Written evidence submitted by East & North Herts NHS Trust (MSE0070)

 

 

Introduction

Herts and West Essex Local Maternity and Neonatal System (LMNS) is based on the geographical footprint of the Herts and West Essex Sustainability and Transformation Partnership (STP). It consists of CCGs in Hertfordshire and West Essex, and local NHS Maternity providers i.e.  East and North Hertfordshire NHS Trust, West Hertfordshire NHS Trust and The Princes Alexandra Hospital NHS Trust.

The Herts and West Essex LMNS is on the London Commuter belt. The west part of the STP footprint is Hertfordshire, served by West Hertfordshire NHS Trust and East & North Hertfordshire NHS Trust. The east of the footprint is West Essex, served by Princess Alexandra Hospital in Harlow.

 

Although the majority of women in our STP footprint choose to access maternity care within Herts and West Essex, there are many who choose to access services in neighboring STP footprints. In addition women in neighboring areas access maternity services within our STP footprint. Therefore Herts and West Essex LMNS reviews the maternity pathways and transformation plans across the boundaries with a view to ensure women and their families are accessing high quality, consistent and equitable maternity services wherever they choose to access them.

 

 

Population Split by CCG                                           Population Split by Local Authorities

East and North Herts CCG

559,100

Herts Valleys CCG

588,200

West Essex CCG

300,200

Total

1,447,500

Essex

1,443,000

Hertfordshire

1,035,000

 

 

Number of births in financial year 2019-20

 

 

 

West Essex has slightly more older people and fewer 15-34 year olds than the national average and is less ethnically diverse than that of the England average. The average life expectancy for West Essex is above the England average.  Despite an upward trend in life expectancy, there are inequalities with significant pockets of poorer health related to deprivation, lifestyle choices and poor engagement with statutory agencies. Males have a lower life expectancy than females. The most common conditions - as reported by disease register size - are hypertension, obesity, asthma, diabetes, and depression. Smoking is still the largest contributing risk factor for morbidity and mortality. About two thirds of adults in West Essex are overweight or obese; even though not statistically significantly different than the national average this is still a concerning figure.

Hertfordshire - Over half a million people live in the NHS Herts Valleys Clinical Commissioning Group (HVCCG) area and this figure is expected to rise by just under a quarter (23%) between 2010 and 2035 (Population Projections Unit, ONS, March 2012). In 2011 the resident population in the five districts in the HVCCG area was 563,000. Approximately 20% of residents were aged under 16, 64% were of working age (16 to 64) and 15% were aged 65 and over. Compared to regional and national population breakdowns there is a slightly higher proportion of children and adults of a working age living in HVCCG. Approximately 200 different languages are spoken by pupils living in the county of Hertfordshire.

 

Ethnic group measured by mothers at Birth across LMNS using ONS categories for financial year 2019-2020

 

 

 

The East & North Herts NHS Trust is part of a wider LMNS system as detailed above with West Herts Hospitals and Princess Alexandra Hospital Harlow.  Ideally, a response would have been submitted from an LMNS perspective, however, due to the limited time available for submission of the response, the information given following the Parliamentary call is based on evidence submitted by the East & North Herts NHS Trust only.

 

 

 

What the impact has been of the work which has already taken place aimed at improving maternity safety, and the extent to which the recommendations of past work on maternity safety by Trusts, Government and its arm’s-length bodies, and reviews of previous maternity safety incidents, are being consistently and rigorously implemented across the country;

 

 

 

 

 

the contribution of clinical negligence and litigation processes to maternity safety, and what changes could be made to clinical negligence and litigation processes to improve the safety of maternity services;

 

 

The Early Notification scheme progress report (Sep 2019) made a number of recommendations;

 

 

 

Advice, guidance and practice on the choices available to pregnant women about natural births, home births and interventions such as C-sections, and the extent to which medical advice and decision-making is affected by a fear of the “blame culture”;

 

 

 

 

 

How effective the training and support offered to maternity staff is, and what improvements could be made to them to improve the safety of maternity services;

 

 

 

 

 

The role and work of the Healthcare Safety Investigation Branch in improving the safety of maternity services, and the adequacy and appropriateness of the collection and analysis of data on maternity safety;

 

 

 

 

15 September 2020