NHS sets out challenges for hospital gynaecology and maternity services in Liverpool

NHS Cheshire and Merseyside’s board will consider the case for change at a meeting on 9 October 2024. Subject to the board’s approval of the document, a period of public engagement will begin on 15 October 2024, giving people an opportunity to share their views about the issues. 

The majority of hospital gynaecology and maternity care in the city takes place at Liverpool Women’s Hospital on Crown Street in Toxteth. The case for change highlights how the biggest challenge facing these services is the fact that they are on a different site to most other acute and emergency hospital care – Liverpool Women’s is the only specialist centre for gynaecology and maternity in the country where this arrangement exists. 

It’s a situation which can create problems and delays with care, with seriously ill patients sometimes having to be transferred by ambulance to other local hospitals. Currently around 220 ambulance transfers are made between Liverpool Women’s Hospital and the Royal Liverpool or Aintree hospitals every year, and about half of these ambulance journeys happen in emergency situations. 

Although issues around hospital gynaecology and maternity services in Liverpool have been looked at before, this is a new process which is being led by NHS Cheshire and Merseyside, working in close partnership with hospital trusts in the city. No proposals are being put forward at this stage, and no decisions about how services might look in the future have been made. 

Dr Lynn Greenhalgh, Chief Medical Officer for Liverpool Women’s NHS Foundation Trust said:

“NHS staff in Liverpool have put in place a range of measures to manage the risks that come from gynaecology and maternity services being separate from other hospital care. However, while we are working hard to keep care safe for now, we can’t resolve all of the challenges under current arrangements.

“The health needs of our population, and the treatments we provide, have changed a lot since Liverpool Women’s Hospital first opened, and increasingly gynaecology and maternity patients require input from specialists who are not based on Crown Street. This can impact on people with other serious health conditions that need to be managed alongside their gynaecology and maternity care, those who develop unexpected complications which need urgent support from a different team or from an intensive care unit, and people with very complex surgical needs, including many patients with gynaecological cancer.

“We want everyone to receive the best care possible, wherever they are being treated in Liverpool. Setting out the issues in the case for change is an important first step in recognising the situation as it stands today, so that we can work with staff, patients, the public and our wider stakeholders, to decide on the best way to move forward.”

Dr Fiona Lemmens, Deputy Medical Director for NHS Cheshire and Merseyside said:

“The way that hospital gynaecology and maternity services in Liverpool are organised means that some care does not meet national care standards. If we don’t address this, there is a growing risk that we might not be able to provide some specialist care in Liverpool in the future.

“The issues set out in the case for change have been spoken about before, but this is a new opportunity to tackle what we believe is an urgent health priority. All the local NHS organisations involved with gynaecology and maternity care in Liverpool are committed to working together to address these challenges, so that we can improve care for patients and protect services for the future.

“It’s important to stress that while it’s too early in the process to speculate about how services could look in the future, there are no plans to close the Crown Street site. The NHS is continuing to invest in these facilities, which are a key part of our local health system. Whatever proposals might be put forward for gynaecology and maternity services, Crown Street will continue to play a vital role in the provision of NHS services.” 

Current arrangements for women’s services also mean that all of the city’s gynaecology and maternity specialists are at Liverpool Women’s, so that other hospitals are therefore less able to meet women’s medical needs when they present at accident and emergency (A&E), or when receiving care under another service. Every day, an average of four pregnant women visit A&E at either the Royal Liverpool or Aintree hospitals, with around 70% having a condition that could impact on their pregnancy. 

Subject to NHS Cheshire and Merseyside’s board approving the case for change on 9 October 2024, a six-week public engagement will start on 15 October 2024. This will give people an opportunity to share their views on the issues presented in the case for change, and their own experiences of care. 

A series of engagement events, both online and face-to-face, will take place during November, so that people can hear more from those involved in gynaecology and maternity services. Further details about this will follow after 9 October 2024. 

Responses gathered during the engagement will be analysed by an independent organisation and put into a report, which is likely to be published in early 2025. Feedback will be used to help inform what happens next, including the development of any proposals for how hospital gynaecology and maternity services could look in the future.

The case for change has been published with the NHS Cheshire and Merseyside board papers, which are available here: www.cheshireandmerseyside.nhs.uk/get-involved/upcoming-meetings-and-events/ 

Further details about plans for public engagement will be shared following the NHS Cheshire and Merseyside board meeting on 9 October 2024.