Independent review into Moray maternity services calls for Community Maternity Unit

It’s been three years since the birthing unit at Elgin’s Dr Gray’s Hospital was temporarily downgraded in June 2018 following major staff shortages. 

The change was only supposed to last one year, but with the NHS under pressure and facing recruitment problems across the country, services have never been fully restored. 

Before the change, 85 per cent of Moray babies were born in Dr Gray’s, but over the last three years almost three-quarters of babies in Moray have been born in Aberdeen. 

Campaigners have long complained about parents being forced to undertake a long journey to give birth. It can take more than 90 minutes to drive between Elgin and Aberdeen. 

The independent review was commissioned in March by the Scottish Government to examine how the unit can be restored to full strength.

In the short term it calls for a Community Maternity Unit linked mainly to Raigmore where women are offered a choice of intrapartum care at either Dr Gray’s, Aberdeen or Raigmore, with the associated antenatal care provided in Dr Gray’s. 

It would also see midwife-led and consultant-supported antenatal care in Dr Gray’s, offering “the potential to provide approximately 20 per cent of Moray births”. 

However, these would only be “low risk” births and there’s be “no facility for obstetric interventions, such as instrumental deliveries or emergency caesarean sections.” 

Consultant-provided elective caesarean sections in Dr Gray’s could be provided by consultant obstetrics and gynaecology staffing and supported by the existing theatre and anaesthetic teams. 

In the medium to long-term, the report authors suggest a rural consultant-supported maternity unit which would allow Dr Gray’s “to function at a level commensurate with other small, rural district general hospitals in Scotland”.

That would see midwife-led and consultant-supported intrapartum care in Dr Gray’s, with the service offered to women who have been carefully risk-assessed and meet agreed criteria to give birth in Elgin. 

This, the report authors say, has the potential to provide care for between 50%-70% of Moray women, as well as obstetric medical cover available on a 24/7 basis, and would include provision for obstetric interventions, including instrumental births and emergency caesarean sections, elective caesarean section service in Dr Gray’s for selected women provided by consultant obstetrician and gynaecologists, and supported by the anaesthetic and theatre teams.

However, this will require a significant increase in recruitment. 

Chair of the review group Ralph Roberts said: “In order to reach our conclusions and recommendations we have focused on listening to the women, families and service users in Moray, as well as the staff involved in delivering the services. We have then taken on board the professional advice of our clinical experts.

“Our aim was to benefit those planning and delivering services, but most importantly to serve the mothers and babies who have a right to be appropriately supported through their pregnancy and birth experience.

“We believe these robust recommendations are most appropriate for Moray at this time and looking to the future, and we would encourage all parties to work collaboratively to deliver on them for the benefit of the whole community.”

Welcoming the publication of the independent report of the Moray Maternity Services Review, Health Secretary Humza Yousaf said: “The Scottish Government commissioned this report as part of our commitment to the reintroduction of consultant-led maternity services at Dr Gray’s in a safe and sustainable way.

“I am grateful to Ralph Roberts and his review team for their work. This is a thorough and substantial report. I would also like to express my thanks to the women, families and service users and to the staff and professionals across NHS Grampian, NHS Highland and the wider Scottish health service who shared their views and experiences to help shape this report.

“I am considering all of the recommendations carefully. At this stage the government does not rule out any options moving forward. We will rightly meet with local people, clinicians and elected representatives to hear first-hand from them.

"I know this is a highly anticipated report, and I repeat my commitment to move forward with making significant improvements to maternity services at Dr Gray’s with pace.

"Subject to discussions at parliamentary bureau I would be happy to make a ministerial statement to parliament on this important issue, at parliament’s earliest convenience.”