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E&NH0342 Lister’s £16.4 million maternity services expansion given green light Work starts immediately as NHS East of England approves full business case that will see Trust build state-of-the-art maternity unit by 2011 Stevenage, UK – 11 August 2009 – In just two years time, Hertfordshire will have one of the best maternity services in the country. This follows the approval of the Trust’s full business case for the new £16.4 million facility that will be completed before the end of 2011. Preparatory works on site start immediately. This important development at the Lister will provide pregnant women living in east and north Hertfordshire, as well as south Bedfordshire, with greater choice over how they give birth to their babies. The project comprises a two-storey expansion of the Lister’s current maternity and neonatal unit, which when completed will enable it to support over 5,500 births every year when it opens fully in late 2011. When this happens, the inpatient birthing service at the QEII will transfer up to the new Listerbased service. The QEII maternity service will continue to provide ante and post natal care for local women, as is the case today – this will not be changing and will form an integral part of the local primary care trust’s plans for the a new local general hospital on the QEII site, which is scheduled to be ready by 2013. Once opened, the new Lister unit will enable the Trust to bring together all of its specialist maternity and neonatal staff onto a single site, providing women with improved options in how they give birth to their children. For the majority of women, this means that they will be cared for by a midwife throughout their pregnancy and birth of their baby, but safe in the knowledge that the consultant-led service is just a step away should complications arise. Where it is safe to do so, some mothers may choose to have a home birth – the rate of such births in east and north Hertfordshire is already better than the national average. 2/Lister’s £16.4 million maternity services expansion given green light Welcoming the decision reached by NHS East of England to approve the project’s full business case, the Trust’s chief executive, Nick Carver, said: “Following hot on the heels of work starting on the new £47 million Lister Surgicentre, which will carry out virtually all of the Trust’s day case and short stay planned surgery, we now have the go ahead to develop a new maternity service to support the whole of east and north Hertfordshire, as well as south Bedfordshire. This £16.4 million project will transform the service we can offer pregnant women, providing them with more choices of how they have their baby. When completed before the end of 2011, we will have a maternity unit that will rival the facilities of the best in the country. “For example, those women with uncomplicated pregnancies who have not opted for a home birth may wish to be cared for in the new midwife-led unit at the Lister. Unless complications arise, this makes it possible for them to have a birth that never involves a doctor. For those who need or wish to have a doctor looking after their pregnancy or birth of their baby, then these women will have access to the Trust’s consultant-led service – which will be located close by the midwife-led unit. “Critical to these important changes is that throughout their pregnancy and after they have left hospital, all women will receive their support from midwives in their local hospital or health centre. This is especially true for the QEII, where women and their babies will continue to attend ante and post natal services, as is the case today.” The Trust’s divisional chair for women’s services, who is a consultant obstetrician and gynaecologist, Mr Robert Sattin, said: “In addition to helping to create greater choice for women by developing our maternity services in this way, it will also enable us to make even greater quality improvements. Bringing together our specialist maternity and neonatal staff onto a single site means that our most senior doctors and midwives will be available for longer periods every day. This is a widely recognised factor in improving the care that women and their unborn babies receive, especially for more complicated pregnancies or those that develop unexpected problems while giving birth.” 3/Lister’s £16.4 million maternity services expansion given green light “The redevelopment also allows us to address some long-standing issues for the women who use our service, for example providing facilities for partners to stay with those mothers who go into early labour. As well as building the new two-floor expansion, the existing maternity and nenonatal intensive care facilities at the Lister will be refurbished. Importantly, the whole new unit will be designed with future expansion in mind, should the need arise.” The Trust’s head of midwifery, Chris Nixon, said: “This is an opportunity to improve the quality of our service so that women are offered an informed choice not just around the type of care they receive, but also where they have it in order to fit with their individual needs. As midwives, we are excited about the opportunity to be involved in setting up and running a co-located midwife-led unit for women in our area. This important development fits well with our aspirations for our local maternity services and is in line with national recommendations in expanding further the options women have when it comes to choosing the place of birth for their babies.” The proposed new expanded maternity service at the Lister will support over 5,500 births, with its design having involved both staff and users of the existing service. The new development takes into account the desire for greater patient choice, as well as local predicted population and service demand growth – which has been calculated at 2.46% per year. The unit has been designed with new delivery rooms – some of which will have water birth facilities – and neonatal cots. During the construction of the expanded maternity unit, the existing staff and public parking area in front of the current maternity building will form part of the building site. New car parking arrangements for both staff and the public are being made nearby, with the current pedestrian access route also needing to be rerouted. All these changes will be sign-posted clearly following preparatory works that will be completed by 7 September, after which point construction of the new unit will begin. Slight alterations to the road layout will also be required. 4/Lister’s £16.4 million maternity services expansion given green light The creation of the new maternity service by the end of 2011 forms a key part in implementing the decisions made by the NHS following the 2007 Delivering quality health care for Hertfordshire consultation and is in line with the regional health strategy, Towards the best, together agreed across the East of England last year. - ends - Notes to editors During the detailed design development processes following the outline business case (OBC) being approved in October 2008, the scope of the proposed expansion of the Lister’s maternity has been changed to take in to account the following factors. These have been included in the full business case approved by NHS East of England on 10 August 2009. 1. Two additional birthing rooms were added to the consultant-led unit immediately prior to final detailed design development process. This was necessary in order for the Trust to have an opportunity for greater future flexibility particularly in light of changing proportions of high-risk versus low-risk pregnancies; 2. The hospital’s neonatal unit will undergo substantial reconfiguration as opposed to the light-touch refurbishment planned originally in the OBC. The decision to expand the scope of work is based on consideration of service complexity and clinical risk issues, which has resulted in an increase in cot numbers and the whole unit being fitted out to a higher specification than indicated previously; 3. A requirement for additional inpatient beds within the existing unit in order to be in line with the national Safer childbirth report, which set out minimum standards for the organisation and delivery of care in labour and was published by the royal colleges in 2007; 4. For the maternity day assessment unit (DAU) to operate effectively in managing complex pregnancies and reducing unnecessary antenatal admissions, it needed to be enhanced to provide centralised care where required. A decision was taken to create an area specifically for this purpose, whilst retaining adjacencies to the consultant and midwife-led units (MLU), as well as inpatient wards. The day assessment unit includes a: 1. six-bed monitoring bay; 2. consulting/exam room with scanning facilities; 3. counselling room (to be shared with the inpatient area); As a result of the detailed planning and design process carried out subsequent to OBC, it was concluded the building and refurbishment process will need to be managed in two phases. This will ensure that there is as little service disruption, with minimal clinical risk as possible during the transition from the existing to the new service. The first phase will be open from early 2011, with the full expansion being completed before the end of the same year (2011). It is at the latter point when inpatient services only will be transferred from the QEII; ante and post-natal services will be retained at the QEII. For more information on this press statement, please call Peter Gibson, head of public affairs on: 01438 781522 or Steve Creswell, public relations officer on: 01438 781736 (both direct lines); for out-of-hours, please page the duty press officer on 07659 103839.