Huge shake-up could see maternity services moved from Liverpool Women’s Hospital

NHS publishes major case for change that could result in maternity and gynaecology services being moved away from famous Crown Street site

A huge shake-up could see maternity services move away from Liverpool Women’s Hospital. The National Health Service has published a major case for change in how maternity and gynaecology services are delivered in the city.

Health bosses believe the safest move will be to co-locate these services on one of the city’s large, acute hospital sites like the Royal Liverpool Hospital – and away from the much-loved Crown Street building in Toxteth. NHS Cheshire and Merseyside’s board will consider the case for change at a meeting on October 9. Subject to the board’s approval of the document, a period of public engagement will begin on October 15, giving people an opportunity to share their views.

The majority of hospital gynaecology and maternity care in the city takes place at Liverpool Women’s Hospital on Crown Street. In its case for change, NHS bosses argue that the biggest challenge facing these services is the fact that they are on a different site to most other acute and emergency hospital care. Liverpool Women’s is the only specialist centre for gynaecology and maternity in the country where this arrangement exists.

READ MORE: Plans to move Liverpool Women’s Hospital are firmly back on the agendaREAD MORE: Alder Hey releases statement as concerns grow over use of physician associates

The NHS says this current set-up can create problems and delays with care, with seriously ill patients sometimes having to be transferred by ambulance to other local hospitals. Currently around 220 ambulance transfers are made between Liverpool Women’s Hospital and the Royal Liverpool or Aintree hospitals every year, and about half of these ambulance journeys happen in emergency situations.

The Liverpool Women’s Hospital only opened in its current Toxteth home in 1995 but has been the subject of a number of proposals for its closure or relocation – as well as the subject of plenty of campaigns against any such moves. Since 2015, Liverpool Women’s Hospital NHS Foundation Trust has argued that patient safety would be improved by re-locating the service close to a major acute hospital where patients can be quickly transferred in emergencies.

In 2016 plans were announced to move Liverpool Women’s Hospital out of its home under a major NHS shake-up. The preferred proposal was for maternity and women’s services to be relocated to a new £100m facility next to the new Royal Liverpool Hospital – which had been intended to open the following year but would go on to be delayed by five years. These proposals sparked large campaigns, protests and rallies by those desperate to keep the Women’s Hospital on its current site and as an individual facility for the women of the city.

The NHS says this current process is a brand new one and is being led by NHS Cheshire and Merseyside, who are working closely with hospital trusts in the city. Health bosses insist that no proposals are being put forward at this stage, and no decisions about how services might look in the future have been made.

Dr Lynn Greenhalgh, Chief Medical Officer for Liverpool Women’s NHS Foundation Trust said: “NHS staff in Liverpool have put in place a range of measures to manage the risks that come from gynaecology and maternity services being separate from other hospital care. However, while we are working hard to keep care safe for now, we can’t resolve all of the challenges under current arrangements.

“The health needs of our population, and the treatments we provide, have changed a lot since Liverpool Women’s Hospital first opened, and increasingly gynaecology and maternity patients require input from specialists who are not based on Crown Street. This can impact on people with other serious health conditions that need to be managed alongside their gynaecology and maternity care, those who develop unexpected complications which need urgent support from a different team or from an intensive care unit, and people with very complex surgical needs, including many patients with gynaecological cancer.

“We want everyone to receive the best care possible, wherever they are being treated in Liverpool. Setting out the issues in the case for change is an important first step in recognising the situation as it stands today, so that we can work with staff, patients, the public and our wider stakeholders, to decide on the best way to move forward.”

When asked by the ECHO if health bosses believe that the way to go is to co-locate maternity services at the city’s larger, acute hospitals and away from Crown Street, Dr Greenhalgh said: “Yes, absolutely.”

Dr Fiona Lemmens, Deputy Medical Director for NHS Cheshire and Merseyside said: “The way that hospital gynaecology and maternity services in Liverpool are organised means that some care does not meet national care standards. If we don’t address this, there is a growing risk that we might not be able to provide some specialist care in Liverpool in the future.

“The issues set out in the case for change have been spoken about before, but this is a new opportunity to tackle what we believe is an urgent health priority. All the local NHS organisations involved with gynaecology and maternity care in Liverpool are committed to working together to address these challenges, so that we can improve care for patients and protect services for the future.

“It’s important to stress that while it’s too early in the process to speculate about how services could look in the future, there are no plans to close the Crown Street site. The NHS is continuing to invest in these facilities, which are a key part of our local health system. Whatever proposals might be put forward for gynaecology and maternity services, Crown Street will continue to play a vital role in the provision of NHS services.”

Asked if this means the end of Liverpool Women’s Hospital, Dr Lemmens said: “No, absolutely not. The hospital at Crown Street, which we all know as Liverpool Women’s Hospital, we absolutely recognise the strength of feeling and love that there is in the city for that hospital. That hospital is a building, what is really special about it is what happens inside, the staff and the services that get delivered. That building will remain a vital part of our NHS provision across the city. We need that space to deliver clinical services.”

Another concern for health leaders in Liverpool is that the current arrangements mean that all of the city’s gynaecology and maternity specialists are at Liverpool Women’s, meaning that other hospitals are therefore less able to meet women’s medical needs when they present at accident and emergency (A&E), or when receiving care under another service. The NHS found that every day, an average of four pregnant women visit A&E at either the Royal Liverpool or Aintree hospitals, with around 70% having a condition that could impact on their pregnancy.

Subject to NHS Cheshire and Merseyside’s board approving the case for change at its meeting next week, a six-week public engagement will start on October 15. People will be encouraged to share their views on the potentially huge changes.

A series of engagement events, both online and face-to-face, will take place during November, so that people can hear more from those involved in gynaecology and maternity services. Further details about this will follow.

Health bosses said that responses gathered during the engagement will be analysed by an independent organisation and put into a report, which is likely to be published in early 2025. Feedback will be used to help inform what happens next, including the development of any proposals for how hospital gynaecology and maternity services could look in the future.