Chamber and committees

The information requested is not held centrally. However, the number of claims made against NHS Boards in respect of Obstetrics and Gynaecology cases in each of the last 10 years is shown in the following table:

	2005-06	2006-07	2007-08	2008-09	2009-10	2010-11	2011-12	2012-13	2013-14	2014-15
Argyll and Clyde	<5	-	-	-	-	-	-	-	-	-
Ayrshire and Arran	-	-	<5	<5	<5	<5	6	5	<5	<5
Borders	-	-	<5	-	-	<5	-	-	<5	<5
Dumfries and Galloway	-	-	<5	-	-	-	-	-	-	-
Fife	-	<5	<5	<5	-	<5	<5	<5	<5	8
Forth Valley	5	9	5	<5	<5	<5	<5	<5	<5	<5
Grampian	-	-	-	<5	<5	<5	<5	<5	<5	<5
Greater Glasgow & Clyde	<5	<5	8	14	8	14	11	8	5	13
Highland	<5	<5	<5	-	-	<5	<5	<5	<5	<5
Lanarkshire	-	-	-	<5	<5	<5	5	8	<5	7
Lothian	5	<5	10	10	9	8	10	6	13	12
Orkney	-	-	-	-	-	-	-	-	-	<5
Shetland	-	-	-	-	-	-	-	-	-	-
Tayside	-	<5	<5	-	<5	<5	<5	<5	<5	6
Western Isles	-	-	-	-	-	-	-	-	-	<5

Source: NHS National Services Scotland Central Legal Office

Note: To preserve anonymity, where the actual number of cases is less than 5, it has been shown in this way.

The value of claims made against NHS Boards in respect of Obstetrics and Gynaecology cases in each of the last 10 years is shown in the following table:

	2005-06 £(m)	2006-07 £(m)	2007-08 £(m)	2008-09 £(m)	2009-10 £(m)	2010-11 £(m)	2011-12 £(m)	2012-13 £(m)	2013-14 £(m)	2014-15 £(m)
Argyll and Clyde	0.2	-	-	-	-	-	-	-	-	-
Ayrshire and Arran	-	-	0.2	0.2	0.1	5.8	1.1	4.2	0.7	1.1
Borders	-	-	1.5	-	-	0.1	-	-	0.2	0.1
Dumfries and Galloway	-	-	0.0	-	-	-	-	-	-	-
Fife	-	1.6	0.0	4.2	-	1.6	3.1	0.5	2.2	0.5
Forth Valley	0.1	1.6	3.8	0.7	2.6	2.1	0.4	1.1	0.3	0.4
Grampian	-	-	-	5.0	0.2	0.2	0.1	0.1	0.0	0.8
Greater Glasgow & Clyde	2.0	4.8	2.3	10.6	2.2	16.0	6.5	7.9	4.1	2.9
Highland	0.8	0.8	3.3	-	-	5.0	0.2	0.7	0.0	0.3
Lanarkshire	-	-	-	2.3	10.1	6.8	2.0	3.5	0.0	4.1
Lothian	0.0	0.0	6.1	1.0	9.3	4.1	3.3	0.8	10.4	4.5
Orkney	-	-	-	-	-	-	-	-	-	0.0
Shetland	-	-	-	-	-	-	-	-	-	-
Tayside	-	0.5	1.1	-	0.4	0.1	0.2	0.1	1.6	3.0
Western Isles	-	-	-	-	-	-	-	-	-	0.0
Total	3.0	9.3	18.2	23.9	25.0	41.8	16.9	18.7	19.4	17.6

Source: NHS National Services Scotland Central Legal Office

Healthcare Improvement Scotland has received one complaint regarding maternity care in the last 10 years. It was regarding a singleton pregnancy in 2014. The Scottish Government does not hold the information to answer parts (ii) and (iii). The Scottish Government cannot supply the number of complaints broken down by singleton or multiple pregnancy or by hospital, however NHS National Services Scotland has provided information on the number of complaints by NHS boards for the last 10 years.

Number of complaints1 received for Hospital and Community Health Services2 by NHS Board and
Maternity Service Area: 2004/05 to 2013/14

NHS Board Area

Number of complaints by Maternity Service Area

2004-05

2005-06

2006-07

2007-08

2008-09

2009-10

2010-11

2011-12

2012-13

2013-14

Scotland	128	148	195	177	217	209	241	219	199	199
Argyll and Clyde3	6	2
Ayrshire and Arran	11	6	6	7	2	21	16	13	14	14
Borders	2	5	3	4	1	1	-	2	2	1
Dumfries and Galloway	5	10	8	12	4	7	4	5	5	10
Fife	0	1	4	10	14	10	17	7	7	1
Forth Valley	7	11	5	2	18	19	10	4	7	16
Grampian	28	34	38	28	26	32	40	60	68	71
Greater Glasgow3	19	13
Greater Glasgow and Clyde3			20	22	49	47	70	68	33	18
Highland3	16	11	3	4	10	5	10	15	11	15
Lanarkshire	11	6	26	6	15	2	-	-	3	1
Lothian	21	39	69	56	50	46	54	41	32	31
Orkney	0	0	0	0	0	-	1	1	1	1
Shetland	0	1	0	1	0	1	1	-	3	-
Tayside	1	8	12	24	27	17	16	1	11	19
Western Isles	1	1	1	1	1	1	2	2	2	1

Source: Information Services Division (ISD Scotland) NHSScotland complaints: Data provided from NHS boards and compiled by ISD Scotland.

Data as at July 2014 and may be subject to change in future reporting.

1 In the NHS complaints procedure, a complaint is defined as 'an expression of dissatisfaction requiring a response'. Citizen's Charter Complaints Task Force. The number of complaints includes complaints still open i.e. complaints which have not yet been completed within the reporting period but excludes complaints withdrawn i.e. not taken forward, consent not received, and complaints which have been transferred to another NHS board, division, service or national support organisation.

2 Hospital and Community Health Services only (excludes complaints relating to family health services, special NHS boards and national and support organisations).

3 Argyll and Clyde: Following the dissolution of Argyll and Clyde health board in April 2006, the number of complaints for Argyll and for Clyde regions are now shown under Highland and Greater Glasgow and Clyde respectively.

‘-‘ denotes zero i.e. nil data/records.

The Scottish Government does not hold this data, however, NHS National Services Scotland has provided this data in the following tables:

Maternities1 that resulted in singleton births in the last 10 years, by health board of residence2 and hospital of birth3

Financial year ending 31 March

i) Hospital of birth by financial year	2004	2005	2006	2007	2008	2009	2010	2011	2012	2013
Aberdeen Maternity Hospital	3951	4070	4064	4417	4577	4705	4877	4783	4931	4984
Aboyne Hospital	35	60	62	81	64	60	77	59	2	0
Arbroath Infirmary	81	83	98	180	168	157	115	115	108	88
Ayrshire Central and Maternity Hospital	3406	3471	3461	1755	0	0	0	0	0	0
Balfour Hospital	96	127	136	140	133	144	128	126	139	143
Belford Hospital	47	35	52	44	35	39	36	32	37	43
Borders General Hospital	986	993	966	1079	1119	1178	1186	1164	1107	1148
Caithness General Hospital	224	205	223	212	254	250	148	160	182	188
Campbeltown Hospital	2	8	17	16	13	14	20	18	25	16
Chalmers Hospital	38	53	45	76	10	9	3	0	0	0
Crosshouse Hospital	0	0	0	1881	3698	3723	3635	3734	3689	3497
Dalrymple Hospital	75	36	0	0	0	0	0	0	0	0
Dr. Gray's Hospital	848	954	942	998	1103	1143	1147	1031	1038	1048
Dumfries and Galloway Royal Infirmary	1223	1270	1287	1328	1324	1285	1329	1289	1262	1247
Dunoon and District General Hospital	31	33	37	27	35	30	38	33	32	19
Falkirk and District Royal Infirmary	446	0	0	0	0	0	0	0	0	0
Forth Park Maternity Hospital	3063	3243	3266	3443	3619	3726	3682	3667	3689	3429
Forth Valley Royal	0	0	0	0	0	0	0	0	2293	3101
Fraserburgh Hospital	74	59	64	76	69	28	6	45	21	28

Financial year ending 31 March

	2004	2005	2006	2007	2008	2009	2010	2011	2012	2013
Galloway Community Hospital	0	0	0	2	84	93	84	80	83	60
Garrick Hospital	0	39	73	70	7	0	0	0	0	0
Gilbert Bain Memorial Hospital	157	154	128	163	131	143	157	147	141	179
Inverclyde Royal Hospital	536	89	101	86	97	94	110	67	64	44
Islay Hospital, Bowmore	1	2	0	0	2	1	2	2	1	1
Isle of Arran War Memorial Hospital	6	7	8	5	1	6	2	3	5	1
Jubilee Hospital, Huntly	26	0	0	0	0	0	0	0	0	0
Kincardine O'Neil War Memorial Hospital	7	0	0	0	0	0	0	0	0	0
Lorne and Islands District General Hospital, Oban	53	33	21	10	15	24	28	38	39	15
Mackinnon Memorial Hospital	7	17	20	13	23	18	27	20	18	19
Mid Argyll Hospital	15	20	13	2	0	0	0	0	0	0
Mid-Argyll Community Hospital	0	0	0	6	17	17	18	15	11	14
Montrose Royal Infirmary	111	124	158	181	202	216	204	172	198	183
New Royal Infirmary of Edinburgh	5763	5609	5821	5953	6478	6595	6292	6546	6706	6437
Ninewells Hospital	2957	3415	3515	3157	3896	3903	3848	3826	3968	3752
Perth Royal Infirmary	1106	398	189	343	303	256	330	367	308	290
Peterhead Cottage Hospital	96	110	117	141	171	173	190	151	148	154
Portree Hospital	0	0	0	0	0	0	0	1	0	1
Princess Royal Maternity Hospital	5071	5278	4893	5232	5508	5667	5902	6113	6238	5999
Raigmore Hospital	1754	1845	1841	1869	1960	2120	2066	2122	2086	2028
Royal Alexandra Hospital	2278	3152	3029	3187	3326	3447	3465	3481	3558	3567
Southern General Hospital	2787	2930	2975	3036	3306	3281	3775	5598	5632	5479
St. John's at Howden, Livingston	2628	2707	2635	2738	2922	2880	2905	2849	2717	2605
Stirling Royal Infirmary	2435	3061	3080	3144	3246	3167	3228	3133	842	0
The Ayr Hospital	1	0	0	0	0	0	0	0	0	0
The Queen Mother's Hospital	3799	3332	3437	3284	3378	3171	2362	0	0	0

Financial year ending 31 March

	2004	2005	2006	2007	2008	2009	2010	2011	2012	2013
Uist and Barra	2	1	0	0	0	0	0	0	0	0
Vale of Leven District General Hospital	45	54	65	73	89	97	113	83	104	95
Victoria Hospital, Rothesay	12	17	16	12	16	13	11	11	6	8
Western Isles Hospital	202	175	175	237	213	201	179	178	206	195
Wishaw General Hospital	4588	4648	4437	4776	4695	4802	4675	4777	4871	4692
Other4	1	4	27	17	3	0	0	0	0	0
Scotland	51070	51921	51494	53490	56310	56876	56400	56036	56505	54797

 

ii) Health board of residence by financial year

	2004	2005	2006	2007	2008	2009	2010		2011	2012	2013
Ayrshire and Arran	3521	3540	3551	3711	3766	3803	3673		3784	3729	3542
Borders	970	983	939	1022	1044	1075	1050		1048	985	1008
Dumfries and Galloway	1290	1348	1355	1405	1411	1374	1417		1373	1346	1305
Fife	3534	3661	3650	3797	4035	4108	4055		4049	4068	3804
Forth Valley	2909	3065	3051	3146	3253	3191	3210		3125	3101	3004
Grampian	5002	5221	5214	5689	5923	6046	6209		5996	6011	6082
Greater Glasgow and Clyde	12506	12801	12540	12773	13657	13684	13705		13479	13725	13442
Highland	2726	2809	2812	2826	2922	3144	3003		3012	3023	2894
Lanarkshire	5879	5988	5687	6140	6089	6139	6021		6020	6076	5837
Lothian	8146	8067	8231	8473	9192	9255	8956		9127	9226	8913
Orkney	149	178	180	200	192	199	185		185	197	198
Shetland	220	224	222	258	211	245	275		239	240	276
Tayside	3852	3723	3699	3617	4240	4209	4196		4167	4266	3980
Western Isles	238	211	214	271	242	237	214		204	245	232
Scotland5	51070	51921	51494	53490	56310	56876	56400	56036		56505	54797

1 - Excludes home births and births at non-NHS hospitals.

2 - Health board 2006 boundaries

3 - Over the 10 year period some hospitals have closed, transferred services or are new-builds, and therefore may not be represented every year.

4 - Other includes a small number of cases where a birth occurs at home or en route to hospital and then a subsequent admission to hospital occurs. In general, SMR02 excludes home births.

5 - Scotland data includes births where NHS board of residence is unknown or outside Scotland. Includes live and still births

IR2015-01223/S4W26150

Source: SMR02

 

 

Maternities¹ that resulted in multiple births in the last 10 years, by health board of residence² and hospital of birth³

Financial year ending 31 March

i) Hospital of birth by financial year

2005

2006

2007

2008

2009

2010

2011

2012

2013

Aberdeen Maternity Hospital	80	63	87	94	74	88	83	80	89	84
Ayrshire Central and Maternity Hospital	51	63	55	20	0	0	0	0	0	0
Balfour Hospital	1	0	0	0	0	0	0	0	0	0
Borders General Hospital	9	26	13	16	13	12	18	14	22	13
Caithness General Hospital	0	0	0	0	0	0	0	1	1	1
Crosshouse Hospital	0	0	0	33	62	49	55	59	45	55
Dr. Gray's Hospital	10	2	8	4	12	14	7	10	12	9
Dumfries and Galloway Royal Infirmary	16	18	16	24	22	13	25	14	18	24
Falkirk and District Royal Infirmary	7	0	0	0	0	0	0	0	0	0
Forth Park Maternity Hospital	43	47	49	44	53	72	70	54	44	57
Forth Valley Royal	0	0	0	0	0	0	0	0	34	38
Garrick Hospital	0	0	1	0	0	0	0	0	0	0
Inverclyde Royal Hospital	3	0	0	0	0	0	0	0	0	0
Lawson Memorial Hospital	0	0	0	0	0	1	0	0	0	0
Lorne and Islands District General Hospital, Oban	0	1	0	0	0	0	0	0	0	0
New Royal Infirmary of Edinburgh	107	108	106	101	124	121	115	120	114	93
Ninewells Hospital	79	34	36	47	80	81	95	67	75	71
Perth Royal Infirmary	0	0	1	5	2	0	0	0	0	0
Princess Royal Maternity Hospital	97	87	88	90	104	98	107	128	95	101
Raigmore Hospital	35	25	25	31	31	38	26	38	38	27
Royal Alexandra Hospital	35	48	62	45	44	52	58	63	51	53
Southern General Hospital	36	38	50	45	65	43	60	103	82	83
St. John's at Howden, Livingston	34	27	30	41	46	36	50	37	35	18
Stirling Royal Infirmary	32	37	54	41	40	61	60	49	9	0
The Queen Mother's Hospital	77	57	55	72	51	40	34	0	0	0
Western Isles Hospital	3	2	3	3	4	3	3	3	0	3
Wishaw General Hospital	66	72	62	70	86	79	68	83	65	68
Scotland	821	755	801	826	913	901	934	923	829	798

1 - Excludes home births and births at non-NHS hospitals.

2 - Health board 2006 boundaries

3 - Over the 10 year period some hospitals have closed, transferred services or are new-builds, and therefore may not be represented every year.

4 - Other includes a small number of cases where a birth occurs at home or en route to hospital and then a subsequent admission to hospital occurs. In general, SMR02 excludes home births.

5 - Scotland data includes births where NHS board of residence is unknown or outside Scotland.

Includes live and still births

IR2015-01223/S4W26150

Source: SMR02

Background Notes – Recommended not for publication- please discuss with Information Services Division (ISD) before publishing.

1. Data are sourced from the Scottish Morbidity Record 02 (SMR02) submitted by maternity hospitals to ISD.

2. There is no legal requirement to submit SMR02 data to ISD.

3. Live and still births are included on SMR02.

The Scottish Government does not hold information on multiple pregnancy related patient safety incidents at hospital or NHS board level.

We expect that all NHS health boards in Scotland have in place effective systems to support review of and learning from patient safety incidents locally to ensure women and babies have safe and effective care.

The Maternity and Children’s Quality Improvement Collaborative established by the Scottish Government in 2013 aims to reduce avoidable harm in maternity, neonatal and paediatric care by 30% by 2015, as defined by reference to specific criteria. It is already making significant progress in improving services and keeping safety at the top of the agenda.

The Scottish Perinatal Infant Mortality and Morbidity Report 2012 outlines on page 12 the outcomes for registered twin pregnancies:

http://www.healthcareimprovementscotland.org/our_work/reproductive,_maternal__child/reproductive_health/spimmr_2012.aspx

The Maternal, Newborn and Infant Clinical Outcome Review Programme published the first of a series of reports aimed at learning lessons to inform maternity care in December 2014, and its perinatal audit in June 2015. The Scottish Government has established an expert group to consider these reports and make recommendations for actions for Scotland.

(a) Research:

The Chief Scientist Office (CSO) of the Scottish Government Health and Social Care Directorate supports and promotes high quality research aimed at improving the quality and cost-effectiveness of services offered by NHSScotland and securing lasting improvements to the health of the people of Scotland.

CSO invests directly in research projects through its response mode funding system, which relies on high quality research applications being made by the research community with proposals funded on the basis of scientific excellence. This system covers research across a very broad range of areas of health and would include consideration of research proposals into stillbirth and neonatal death. Proposals to CSO funded fellowship schemes could also include research in these areas.

In addition, CSO contributes financially to National Institute for Health Research (NIHR) research programmes in order that researchers based in Scotland can lead applications to these health research programmes, and again applications to these programmes could include research proposals in these areas.

CSO Response Mode Grant Funding:

The CSO grant funding initiatives financial support for 31 research projects has been provided since June 2009 in areas of maternal, fetal and/or neonatal health. Funding of £2.9 million has so far been provided in relation to these projects.

The CSO has funded stillbirth research being led by the University of Edinburgh; AFFIRM (Can Promoting Awareness Fetal movements and Focussing Interventions Reduce Fetal Mortality), which is a stepped wedge cluster randomised trial. Sands, Tommy’s and SiMBA have also contributed to the study which is aimed at reducing stillbirth rates.

The Scottish Government has also given Sands £25,000 to be allocated to their UK-wide Research Fund for 2015/16.

National Institute for Health Research (NIHR) Research Programme Funding

The estimated 2015-2016 contribution to the NIHR Research programmes is £10.1 million.

There are currently eight projects led by Scottish institutions with a current total cost of £10.5 million.

Reproductive Health & Childbirth Specialty Group

The funding provided in 2015-2016 is £22,000.

(b) Clinical best practice in relation to multiple pregnancies

Evidence based advice on the care of women with multiple pregnancies is set out in the following: -

The National Institute for Health and Care Excellence clinical guidelines Multiple Pregnancies – The management of twin and triplet pregnancies in the antenatal period. In line with these guidelines, we would expect clinical care for women with twin and triplet pregnancies to be provided by a nominated multidisciplinary team consisting of a core team, including named specialist obstetricians, who have experience and knowledge of managing twin and triplet pregnancies; and

The Royal College of Obstetricians and Gynaecologists, Royal College of Midwives, Royal College of Anaesthetists and Royal College of Paediatrics and Child Health report on Childbirth: Minimum Standards for the Organisation and Delivery of Care in Labour (2007). This report sets out the essential minimum staffing standards required to support women in labour and provide safe care for them and their babies.

<>The Scottish Government’s review of maternity and neonatal care aims to examine choice, quality and safety of maternity and neonatal services in light of current evidence and practice, in consultation with the workforce, NHS boards and service users and make recommendations for a Scottish model of care that contributes to the government's aims of patient centred care which provides the right care for every woman and baby every time and giving all children the best start in life.