In response to declining birth rates, local NHS bosses are proposing to close one maternity unit at either the Whittington or the Royal Free, reports James Cracknell

The maternity unit at Whittington Hospital is one of two in North London being considered for closure under a proposed shake-up of NHS services.
Because of declining birth rates, local NHS bosses are proposing to “align services with the changing needs of the community” by closing either the maternity unit at the Whittington in Archway or at Royal Free Hospital in Camden.
The NHS North Central London Integrated Care Board (NCL ICB) is responsible for commissioning health services across Barnet, Enfield, Haringey, Camden and Islington and is proposing to launch a consultation that includes the options of closing either unit – with Royal Free’s maternity unit being the current preferred option for closure.
Another smaller-scale birthing facility at Edgware Community Hospital is also earmarked for closure.
The maternity units at Barnet Hospital, North Middlesex Hospital in Edmonton, and University College London Hospital in Euston, are being retained.
All the proposed options are subject to public consultation and further decision-making by NCL ICB. A final decision is expected to be made over the autumn or winter of next year (2024/25), and implementation would need to be “planned carefully before any changes are made”.
In the meantime, there will be no changes to patient care or for staff working to deliver these services at present.
The maternity shake-up is part of a wider programme, dubbed ‘Start Well, which “aims to improve the quality and safety of care for pregnant women and people, reduce inequalities in outcomes and give every child the best start in life”.
Clinicians including doctors, midwives and other healthcare professionals have led the design of the proposed options for maternity care in North London over the past two years, with input from parents, patients and families. These have been jointly developed with NHS England Specialised Commissioning.
Jo Sauvage, chief medical officer for NCL ICB, said: “While NHS frontline staff work incredibly hard to deliver good quality maternity, neonatal and paediatric surgical care, services aren’t currently set up in the best way to meet the changing needs of local people.
“Fewer babies are being born in North Central London and more complex care is often needed during pregnancy and birth, and we need to adapt our services to that. Our goal is to align services with the changing needs of the community and continually evolving best practice”.
Subject to board approval in the first week of December, the proposed options will go out to a 14-week public consultation from Monday, 11th December, with views of patients, staff and the public being sought.
Jo added: “We firmly believe every baby and child should have the best start in life. Good foundations in pregnancy and birth have a big influence on life chances and support reducing inequalities. So it is important that pregnant women and people have a positive birth experience and we ensure that everyone has access to the same high quality services no matter where they live or choose to have their baby.”
Royal Free’s maternity unit is said to be the preferred option for closure because the Whittington also has a ‘level two’ local neonatal unit, while the Royal Free only has a ‘level one’ unit for neonatal care – “therefore there would be a smoother transition to the new model of care with minimal need for staffing changes”.
In both proposed options all maternity and neonatal services would close at one hospital site and there would be a focus across all hospitals “to deliver best practice clinical quality standards and our new model of care”.
Either proposed option would require significant additional investment, of around £40million, to “improve, expand and modernise the estate and facilities in the hospitals that would continue to deliver maternity and neonatal care”.
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