Key facts
- Up to 20 of England's 155 NHS maternity units may need to close or change their role.
- Matthew Hopkins, NHS Alliance director, called for consolidation of services for safer, more sustainable care.
- Obstetricians and midwives oppose closures, advocating for local access to maternity services.
- Rising C-section rates are straining resources, requiring more staff and operating theatres.
- Many units at risk are in rural or coastal areas with challenging staffing situations.
Up to 20 maternity units in England may need to close to ensure safe care for mothers and babies, according to Matthew Hopkins, the NHS Alliance’s director for acute care. He stated that centralizing childbirth services into fewer hospitals is inevitable and necessary for patient safety, despite potential political opposition. Hopkins urged ministers to show courage in backing these changes, even though it may mean mothers travel further for care.
Smaller maternity units delivering 1,500 to 2,000 babies annually are becoming increasingly unsustainable due to a widespread lack of obstetricians and a sharp rise in caesarean sections. Many units at risk are in rural or coastal areas where staffing is particularly challenging. Hopkins called for a thorough appraisal of maternity services to ensure the current configuration is fit for purpose.
However, his comments provoked an outcry from obstetricians and midwives who insist that maternity care should remain accessible locally. The Royal College of Midwives stated that women rely on local units, while the Royal College of Obstetricians and Gynaecologists suggested exploring workforce solutions other than closures. The warning comes as a government taskforce is expected to publish a report on improving childbirth care before Christmas.
Recent examples highlight the challenges, including the temporary closure of North Devon's maternity unit due to understaffing, and the reopening of Yeovil hospital's unit after nearly a year-long closure. The maternity unit at Daisy Hill hospital in Northern Ireland was also earmarked for closure due to staff shortages. Professor Marian Knight of Oxford University supports consolidating maternity services into fewer, larger units to manage the surge in C-sections, which have risen significantly in England.