Following on from our discussions about the future of the maternity unit in Caithness General, the safety of patient transport and after careful consideration, I have a number of points I would like to raise.
As you know, given the situation two weekends ago with the weather there has been a lot of anger in the community which has spilled out onto social media, and has been widely covered in the local press
People are rightly concerned that there is not an adequate safe system in place for patient transfers and a lack of coherent strategy going forward. I realise that this is an issue for the Scottish Ambulance Service as well but so far they seem to be absent from any communication, this also has to change –
1. What collaborative working is taking place to ensure safe transfers take place and that the rest of the community in Caithness are not disadvantaged?
2. Can NSHH or SAS access a 4x4 vehicle and driver that could be used specifically for women in labour being taken to Inverness to avoid them using their own cars or in the instance where no transport is available to them and can they be given some other form of communication as the mobile phone signal is patchy in some places on the A9.
3. Where is the fixed wing plane based that would be used if needed?
Given that the one question still waiting to be answered is that of emergency surgical intervention, should the need arise, can you please answer the following –
4. Can general surgeons perform an emergency caesarean section?
5. Why can’t the current obs/gynae consultants remain in Caithness, based in CGH, continuing day to day gynae (not obs) work but be there as an emergency backup and rotate to Raigmore? The CMU would work as proposed but it would give many people in the county peace of mind.
6. What would happen if a mother had a post haemorrhage at home and there was no time to transfer? The above point would guarantee that her life could be saved.
7. Could registrars that are completing their final year of training be rotated to CGH for the last three months before they qualify either in their registrar capacity or as acting consultants? They would bolster the current team and they could get experience in a rural setting. This would provide them with an invaluable opportunity. This would ensure more people being seen locally and decrease the need for people travelling to Inverness.
8. Are we reinstating the junior doctor scheme this year and how will this help locally?
On call midwives –
9. Will there be a midwife in the hospital overnight or will they all be on call if the ward is empty?
10. Who would a mother to be contact if she started labour early, the hospital, the ward or the midwife directly?
We talked at the start when this report came out that the message had to be right. I am still waiting to see how this is going to work. More and more people are getting scared and nervous. I have spent the whole of last weekend and last week trying to ally people’s fears but I have become an easy target because I am local. It is up to NHSH to explain how this is going to work as I can only do so much –
11. Are the midwives currently explaining to women why they need to go to Raigmore? Do the staff understand fully why the change has to be made?
12. Can this message be built in to the anti-natal classes?
13. Can a leaflet be produced to explain?
14. What communication has there been locally with community councils, charitable organisations, private businesses, trade unions or social enterprises?
15. Why are women in Raigmore not being discharged in the morning if they have a long journey ahead of them? Some are having to travel home in the dark.
16. What public engagement (of which there has been very little so far) has been planned?
I would also appreciate an explanation of what has been changed, as discussed at the public meeting in Wick, to ensure the safety of mothers and babies and to make sure that giving birth is a family centred experience. We knew this change would be difficult and that we had to ease into it, doing all we can to make sure the public understand and trust why it has to happen. Accommodation continues to be an issue, with one father’s room being given to someone else because apparently he didn’t know he had to book in. I really don’t think any progress has been made but perhaps you can correct me on that.
I look forward to your reply.