Although some of these issues around gynaecology and maternity services in Liverpool have been looked at before, this is a new process which will focus on the challenges as they stand today.   

There are no plans to close Crown Street, which is an important NHS asset, and we are continuing to develop services there. Whatever proposals might go ahead in the future for gynaecology and maternity services, the current hospital site will continue to be used for the provision of NHS services.

No, this work is aimed at reducing clinical risks, improving the quality of care that patients receive, and making these services sustainable for the longer term. Whatever proposals might go ahead in the future, it is likely to involve further investment.

No, this process is not about reducing any services. It’s about improving the gynaecology and maternity services that we have already, and protecting them for the future.

Yes, gynaecology and maternity services in Liverpool are arranged in a different way to elsewhere in country.  All other specialist centres for maternity care in England are located alongside acute and emergency hospital services.

You can learn more about the main challenges facing these services in the Case for Change summary document here.

Because Liverpool Women's gynaecology and maternity care is located separately from other adult hospital care, there can be challenges providing care to patients who: 

• Have another health condition that needs managing alongside their gynaecology or maternity care

• Have unexpected complications during their care which needs urgent support from a different specialist team

• Become seriously unwell or rapidly deteriorate during their care and need support from an intensive care unit

• Have very complex surgical needs, including many patients with gynaecological cancer

No, these are not small numbers. Around 60% of women (approximately 5,000 women per year) who have their babies at Liverpool Women’s have complex health needs or another significant  condition that need to be managed by other hospital teams alongside gynaecology or maternity care.

The challenges facing hospital gynaecology and maternity services aren’t to do with the Liverpool Women’s Hospital building. They’re about the way that medicine, and the health needs of our population, have changed over the last 30 years.

Key changes that have taken place during this time include:

• More people with serious health conditions are able to have children
• More people are having babies at a later age
• Demand for gynaecological services is increasing
• Advances in cancer treatment (including for gynaecological cancers) 

Doctors, nurses and midwives at Liverpool Women’s and other local hospitals are working hard to manage clinical risks and keep care safe for patients. Some of the main ways that they do this include:

• Senior doctors travelling by ambulance with very unwell patients who need to be moved to other hospitals, so that their care can continue during an ambulance transfer.
• Teams from Liverpool Women’s and other hospitals working together to share knowledge, training and resources, and provide bespoke care packages for gynaecology and maternity patients with complex care needs.
• For complex maternity patients, there are services jointly delivered with doctors who are specialists in a variety of medical conditions, including heart disease, diabetes and kidney disease.
• Many complex gynaecology patients are now jointly managed through teams made up of staff from Liverpool Women’s, the Royal Liverpool Hospital and The Clatterbridge Cancer Centre.
• New joint roles have been created in anaesthetics, meaning that these staff will work across both Liverpool Women’s and the Royal Liverpool Hospital, providing a broader range of experience.
• An outreach midwife service has also been established, to provide care to patients being treated at other hospitals.

The way that hospital gynaecology and maternity services are currently organised in Liverpool is actually disadvantaging women’s health, when compared to:

• those using services at other hospitals in Liverpool
• women using gynaecology and maternity services in other parts of the country

Without a permanent solution being found, patients in Liverpool will be left with poorer quality care than gynaecology and maternity patients receive in other parts of the country.

This situation is likely to increase health inequalities that are already experienced by many of our local communities, particularly those from ethnic minority groups and socially deprived backgrounds, who are already more negatively affected by the way that services are organised.

There is clear evidence that patients who attend A&E departments at the Royal Liverpool or Aintree hospitals with conditions affecting their pregnancy, and those who need ambulance transfers for critical care, are more likely to come from a socially deprived and/or ethnic minority
background.

It is simply not possible for the NHS to deliver care in this way. This is because there are simply not enough specialist doctors, nurses and support teams available to be able to duplicate all types of care at every hospital site.