Majority of the public and local NHS staff oppose Royal Free maternity ward closure

Initial feedback on controversial proposals to close a north London maternity ward suggests a majority of the public and local NHS staff oppose the plans. 

NHS North Central London Integrated Care Board (NCL ICB), which covers Barnet, Camden, Enfield, Haringey and Islington, has proposed reducing the number of hospital maternity units across the boroughs from five to four.

A public consultation on the proposal ran from December to March, with staff and users asked to give feedback on closing the maternity ward at Royal Free Hospital in Camden, NCL ICB’s preferred choice, or otherwise closing the unit at Whittington Hospital in Islington.

Services at Barnet Hospital, North Middlesex University Hospital in Edmonton, and University College Hospital, would be retained and invested in “significantly” under the plans.

The results of the initial consultation were discussed by NCL ICB bosses at a joint health overview and scrutiny committee meeting at Camden Town Hall on Thursday 25 July.

Of those surveyed, 67 percent agreed that north London maternity services faced “challenges”, however, less than half of NHS staff agreed with consolidating maternity and neonatal services from five to four sites, while only 25 percent of users, parents, and carers welcomed the move.

Concerns were raised around the increased service pressure consolidation would cause, the disruption to effective working relationships, and the impact on capacity, staffing, and quality of care. 

There were also travel concerns, including longer travel times for people near the closed ward, unreliable public transport, and increased congestion and travel costs. 

Matt White, a Haringey councillor and joint health and overview and scrutiny committee member, asked the NHS health bosses present why — given the amount of reviews and consultations that had taken place going back to 2021 — the proposals were so unfavourably received.

Cllr White asked: “How is it possible you can start with a blank page, ask people what they want, come up with this answer, propose it, and they say that’s not the answer we want?”

Sarah Mansuralli, chief strategy and population health officer for NCL ICB, referred to “declining birth rates”, increasingly complex care needs, and keeping staff “skilled up”. Declining birth rates were also discussed at a previous meeting.

She said: “I think it’s quite an emotive subject, nobody wants to see services close.

“Equally, what the consultation material really helped the public, staff, and different communities understand is that there is a very good rationale and evidence base [for the proposals].”

Levels of NHS neonatal care are rated as basic care, level one; speciality care, level two; and sub-speciality care, level three. NCL ICB proposes implementing a care model that “ensures all NCL sites offer the same minimum level of neonatal care” with a level two rating. Sarah said this could not be achieved across the five existing neonatal sites, only four. 

Sarah said: “When we then compare it, we all want to have level two units, we don’t want to close any services to achieve that. One of the things we looked at was could we offer level two care if we kept all five units open — the answer to that was, clearly it was not feasible or deliverable. In summary, it’s very much about workforce and clinical competencies.”

The NCL ICB consultation also asked for feedback on two other proposals; closing the birth suites at Edgware Community Hospital, but retain the antenatal and postnatal services; and consolidating surgery for young children at two centres of expertise. 

In terms of the maternity ward plans, health bosses said the feedback given would be used to “inform the next steps of the process”. A decision will not be confirmed until January.

North Central London Joint Health Overview and Scrutiny Committee, Thursday, 25 July 2024.