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Maternity and Child Health Review

Please see the project updates below. We will continue to provide regular updates and progress with this work. Should you require any further information please contact Barbara Jackson in the first instance on 01745 534136 email barbara.jackson@wales.nhs.uk.
 
The Community Health Council is your independent NHS watchdog. It offers free independent advice about local health services and a way for you to have your say about local and national NHS services.
 
You can contact the Betsi Cadwaladr Community Health Council in confidence with your views on Maternity and Child Health Services by e-mailing admin@bcchc.org.uk, telephoning 01248 679284/ 01978 356178 or writing to Betsi Cadwaladr Community Health Council, 11 Chestnut Court, Ffordd y Parc, Parc Menai, Bangor, Gwynedd LL57 4FH or visit their website.
 

In January 2011 the Review Board tasked two groups of senior clinicians across the region to focus on seeking a clear opinion regarding the need for change.  The findings of these two groups have now been published:
 
 
 
19.04.12 - Maternity and Child Health Project Board Update
 
19.04.2012 - Maternity and Child Health Project Board Update
 
The Project Board continues to develop scenarios for how services could be delivered in the future.

Maternity, Gynaecology and Paediatrics
The paediatrics and maternity and gynaecology workstreams continue to refine potential scenarios and will soon be in a position to finalise viable scenarios. Significant work had been completed to identify where maternity, gynaecological and paediatric services are interdependent on other services. This is vital in proposing safe solutions for future services.
 
The project board continues to discuss the interdependencies before a final decision on possible scenarios can be proposed to the Health Board. Transport issues are being discussed with the Welsh Ambulance Services Trust to ensure that any proposed scenarios are viable in terms of access and the transfer of patients if necessary.
The emerging conclusions of other service reviews will also need to be considered.
 
Neonatal Services

Following extensive discussions, the Neonatal working group has developed scenarios for future service delivery. Before final options are proposed, the project board is seeking assurance that proposed scenarios are sustainable and whether appropriately skilled staff medical can be recruited to ensure services can be safely run in the future.
 
It is important at this stage to emphasise that no final options have been agreed.
 
If significant service changes are proposed, the Health Board will discuss with the Community Health Council how the public can be fully consulted before reaching a final decision.
 
 
 
13.03.2012 - Maternity and Child Health Project Board Update
 
The Project Board is continuing to guide the two clinical work streams in developing the detailed options which can be considered for further engagement. 
 
The focus will now be on the following areas:
  • Clinical links – the project board of all the reviews are  meeting to develop work on the essential clinical links and understand the impact on other services for example anaesthetics
  • Travel and transport – refreshing travel times, reviewing community transport, ambulance provision and transfers between hospitals
  • Impact assessment – drawing together Equality Impact Assessment and other areas into an integrated impact assessment
  • Finance – each service area working on detailed costings which will be pulled together into an overall position
  • Bringing the two work streams together in order that a preferred option can be agreed between the four services areas in line with the agreed acceptability criteria
 
It is important at this stage to emphasise that no final options have been agreed.
 
If significant service changes are proposed, the Health Board will discuss with the Community Health Council how the public can be fully consulted before reaching a final decision.

09.02.2012 – Maternity and Child Health Project Board Update
 
The Project Board is continuing to guide the two Clinical work streams in developing detailed options which can be considered for further engagement.  Consideration is also being given to how any proposals for maternity and child health can be developed alongside possible changes to other services. The interdependency between these services will need careful analysis before recommendations can be made. In addition the Project Board continues to focus on the issues of community models of care, finance, sustainable staffing and transport. 
 
The Board discussed the Review timeline with the expectation that any preferred option will be presented to BCU board in May.  Staff engagement events will be arranged for April and May, to share final proposals with all staff. 
 
It is important at this stage to emphasise that no final options have been agreed.
 
If significant service changes are proposed, the Health Board will discuss with the Community Health Council how the public can be consulted with before reaching a final decision.
 
 
 
06.12.2011 – Maternity and Child Health Project Board Update
 
The Betsi Cadwaladr University Health Board has approved that there is a case for change for maternity, gynaecology and child health services at its meeting on the 24th November.
 
The Project Board will now consider how proposals can be developed alongside possible changes to other services. The dependency between these services will need careful analysis before recommendations can be made.
 
Clinicians initially put forward a range of proposals following a detailed analysis of the evidence and considering staff and public opinion. These aim to address the issues of safety, patient experience, increasing demand on services, staffing levels, training, public health and finance.
 
The issues of finance, staffing, transport and the dependencies with other clinical services must now be fully considered as part of further engagement with staff, patients and other stakeholders. An equality impact assessment on the possible service changes has also commenced.
 
A further progress report will be presented to the BCUHB Board in January.
 
It is important at this stage to emphasise that no final options have been agreed.
 
If significant service changes are proposed, the Health Board will discuss with the Community Health Council how the public can be fully consulted before reaching a final decision.
 
10.11.2011 – Maternity and Child Health Project Board Update
 
The Project Board has developed proposals on how Maternity Gynaecology and Child Health services could be provided across North Wales in the future.
 
Clinicians initially put forward a range of proposals following a detailed analysis of the evidence and considering staff and public opinion. These aimed to address the issues of safety, patient experience, increasing demand on services, staffing levels, training, public health and finance.
 
Having assessed all proposals against these criteria, the project board is now considering how inpatient maternity, gynaecology and child health services can be delivered safely and to a high standard at three or two main hospital sites.
 
Alongside this, there will be more focus on community and public health services to improve women and children’s health and wellbeing.
 
The Health Board and its partners will also adopt a more pro-active public health approach. This will aim to reduce the impact of tobacco, alcohol and obesity and prevent teenage pregnancy. Breastfeeding, immunisation and injury prevention will be encouraged.
 
This will reduce demand on hospital services by providing health promotion and community services close to or in patient’s homes.
 
The staffing and financial requirements will now be considered and a progress report will be presented to the BCUHB Board in November.
 
It is important at this stage to emphasise that no final options have been agreed.
 
If significant service changes are proposed, the Health Board will discuss with the Community Health Council how the public can be fully consulted before reaching a final decision.
 

 
04.10.2011 – Maternity and Child Health Project Board Update
 
The Project Board is now developing options on how the Maternity and Child Health services could be provided across North Wales in the future.
 
Following a detailed analysis of the evidence and staff and public opinion, a wide range of initial proposals have been put forward by clinicians to address the main issues of safety, patient experience, increasing demand on services, staffing levels, training, public health and finance.
 
All options are currently being considered against agreed criteria to address these issues before a final shortlist is agreed by the project board.
 
The shortlisted options will be widely shared once they have been agreed by the project board. The options will also be tested with key stakeholders at engagement events during November before a final assessment is made on their suitability to be proposed to the BCUHB Board in November.
 
It is important at this stage to emphasise no final options have yet been agreed.
 
If significant service changes are proposed, the Health Board will discuss with the Community Health Council how the public can be fully consulted before reaching a final decision.
 
 
 
07.09.11 - The Project Board has begun the process of developing options on how the Maternity and Child Health services could be provided across North Wales in the future.
 
Following a detailed analysis of the evidence and opinion gathered, a wide range of initial proposals have been put forward to address the main issues of safety, patient experience increasing demand on services, staffing levels, training, public health and finance.
 
Work will continue during September to develop a shortlist of options that can be presented to the BCUHB Board.
 
It is important at this stage to emphasise that no final options are proposed.
 
Over the last few weeks engagement events have been held for staff, GPs, patients and partner organisations. These events provided opportunities to talk to people about what works well, what needs to improve, and what they would find acceptable. We would like thank everyone for their time and contributions.
 
Evidence has been gathered from a wide range of sources including a literature review by Public Health Wales, the relevant Royal Colleges, midwives, doctors, GPs, nurses, other staff, voluntary groups, partner organisations and patients.
 
Next Steps
 
A detailed shortlist of options will now be developed to address the issues identified as part of the review process. Information on the shortlisted options will be widely circulated when the appropriate level of detail is available.
 
A wide range of staff, GPs, partner organisations, voluntary groups and patients are involved in developing these.
If significant service changes are proposed, the Health Board will discuss with the Community Health Council how the public can be fully consulted before reaching a final decision.
 

 
 
08.07.2011: The first stage of the Maternity and Child Health review across North Wales has been completed. It has concluded that the way services are planned and delivered will need to change.

The next stage is to share the findings with staff, partner organisations and patients to talk about how we can improve the quality and standard of care.

Over the coming weeks meetings have been planned for staff, patients and partner organisations to talk about what works well and what needs to improve.  It is important to say that no service changes have been proposed to the project board.

Information has been gathered from Public Health Wales, Royal Colleges, midwives, doctors, nurses, other staff, local authorities, voluntary groups and patients. This information has been carefully considered and agreement has been reached that services need to change for the following reasons:
  • Maternal health is not as good as it should be and this needs to change through good public health and lifestyle changes
  • Recruitment of doctors in all specialties and their training will continue to be a problem for many years
  • There are more births each year and we want to be able to care for more of the sickest babies in North Wales
  • Some maternity care is quite complex and difficult
In the future more needs to be done to help people to stop smoking, reduce obesity, improve mental well being, reduce the number of unwanted pregnancies and increase the number of children and babies being immunised.

The number of specialist nurses, midwives and doctors will not meet the national standards that we want in the future unless the way services are delivered is changed.

Patient safety is the Health Board’s number one priority, improving the health of the population and making sure we live within our public resources are also important.
Where we can and it is safe to do so, services will be as local as possible. Some services could be offered to families from North Powys as well to further develop North Wales services.

The next step will be to put together a range of proposals. Staff, GPs, local authorities, voluntary groups and patients will be involved in developing these ideas.
We will present the outcome of this work to the BCUHB Board in October 2011.
If significant service changes are proposed, the Health Board will discuss with the Community Health Council about public consultation before reaching a final decision.

Mr Nigel Bickerton
Consultant Obstetrician
Chief of Staff for Women’s Services

Dr Brendan Harrington
Consultant Paediatrician
Chief of Staff for Children and Young People
 
05.05.2011: Project Board Update
 
The Project Board meet this week. The Project Co-ordinating group had met and developed a project timeline to allow the Project to complete within the agreed time scales. The plan incorporates many and varied opportunities for engagement in the process and full details will be released as soon as they have been confirmed. 
 
The Project Board also received an update position from the Paediatric work stream. The work stream had spent a significant amount of time reviewing the evidence and has produced an initial draft report outlining the findings of its six task & finish groups. The draft report was considered by the Project Board and its findings, that there is a case for change, were accepted.  The next stage will be consideration of best practice models and acceptability criteria. 
 
The Maternity, Gynaecology and Neonatal work stream are continuing to review the evidence on the need for change and are expected to report on the 9th May 2011.
 
It is important to recognise that the project is still focussing on clarifying whether or not there is a need to change the way in which services are presently delivered.   
 
The next stage will consider best practice models and acceptability criteria.  Work stream members will be expected to work closely with their colleagues to identify suitable best practice models for all service areas.  It is anticipated that this stage of the review will begin at the end of June and continue through until August 2011. 
 
The final stage of the process will be an appraisal of potential ways forward, whereby all models identified by the experts groups will be measured against the acceptability criteria defined by staff, service users and partners.
 
03.04.2011:  Project Board Update
 
The Project Co-ordinating group had met and developed a project timeline to allow the Project to complete within the agreed time scales. The plan incorporates many and varied opportunities for engagement in the process and full details will be released as soon as they have been confirmed. 
 
The Project Board also received an update position from the Paediatric workstream. The workstream had spent a significant amount of time reviewing the evidence and has produced an initial draft report outlining the findings of its six task and finish groups. The draft report was considered by the Project Board and its findings, that there is a case for change, were accepted.  The next stage will be consideration of best practice models and acceptability criteria. 
 
The Maternity, Gynaecology and Neonatal workstream are continuing to review the evidence on the need for change and are expected to report on the 9th May 2011.
 
It is important to recognise that the project is still focussing on clarifying whether or not there is a need to change the way in which services are presently delivered.   The next stage will consider best practice models and acceptability criteria.  Workstream members will be expected to work closely with their colleagues to identify suitable best practice models for all service areas.  It is anticipated that this stage of the review will begin at the end of June and continue through until August 2011.  The final stage of the process will be an appraisal of potential ways forward, whereby all models identified by the expert groups will be measured against the acceptability criteria defined by staff, service users and partners.
 
05.04.2011: Project Board Update
 
The Project Board received and discussed a letter issued by Jonathan Morgan, Chair of the National Committee Inquiry on NHS Reviews, Government Guidance on Engagement and Consultation on Changes to Health Services.
 
The BCUHB response to Shrewsbury and Telford hospitals NHS Trust’s consultation on the future of hospital services in Shropshire, Telford and Wrekin was also considered by the project Board.
 
The Board received its update from the Co-ordinating group on the main actions progressed since the last Board meeting on 3rd March 2011. 
 
The focus of work recently has been to identify opportunities for effective service user engagement within the review and this will continue to be given high priority over the coming months. A range of local opportunities for service users to give their views across North Wales will be arranged over the next few weeks. These will include face to face, printed and electronic methods. 
 
A third meeting of the Paediatric work stream took place on 28th March at which the leads of the six task and finish groups provided further progress updates. The demands of the local population and the implications for the quality of training arrangements were discussed in order to ensure a sustainable service in the future.
 
Dr. Nick Nelhans will represent Dr. Brendan Harrington at Project Board in a Clinical Director capacity for Paediatrics (East).
 
The Maternity, Gynaecology and Neonatal workstream met on 29th March 2011 and Mrs Geeta Kumar, Clinical Director for Women’s CPG (East) was announced as the new Chair. Professional standards and medical and nursing staff levels were discussed alongside the expected health needs of the population now and in the future.
 
Further invitations have been sent to GPs in North Wales to enhance clinical engagement in the project.
 
The project Risk and Issues Log was discussed as a standing agenda item.
The next meeting of the Project Board will be held on Tuesday 3rd May.
 
 
03.03.2011: Project Board Update
 
The Project Board discussed a revised timescale. It is anticipated that with the likelihood that a final report would be submitted to the Health Board in September 2011.
If significant service changes are proposed, the Health Board would then discuss with the Community Health Council how to consult effectively with the public.

The Equality Impact Assessment process continues. This work will provide invaluable information to the review by enhancing our understanding of local population need and helping to ensure that our equality duty is met.
A second meeting of the Paediatric work stream took place on 22nd February at which the leads of the six task and finish groups provided progress updates. Dr. Duncan Cameron is chairing this work stream. Each task and finish group will prepare a first draft report of their information gathering exercises to the next work stream meeting on 28th March.
The Maternity, Gynaecology and Neonatal workstream reconvened on 1st March 2011 and the announcement of a Chair is imminent.
 
Renewed efforts to secure more GP involvement in the workstreams were also discussed by the Project Board.
A small group has been established to improve service user involvement in the review. The group will look at various levels of involvement information, feedback and influence and will consider new opportunities for service user engagement.
Health Board Facebook and Twitter sites will soon be established and links to future Project Board updates will be posted there.
 
Some changes have also been made to the Maternity & Child Health Review pages. This is to help people find out more about the review; who is involved, its processes and progress. The website can be
found using the following link:

http://www.wales.nhs.uk/sitesplus/861/page/49043
 
 
10.2.2011: Project Board Update
 
The Project Board accepted a revised Project Governance Framework which incorporates changes to the Project structure and brings greater clarity to roles and responsibilities of group members.
 
A revised project timeline has been proposed which will seek to establish a consensus on the need for change by May 2011.  The extended timescale will seek to report the review outcomes to the BCUHB Board in November 2011.
 
The Board received an update from its Co-ordinating group regarding progress made since the last Board meeting held on 7th January 2011. 
 
Each of the two work streams are required to appoint a Chairperson to lead the work programme and to represent the group interest as a member of the Review Project Board. 
 
The Paediatric workstream reconvened its meetings on 25th January and identified six task and finish groups that will take forward the information gathering to build upon the work previously undertaken. Each T&F Group will be led by senior clinicians who will engage with colleagues in and across specialties and geographical areas.
 
The Maternity, Gynaecology and Neonatal workstream will recommence its meeting on 1st March 2011 to be held at Abergele hospital.
 
The Board was presented with a report from its newly appointed Service User Experience representative who detailed current arrangements for engaging service users. The Project Board agreed that a task and finish group would examine means of enhancing current engagement efforts, including social networking sites.
 
A revised Risk and Issues Log was considered by the Project Board as a key document to support management and ownership of associated risks.
All documents discussed at the meeting will made available on the Health Board’s Intranet and Internet sites within a few days.
 

7.12.2010: Maternity and Child Health Service Review Project Update
 
The Project Board will continue to build on the information and evidence already gathered to inform the case for change.
 
There will be no discussion on possible options until all the necessary information has been gathered and all stakeholders have had the opportunity to present their views as part of the engagement process.
 
Further briefing and information sharing sessions will be arranged over the next few weeks to allow clinicians to present their views and debate the way forward.
 
The comments put forward during this continued period of engagement will bean important factor in guiding any eventual decisions. We will be reviewing
how information is presented to inform the case for change. We will be working harder to ensure primary care colleagues are engaged and we will
continue to look for new ways of involving patients and service users and encourage wider clinical input from across all parts of North Wales.  The project board is not working to a definite timescale at present but it is accepted that the process of engagement and information gathering may take
some time.
 
A summary of the information gathered to date will be presented at each Project Board meeting starting in January 2011. The project board will
consider the evidence and identify areas where further information is needed before agreeing the case for change.
 

1.12.2010: Maternity and Child Health Service Review Project Update
 
The aim of Betsi Cadwaladr University Health Board is to ensure high quality, safe and effective services.  Senior clinicians and stakeholders have been looking at these services to see if there is a need to change and to generate ideas for the future.
 
As you will be aware there have been calls from some for the Health Board to abandon the review of maternity and child health services; however the Review will continue in order to address existing variation in standards and care. It is led by the medical consultants in women and children services respectively and supported by the Director of Nursing and Midwifery, Mrs Jill Galvani.
 
We are supporting clinicians already engaged in wide ranging discussions with staff, partners and other organisations, to gather comments and views that will influence our plans to improve services. The feedback has already shown that clinical colleagues such as midwives, GPs and consultants need more time to work through issues raised to enhance and develop work done to date. We will make sure this happens.
 
Over the coming months more information, evidence and ideas will be gathered with updates to the Health Board meetings on a regular basis. The comments put forward during this continued period of engagement will be an important factor in guiding any eventual decisions. We will be helping people to understand the need for change, working harder to ensure primary care colleagues are engaged, continuing to look for new ways of involving patients and service users and encouraging wider clinical input from across all parts of North Wales.
 
We can be clear that the three District General Hospitals in North Wales are essential and fundamental components of any future service plans.  No decisions will be made until clinical agreement is reached and the views of local people are taken into account.

18.10.2010: Review of Maternity and Child Health Services Extended
 
The Betsi Cadwaladr University Health Board has confirmed that it will now take more time to review Maternity and Child Health services.
 
Further meetings will be held in the coming weeks with Consultants, GPs, the voluntary sector and local authority representatives across North Wales.

No decisions have been made at present and no recommendations will be made to the Health Board until a clinical consensus can be developed.
 
The Health Board remains committed to looking at all options and wants to ensure all available evidence and viewpoints are considered before recommendations on future services are made. The Health Board will discuss with the Community Health Council how we engage and consult with the public.
The main issues raised by stakeholders as part of the review include:
  • The safety of transport and transfer of patients who need urgent care
  • How easily could patients and carers access services across North Wales
  • Affordability
  • Training opportunities for doctors and other staff groups
  • Difficulties in recruiting specialist staff to run services safely
  • How suitable current buildings and facilities are to provide a modern service
The Health Board is concerned that services, as currently run, cannot be sustained into the future. There is a need to work more flexibly and efficiently to ensure quality and safety. We now have an opportunity to develop more effective specialist services and make the best use of the expertise of staff based in hospitals and in the community.
 
Dr Brendan Harrington Consultant Paediatrician and Chief of Staff for Children and Young People said: “We know that people have strong views on these issues and by allowing more time we can ensure that all of these are considered as part of the review. The reason that all options need to be discussed with a wide range of stakeholders is to identify the challenges they pose. We now need to focus on finding solutions to these challenges if we are to provide safe, high quality services for our patients now and in the future”.
 
Mr Simon Leeson, Consultant Obstetrician and Acting Chief of Staff for Women’s Services said: “Based on the responses we have received, we need to review the evidence for change in greater detail. We will then be able to consider how the options could work in practice. We welcome all comments and suggestions and the more people we can engage in this process, the better the service will be in the future.”
The review project board has now welcomed local GP Dr Chris Stockport as a member and will continue tom work over the coming months to find a way forward.

Notes:

1. The four options currently proposed are:

A 3 unit model which would require a different service model to provide the
maternity and paediatric units at Ysbyty Gwynedd, Ysbyty Glan Clwyd and
Wrexham Maelor Hospital
A 2 unit model with obstetric and paediatric units at Ysbyty Gwynedd and Ysbyty
Glan Clwyd, supported by Midwifery led Units
 
A 2 unit model with obstetric and paediatric units at Ysbyty Gwynedd and Ysbyty
Maelor, supported by Midwifery led Units
 
A Central Paediatric Unit at Ysbyty Glan Clwyd with Paediatric day units at Ysbyty
Gwynedd and Wrexham Maelor Hospital in conjunction with a 2 or 3 unit obstetric
model
 
All options would be supported by enhanced community services.
 

6.10.2010
 
A second stakeholder event was held on 5th October 2010 (the first on 9th September 2010) to discuss the way maternity, neonatal and gynaecology, and Child health services are delivered by the Betsi Cadwaladr University Health Board (BCUHB) across North Wales.
 
The event was well attended with over 170 people representing parents, doctors, staff, partner organisations and voluntary groups who discussed their views on the most effective way to deliver safe services with the available staffing levels and financial resources. 
 
Dr Brendan Harrington Consultant Paediatrician said “We face real challenges in relation to recruiting and training skilled doctors, providing obstetricians twenty-four hours a day in all hospitals whilst trying to reduce financial costs.  This position is likely to get worse unless we change our approach.”
This second event follows detailed work which has been ongoing to develop potential options for the service. Four options were discussed building on the views of participants at the first event.  These options include maintaining some services on all three major hospital sites developing midwifery led units, further developing community services and concentrating high risk and specialist care on two sites or potentially one for paediatric inpatients.
 
Participants were clear that any change that is made must address patient safety as an absolute priority.  Patients want prompt access to high quality care.  Parents greatly value local services but are willing to travel for the most intensive or expert care, as long as good quality community services are available close to their home.
 
However those present recognised and accepted that services will not be able to meet national UK quality standards in the future unless the way they are delivered is changed.  Future service delivery may mean concentrating the highest levels of care in fewer centres. 
 
Current service models mean that training and development opportunities for junior doctors in the future will not be adequate and that spreading services across three sites will mean that they do not get enough exposure to intensive and acute cases to develop their skills. 
 
More detailed work is now needed to map out the implications of any proposed change for the Ambulance Service as well as parents and families. 
 
The event highlighted the need for additional information to be made available to inform the review. Further work will now take place and opportunities for engagement with key stakeholders will continue before any proposals are considered by the Health Board. 
 
If any significant or substantial change in service is proposed then we will discuss with the Community Health Council how we engage and consult with the public.
 
Dr Brendan Harrington said: “It is crucial that we engage with all stakeholders at a time of potential change in the provision of healthcare in North Wales.  Services are currently organised based on the boundaries of the former NHS organisations and there is a need to work more flexibly and efficiently to ensure quality and safety and the best possible services for the people of North Wales.”
 

10.9.2010
 
The first of two stakeholder events was held on September 9th to discuss the way maternity, neonatal and gynaecology services are delivered by the Betsi Cadwaladr University Health Board (BCUHB) across North Wales.
Over 150 individuals representing service users, clinicians, partner organisations and voluntary groups were invited to the event. Their views were be gathered as part of the review and allow services to be planned effectively for the future.
The review, which is led by a Consultant Obstetrician and a Consultant Paediatrician will establish a range of options that enable the Health Board to provide high quality, safe and sustainable services and will address:
  • Ensuring that current staff and financial resources are used effectively to provide safe services across North Wales
  • Providing more care in the community and outside the large general hospitals
  • The difficulties in recruiting and training junior doctors are also likely to continue so the priority must be to ensure that safe and effective services can be provided with the current level of medical staff
The way that services are currently run is based on the boundaries of the former NHS organisations in North Wales and cannot be sustained. There is a need to work more flexibly and efficiently to ensure quality and safety. The establishment of a single healthcare organisation across North Wales also provides opportunities for the development of more effective specialist services and making the best use of the expertise of staff based in hospitals and in the community.
 
Nigel Bickerton, Consultant Obstetrician and Chief of Staff for the Women’s Services Clinical Programme Group said: “Demand for maternity and child health services across North Wales is on the increase and we must therefore ensure that we can work more flexibly to meet the challenges by designing our services so that women and children receive the highest level of care in the most appropriate setting”.
 
Brendan Harrington, Consultant Paediatrician and Chief of Staff for the Children and Young People Clinical Programme Group said: “We are facing a number of issues in recruiting medical staff whilst needing to ensure safe levels of service. The current economic situation also means that there is a greater need to make the most effective use of our resources. The contribution of all stakeholders will be vital in helping us achieve our aims”.
 
The review project board will present its findings to the BCUHB board in November 2010.

Last updated: 23 April 2012