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Falling birth rates and low NHS staff moral cause concern in North London

Councillors discussed concerning statistics with North Central London NHS boss, reports Grace Howarth, Local Democracy Reporter

Falling birth rates and low staff morale and trust across the NHS in North London have raised concern among councillors. 

During a North Central London joint health overview and scrutiny committee on Friday (31st May) councillors discussed concerning statistics with North Central London NHS leads. 

Committee member Tricia Clarke asked about the decline in the birth rate, which has led to a proposed cut to maternity units, with services at Whittington and Royal Free hospitals under threat.

Gillian Smith, chief medical officer at Royal Free London NHS Foundation Trust, did not confirm which unit would close but acknowledged the need for closure. 

She said: “We know that in North Central London the birth rate is falling, and we have consequently seen a reduction in the number of births happening across the patch. 

“The quality of the services is good, and the patient feedback is good, but we know if we continue with the number of units that we have we won’t be able to sustain those services in the longer term. 

“The birth rate is falling, that’s one of the main drivers of change in the ‘Start Well’ process.”

The Start Well programme is a North Central London partnership programme which has been underway for a year and is going through an ‘options appraisal process’ for maternity, neonates and paediatric surgical services in the area. The process is due to be concluded in summer.

In terms of Whittington Health NHS Trust, committee chair Pippa Connor asked about a 2023 staff survey which showed 30% of the trust’s staff would not feel secure “raising concerns about unsafe clinical practice” which could lead to a “serious incident”. 


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Sarah Wilding, chief nurse at Whittington Health NHS Trust, said they didn’t have a high proportion of staff reporting concerns anonymously, which was “very unusual”, highlighting that this showed they had a culture which held itself “accountable”. 

She then described the “multiple ways” staff could speak up, including via line managers, occupational health services, and human resources.

In maternity wards, there were also “safety champions” positioned to receive questions from staff. 

Regarding North Middlesex University Hospital NHS Trust, Cllr Connor said the trust’s report didn’t contain enough data especially around “staffing, patient complaints and concerns around the merger [with Royal Free London]”. 

Cllr Connor said: “You’re holding a huge amount of information in your heads that you’re able to come and tell us but I’m just not seeing it on the paper in front of me.”

Lenny Byrne, interim chief nurse at North Middlesex University Hospital NHS Trust, said there was a “huge” amount of data being collected, and at times didn’t know “how much or how little” to include. 

For example he said there was a 120-point improvement plan for maternity units, but it hadn’t been included. 

Victoria Jones, medical director at North Mid, said the “pockets” of poor staff culture were a top priority for the trust.

She said:“The vast majority of our staff are fantastic, but we would want our residents to feel confident that when they come to North Middlesex they’ll be treated by someone who treats them with kindness, respect and has the appropriate training to deliver the care that we want.

“I think the work that we’re doing, where we know there’s been problems identified, we’re doing in a timely fashion and making sure it doesn’t affect wider staffing.”


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