The Health Scrutiny Committee met to discuss the ongoing closure of the Barking Birthing Centre, the findings of a Healthwatch report on maternity services, and the development of a new framework for monitoring health outcomes and inequalities. The committee noted that the Barking Birthing Centre remains closed due to staffing shortages and safety concerns, with plans in place to recruit and train more midwives. The Healthwatch report highlighted disparities in maternity care experienced by BAME communities and those with language barriers, leading to recommendations for improved communication and culturally sensitive care. Finally, the committee was updated on the development of a new monitoring framework aimed at improving health outcomes and reducing inequalities across the borough.

Barking Birthing Centre Service Changes

The Barking Community Birth Centre (BCBC) has temporarily suspended intrapartum care (births within the centre) since 1 June 2023 due to staffing shortages and operational pressures. Diane Jones, Chief Nursing Officer for North East London Integrated Care Board (ICB), explained that there is a national shortage of midwives, particularly those skilled in standalone birthing units. The Trust is implementing a recruitment plan, including overseas recruitment and working with universities to train student midwives. While antenatal and postnatal appointments continue at the BCBC, the centre's reopening date remains unclear.

Councillor Maureen Worby expressed disappointment, highlighting years of effort to re-establish the birthing centre and concerns about it being closed by stealth. She stressed the importance of the centre as the only facility of its kind in the borough and called for it to be actively promoted and reopened. Tom Ellis, Director of Strategy at Newham Hospital, acknowledged the staffing challenges, stating that Newham Hospital has 60 midwifery vacancies. He emphasised the Trust's statutory obligation to provide safe care and that any plan for the BCBC must be realistically deliverable. Sherry Manning, Divisional Director and Associate Director of Nursing for Women and Children's at Newham Hospital, confirmed that midwives themselves raised concerns about risks in the BCBC, leading to its temporary pause. She added that 40 midwifery students are in training and expected to qualify soon.

Councillor Matthew Cole, Director of Public Health, noted the historical context of maternity care, referencing the Changing Childbirth initiative from 1993, and questioned the current ability to offer choices for home births and other non-hospital births due to midwife shortages. He expressed concern about a potential regression to earlier models of care. Diane Jones assured the committee that specialist midwives are working to provide women with as much choice as possible in a safe way, with risk assessments conducted at every stage.

Healthwatch Report on Maternity Services

Manisha Modhvadia of Healthwatch Barking and Dagenham presented findings from a report on maternity services across North East London, which included data from 42 respondents in Barking and Dagenham. The report highlighted that while self-referral generally led to a greater sense of choice in maternity care, those referred by a GP were less likely to feel they had a choice. Ethnic minority groups, particularly those with language barriers, were less likely to experience choice and were more likely to value cultural symmetry in care, but less likely to receive it.

Key findings indicated that:

• Around 55% of respondents in Barking and Dagenham were from the BAME community.
• 60% of respondents self-referred to services, with 96% of these able to choose their preferred clinic.
• 44% of those referred by a GP reported having a choice of location.
• Over 55% reported it was very important to receive care from a professional with a similar cultural background.
• 36% stated it was very important to receive care from a professional who spoke their first language.

Councillor Chris Rice raised concerns about the GP's role as a gatekeeper potentially limiting patient choice. Manisha Modhvadia confirmed that while women should have a choice, factors like hospital capacity and commissioning arrangements could influence this. She also noted that parking difficulties at some clinics could deter attendance. Councillor Maureen Worby emphasised the need for the Integrated Care Board (ICB) to ensure women are aware of their choices, especially given the borough's diverse population and potential language barriers.

The report also identified that Black and Asian ethnic groups are more likely to experience health inequalities in maternity settings. The double barrier for Black ethnic groups was described as valuing cultural symmetry but being less likely to experience it. The report recommended improved awareness of health inequalities, further research into referral structures, and enhanced interpreting services.

Corporate Plan Targets: Health Outcomes and Inequality

Neha Shah, Consultant in Public Health, presented a report on developing a monitoring framework for health outcomes and inequalities. This framework aims to align with the Barking and Dagenham Joint Health and Wellbeing Strategy 2023-2028 and the North East London ICB's forward plan. The initiative seeks to move away from outdated output-based reporting towards an outcome-focused approach. The framework will incorporate a core selection of outcomes for the borough's Corporate Plan 2023-26 and will be developed through engagement and analysis over the autumn. The intention is for this framework to also inform the Health Scrutiny Committee's future work. The committee noted the report and provided no further comments.

The meeting also noted the minutes from previous Health & Wellbeing Board and ICB Sub-Committee meetings, as well as the minutes from the Joint Health Overview and Scrutiny Committee. The committee also noted its work programme for the upcoming year.