Major service change reports
NHS Grampian's consultation on proposed changes to maternity services in Grampian
This report sets out our assessment of whether NHS Grampian's consultation on proposals to close 3 birthing units and replace them with 2 community maternity units followed Scottish Government guidance, which requires that NHS boards seek, listen to and act on the views of potentially affected people and communities when proposing changes to services.
Based on the evidence outlined in this report, our view is that NHS Grampian has followed the national guidance set out by the Scottish Government.
We recognise the efforts made by NHS Grampian to support and involve the public in the option appraisal process. Several aspects were particularly helpful - the guide to option appraisal, the table with specific examples of what the criteria meant, and the midway evaluation with the public representatives. We recommend sharing these aspects within NHS Grampian and with other NHS boards to consider implementing in future option appraisal processes.
NHS Grampian used the learning from a previous consultation on maternity services in 2006 to inform its approach to this consultation, and ensured that service users who had been involved in the previous process had opportunities to be involved again.
NHS Grampian engaged with us at an early stage in its process. It invited us to attend the Maternity Services Leadership Group meetings to advise on the engagement process and was responsive to feedback we provided throughout the process. This resulted in good and continuing communication between our two organisations.
We identified the following learning points:
- NHS Grampian should consider the terminology used in consultation papers to describe the consultation methods that will be used in order to ensure that this is clear. Public feedback mentioned that the term 'open meetings' led to some confusion about who could attend these meetings.
- Reflecting on the public feedback we received, NHS Grampian may wish to consider how it uses social media to raise awareness of its consultations. We note that NHS Grampian used its Facebook and Twitter pages. However in this situation, it may have been more effective to have posted links on relevant online forums, such as Netmums, directing people back to the NHS Grampian website and the online survey.
If the proposals are approved by its Board, NHS Grampian intends to continue to involve women, families and staff across Grampian in the implementation of the proposals. We identified a number of areas that would benefit from further involvement:
- Seek views and feedback from women and service users on the implementation of the routine transfer policy across Grampian.
- Involve women and service users in the further discussions about the provision of consultant outreach and scanning and screening clinics, in particular in Huntly and the Deeside areas where the location and frequency of clinics was raised during the consultation process. We would recommend a similar process to the one undertaken to decide upon the proposed locations for Community Maternity Units.
- Involve women, service users and local communities in the development of Community Maternity Units in Aberdeen, Peterhead and Inverurie. In particular consider their input to the transition arrangements, the promotion of the unit and explore further opportunities for co-production, such as breastfeeding support.
- Continue to work with women, service users and communities on the implementation of the proposals - particularly in areas where there is concern about the potential impact of the proposals.