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This briefing provides you with up-to-date information – please use this when people are asking you questions or raising concerns with you.

 

At a glance:

• We are making progress in recruiting the medical staffing needed to safely reopen the birthing services at North Devon District Hospital. We are cautiously optimistic that we may be in a position to do this by the end of September, subject to final recruitment and safety assurances.

• 34 women and birthing people gave birth at RD&E up to 20 August, with no incidents

• Support with travel and accommodation – women, birthing people and their families do not need to be receiving benefits to access a prepaid card

• New newborn outpatient clinic set up to support families once they've returned to North Devon

• We are encouraging all women/birthing people to call us on our dedicated maternity triage line as soon as they think they are in labour or have any concerns – 01392 406 616. This number is 24/7.

• Devon Health and Adult Care Scrutiny Committee meeting: we are grateful to the councillors and members of the public for their questions and feedback, and we commit to delivering on the Committee's recommendations.

 

Reopening and recruitment update

An active recruitment campaign is in place that is focussed on filling the immediate gaps in staffing with locum doctors, whilst also seeking to recruit substantively to ensure the long-term viability of the service.

 

We recognise there is a national shortage of obstetric and gynaecology consultants and the recruitment market remains very competitive.

 

Current activity includes:

• Two locum obstetrics and gynaecology consultants have now commenced and completed induction.
• Two locum obstetrics and gynaecology tier 2 (registrar) doctors are currently being onboarded and are expected to commence within the next two weeks.
• Visa processes continue for two tier 2 (registrar) doctors who were successful at interview in July. These are substantive appointments.
• Two locum tier 1 (senior house officer) doctors have already commenced and are providing support to the service.
• Recruitment remains ongoing for two substantive consultant posts: a consultant obstetrics lead and a consultant in obstetrics and gynaecology.
• These are being actively marketed via:
  • Advertising across the BMJ, NHS Jobs and Career Gateway.
  • Executive search, who are actively contacting potential candidates directly and who have active conversations with four potential candidates who have expressed an interest.
  • Social media campaigns across LinkedIn, Instagram and Facebook.
  • Direct engagement through the O&G professional body and through consultant colleagues.
• Any help with sharing our adverts more widely across networks is much appreciated.

 

Reopening criteria

To safely reopen we will need to ensure that we have a resilient and sustainable workforce in place and we anticipate it will be through a combination of temporary and permanent staff.

 

We have an eight-person consultant rota and an eight-person tier 2 rota that ensures a 24/7 medical rota. These rotas are separate but connected.

 

There are three aspects to the reopening criteria

 

• The consultant rota and tier 2 rotas have to be filled.
• We have to be assured that the consultant and tier 2 vacancies are filled in a way that minimises the risk of a further short-notice closure.
• We have to be assured that across the clinical team we have got the skills and competencies our patients need.

 

We are making progress in recruiting the medical staffing needed to safely reopen the birthing services at North Devon District Hospital. We are cautiously optimistic that we may be in a position to do this by the end of September, subject to final recruitment and safety assurances.

 

Operational update

Since 11 August and up to 20 August

 

34 North Devon women have given birth at RD&E

0 incidents

3 babies repatriated to transitional care at NDDH

15 vaginal

2 forceps

10 emergency C-section

7 elective C-section

Community midwifery, antenatal care, scans and outpatient services are continuing in North Devon. 

 

The majority of North Devon maternity staff have transferred to support services in Exeter, while a small number of staff remain in North Devon to provide postnatal support, including infant feeding support and newborn checks.

 

Our staff have been absolutely fantastic during this time and have shown incredible  resilience and dedication to the women, birthing people and families they care for.

 

Our senior maternity team are checking in with staff about their experience during this time and if there is any further support they need.

 

Supporting women and birthing people

Additional support is being provided for vulnerable families, including one-to-one contact with complex care teams, support for families who face language barriers, and dedicated clinics to discuss accommodation and transport needs.

 

Mythbuster – do people need to be receiving benefits to access the prepaid cards?

 

People do not need to be receiving benefits to access the prepaid cards we are making available with the support of NHS Devon ICB.

 

The scheme is for:

• Women and birthing people receiving maternity care from the Royal Devon who are affected by the temporary suspension of birthing services at NDDH.
• Those experiencing financial difficulties or practical challenges in accessing maternity care.
• Individuals whose need for support has been reviewed by the maternity team.

 

The maternity team will discuss available options and assess eligibility on an individual basis.

 

There is wider support available which is detailed in our information pack. Some of this wider support is eligible only for people on certain benefits.

 

In addition to the services that are still available in North Devon and the existing postnatal care we offer, we have set up a new Newborn Outpatient Clinic in North Devon.

 

• This clinic is designed to support families with things like jaundice checks and infant feeding support.
• Women and birthing people can be referred by their community midwife, or they can call 01271 322614 between 8am – 4pm, 7 days a week.

 

Communication and engagement

We are continuing with significant communications and engagement to support wide patient, public and stakeholder awareness.

 

We are continuing to keep all currently pregnant women up to date via MY CARE (99% have MY CARE) – or by other means.

 

Our two key messages remain:

• Speak to their midwife at their next appointment. These are at regular intervals from 8-10 weeks. Or they can call our helpline for non-urgent enquiries about the temporary suspension.
• Call our 24/7 urgent maternity triage line as soon as they think they might be in labour or have any other concerns. This enables us to get women to Exeter at the earliest opportunity.

 

We want to make sure that everyone has access to the latest, up to date and accurate information.

• We have introduced a routine online briefing for the wider community. This is available on our website and through social media.
• We continue to update our patient information pack with new information. We're promoting this widely. It is translated and in easy read.
• Our dedicated Trust web page is updated regularly and has the very latest information and FAQs.

 

Our FAQ pages

• Why is this happening?
• What are you doing to restore birthing services at NDDH?
• What does this mean for my pregnancy and birth?
• I think I'm in labour – what do I do?
• Travel and getting to hospital
• Which services are changing?
• What support is available?
• How can I stay informed?

 

We are regularly meeting with the Devon Maternity and Neonatal Voices Partnership team to discuss any feedback they are hearing. To enhance this further we are working together to gather feedback from women, birthing people and families as they experience care with us during the temporary suspension.

 

Our patient information social media campaign has begun and will continue over the next few weeks. Our next post focuses on our key message about calling our 24/7 maternity triage line early. Your support in sharing this would be appreciated – see links at the end of this update.

 

This week's scrutiny meeting

We attended the Devon County Council Health and Adult Care Scrutiny Committee on Monday this week. We are grateful to the councillors and members of the public for their questions and feedback.

 

From this meeting and from the protest in Barnstaple at the weekend, the strength of feeling is clear from our community and we understand why. We fully recognise the impact this is having on our whole community and like everyone we believe that these services are vital and this suspension must be temporary.

 

We commit to transparency and as well as publishing requested details we will work openly with all partners on both managing the temporary suspension and our reopening plan.

 

You can read the papers that were shared with the Committee here on our website, including our equality quality impact assessment (EQIA).

 

The discussion has highlighted the particular barriers and inequality that rural communities face and the challenges that health providers face in maintaining safe local services. That our new hospital rebuild has been put back to 2040 risks heightening service fragility in North Devon. We were heartened by the commitment from our council and commissioning colleagues to work with us to ensure the sustainability of local services.

 

We commit to delivering on the recommendations from the Committee, which include:

• Publishing a restoration plan
• Reviewing and updating our EQIA based on the discussion at the meeting
• Undertaking a lessons learnt review
• Provide a report on the fragility of health services across Devon and the actions being taken to support safe and sustainable services

 

The discussion enabled us to provide further clarity on some of the common questions we are hearing.

 

Mythbuster – couldn't you move RD&E staff up to NDDH?

• We are one Trust, and staff from RD&E have been supporting the service at NDDH for some time and will continue to do so.
• We have several consultants who work in cross-site roles and contribute to the rota. Other clinicians have also provided cover on an ad-hoc basis.
• In line with other smaller units, we require our consultants at NDDH to specialise in both obstetrics and gynaecology. There are not enough births in North Devon to operate separate rotas and maintain clinical skills.
• RD&E has separate obstetric and gynaecology rotas as that site has a higher number of births. This does make cross-cover challenging, but those RD&E consultants that can provide support to the rota in North Devon have done so where they can.
• In addition, our consultants at the RD&E are frequently required to 'act down' and provide additional work to support the tier 2 rota due to a combination of vacancies and work restrictions. This has limited their ability to work in NDDH.
• There is also a national shortage of suitably qualified obstetric clinicians and there are challenges within the rota at RD&E too. We are monitoring this closely, as we do on a regular basis with all our services.

 

Mythbuster – why are you only now recruiting?

• We have continually been running recruitment campaigns for doctors specialising in obstetrics and gynaecology. Over the past year we have run multiple rounds of recruitment and whilst some of these have resulted in job offers from the Trust to individuals, unfortunately none of these have progressed further.
• Our last round before we announced the temporary suspension concluded in July.
• Reflecting on previous campaigns, we have refreshed our consultant recruitment at pace and have benchmarked our offer against other NHS trusts to ensure it is as competitive as possible. We also have an active marketing and executive search campaign in place.
• Whilst we are doing all we can to offer attractive and competitive roles, there is a national shortage of suitably qualified obstetric consultants and the decision to permanently relocate to a smaller, rural unit will be a personal choice.

 

How you can help

• Share our patient information pack for women, birthing people and families and share our social media posts to help us reach more people.
• Here are links to our latest post.
  • Facebook
  • X
  • Instagram
• Signpost people to our website for the latest updates and FAQs.
• Share our new job advert
  • Careers website
  • LinkedIn 
  • Facebook 
  • Instagram 
• Use the information we have shared with you to respond to questions from your community

 

Thank you for your continued support. We will update you again soon.