Declining London Birth Rates Threaten Maternity Services

London (Parliament News) – Concerns rise over declining birth rates and staff morale across North London’s NHS, with proposed maternity unit cuts and issues with trust culture under scrutiny.

Declining birth rates and low staff morale and trust across the NHS in North London have increased concern among councillors.  During a North Central London joint health resume and scrutiny committee on Friday councillors were concerned concerning statistics with North Central London NHS leads. 

What Statistics Alarm Councillors in North Central London NHS?

Committee member Tricia Clarke questioned the decline in the birth rate, which has led to a suggested cut to maternity units, with services at Whittington and Royal Free hospitals under threat.

Gillian Smith, chief medical officer at Royal Free London NHS Foundation Trust, did not prove which unit would close but recognised the need for closure.  She stated: “We know that in North Central London the birth speed is falling, and we have consequently seen a decrease in the number of births happening across the patch. 

“The quality of the services is reasonable, and the patient feedback is good, but we know if we persist with the number of units that we have we won’t be capable of sustaining those services in the longer term.  The birth rate is falling, that’s one of the main drivers of change in the ‘Start Well’ process.”

The Start Well programme is a North Central London collaboration programme which has been underway for a year and is going through an ‘options appraisal process’ for maternity, neonates and paediatric surgical services in the domain. The process is due to be finished in the summer.

What Drives Changes in North Central London’s NHS?

In terms of Whittington Health NHS Trust, committee chair Pippa Connor questioned about a 2023 staff survey which revealed 30% of the trust’s staff would not feel secure “raising worries about unsafe clinical practice” which could lead to a “serious incident”. 

Sarah Wilding, chief nurse at Whittington Health NHS Trust, stated they didn’t have a high proportion of staff briefing concerns anonymously, which was “very unusual”, stressing that this showed they had a culture which held itself “accountable”. 

She then explained the “multiple ways” staff could speak up, including via line managers, occupational health services, and human resources. In maternity wards, there were also “safety champions” arranged to receive questions from staff. 

Regarding North Middlesex University Hospital NHS Trust, Cllr Connor stated the trust’s report didn’t contain sufficient data especially around “staffing, patient objections and concerns around the merger [with Royal Free London]”. 

Cllr Connor stated: “You’re holding a huge amount of information in your heads that you’re able to come and tell us but I’m just not seeing it on the paper in front of me.”

Lenny Byrne, interim chief nurse at North Middlesex University Hospital NHS Trust, expressed there was a “huge” amount of data being gathered, and at times didn’t know “how much or how little” to include. 

For example, he stated there was a 120-point improvement program for maternity units, but it hadn’t been included.  Victoria Jones, medical director at North Mid, stated the “pockets” of poor staff culture were a top priority for the trust.

She stated: “The vast majority of our staff are great, but we would want our citizens to feel confident that when they come to North Middlesex they’ll be feted by someone who treats them with kindness, and consideration and has the appropriate training to deliver the care that we want. “I think the work that we’re accomplishing, where we know there have been issues identified, we’re doing in a timely fashion and creating sure it doesn’t affect wider staffing.”