Oxfordshire hospital makes changes to scanning of pregnant women following concerns

Oxford University Hospitals Trust (OUH) says it has acted on feedback from Baroness Amos’s National Maternity & Neonatal Investigation which reported concerns about childbirth services at the JR, Oxford.

All women who have an identified risk factor for their baby not growing as expected will be offered continued scan monitoring beyond 36 weeks, even where previous scans are normal.

The bring JR scanning in late pregnancy in line with the standard national guidance set out in the NHS England Saving Babies’ Lives Care Bundle.

They come after concerns were raised by the National Maternity & Neonatal Investigation led by Baroness Amos.

“We are working on introducing these changes with immediate effect. We are also commissioning an independent review of our fetal growth scanning pathway,” a trust statement said.

“If you are currently pregnant and under our care, you do not need to do anything. Your midwife or doctor will talk you through any changes that might be relevant at your next appointment.

“As always, we encourage any woman who has concerns during pregnancy, including reduced fetal movements, to contact the service for advice so they can be appropriately monitored and investigated as necessary.”

Baroness Amos published her report, after inspecting 12 hospital maternity departments, including the JR, and described in graphic detail the pressure on JR staff caused by outdated facilities, too many births and logjams.

She said: “Families told us about not being listened to at OUH and felt the hospital prioritised doing things the ‘Oxford Way’ over their care preferences. During our visit we considered the Trust’s practice in relation to antenatal ultrasound scanning."

Guidance by National Institute for Health and Clinical Excellence (NICE) recommends that for an uncomplicated singleton pregnancy two scans are performed, at 11 – 14 weeks to determine gestational age, detect multiple pregnancies and estimate the due date, and at 20-weeks to screen for specific conditions.

The OUH protocol is to offer all women ultrasound scans at 36 weeks as part of the Oxford Growth Restriction Identification Programme (OxGRIP), departing from NICE guidance.

The investigation’s expert advisors were concerned this might affect the trust’s capacity to scan women with a clinical justification beyond that.

One mother who needed a 36+ week scan told the investigation she had been denied a scan because of the OXGRIP policy. The investigation team was also concerned about information provided to women about whether OXGRIP met national guidance.

A recent review of OUH maternity was undertaken by NHS England. The Health Research Authority has also formally reviewed the programme.

An OUH statement said: “The findings of Baroness Amos's review, with feedback from women and families, informed the changes we have announced.

"The core components of our scanning pathway remain in place. The changes build on that pathway and improve how it works for women and families. Further improvements to our maternity and neonatal services will follow as our improvement programme continues.”

Simon Crowther, Interim CEO, said: "Our scanning pathway remains in place and these improvements build on it. We have also commissioned an independent review of the pathway, and its findings will inform the next stage of our improvement work.”