the country. She added that representatives of the NCT had met with KCH and had requested that the statement on the KCH website regarding the safety reasoning for the closure be changed to issues regarding management.

9.5  It was clarified again that the deputation was requesting the sub-committee to scrutinise the process by which KCH had reached their decision to close the practice, including the evidence on which the decision was based.

9.6  Members responded to the deputation with comments and queries. Key points raised included as follows:

9.7  Members referred to the notes from a meeting on 28 April 2010 between members of the Action Group and officers from NHS Southwark and KCH. It was asked whether KCH has recruited new midwives and whether there is currently a gap in the service. Ms Beamish responded that the gap had been covered but not with the same service.

9.8  Members queried whether the next steps by KCH as outlined in the minutes had taken place, - such as the involvement of local mothers in the recruitment of maternity staff.  Ms Beamish confirmed that those steps had been taken. She emphasised, however, that the more significant issue was the KCH allegation that the Albany practice model had been unsafe. She commented that the Albany model saves money and that it is important that the reputation of the Albany practice remains clean, so that the model can be contracted elsewhere.

9.9  Members asked whether mothers were satisfied with the process going forward for replacing the service and suggested that if the sub-committee were to scrutinise the decision process members would be interested to see what replacement had been established and to consider the transition. Ms Beamish stated that there had been an immense vacuum in the service when the Albany practice was first closed and that mothers in Peckham who used the service had waited a long time for a replacement. She added that there were currently two midwives at the Lister practice (where the Albany midwifery had been located) who will provide booking appointments, but should a mother request a homebirth, she would be referred to another of the community maternity teams, which are understaffed.

9.10  Sally Lingard, associate director of communications and marketing, KCH, explained that an aspect of the Albany service that mothers had wanted to retain was that a named midwife be on call 24/7. She said that this was problematic due to the EU working directive regarding working hours, but that new recruitment for the replacement practice would be started at the end of the summer and would include the provision for 24/7 on-call cover. She added that regarding homebirths, if a mother were to request this option she would be given that choice.

9.11  Members queried why KCH had offered to employ the Albany practice midwives when the service had been withdrawn due to safety concerns. Ms Beamish referred to the 28 April meeting notes which state that KCH would be happy to employ any of the Albany midwives and that parents had hoped that KCH would be able hire the midwives and then allocate them back to the mothers they had been working with through the Albany service. It was confirmed however, that none of the seven midwives wanted to take up the recruitment offer from KCH. She commented that the safety allegation therefore remains vague – as to whether the model or the midwives were deemed unsafe. Sally Lingard responded that the formal statement on the KCH website refers to patient safety.

9.12  Members asked whether KCH had responded to the NCT’s and the Association for Improvement in Maternity Services’ (AIMS) critique of the CMACE report. Ann Fox noted that CMACE had responded to the critique on its website and that the NCT had had an email exchange with KCH, but neither NCT nor AIMS had received a formal response to date.

9.13  The chair thanked the members of the Action group and the KCH officers for their contributions and said that they would be notified of the sub-committee’s decision.

  The meeting closed at 10.20pm.