The Royal College of Obstetricians and Gynaecologists (RCOG) welcomes the views expressed in the BMJ by Professor Catherine Nelson-Piercy and colleagues on the need for more obstetric physicians. It validates the RCOG’s views that more resources are needed in our maternity services to meet the demands posed by the increasing birth rate and numbers of pregnancy complications seen by healthcare professionals.
Indeed, the RCOG would take the argument further by stating that the recommendations in our recent High Quality Women’s Health Care report to introduce women’s health networks in the NHS will go a long way to improving the care of women and in reducing maternal and child deaths.
These networks will work by linking the range of women’s health services together with other specialties such as cancer, heart, respiratory and mental health so that care can provided in a continuum. Alongside these key medical disciplines is the need to work closely with GPs and social services so that women get the care they need and want in a seamless and timely manner.
Integral to the success of women’s health networks is the life-course approach that we must embrace. This is tied to the public health agenda and focuses on care provided from adolescence to beyond the post-menopausal period. This includes advice and support to girls and women so they can lead healthier lives.
We know that there are certain periods when women are more susceptible to receiving advice. We can identify these key life moments when the disease prevention message is communicated to them and tailor services to suit them along the lines which the current NHS reforms aspire towards. This integrated approach has the further benefit of helping in public health planning and the commissioning of services.
Dr Tony Falconer, RCOG President said “The reason direct obstetric deaths have reduced over the years is due to improved organisation of clinical cover and more uniform care through adherence to national clinical guidelines. We must ensure that this trend improves through increased senior presence on the labour ward for those patients needing immediate access to such care.
“The RCOG pioneered sub-specialty training in areas of clinical need such as fetal and maternal medicine and the next step in the evolution of services is to link all these different parts together through networks which we believe will provide better care, improve outcomes and drive up quality.
“If we follow the models we’ve proposed, physicians will work hand-in-hand with consultant obstetricians and midwives in the larger centres where clinical expertise is concentrated. This will enable further multi-disciplinary teamworking.
“We welcome closer working with our physician colleagues in maternity services. There will be opportunities for us to develop joint-training in the areas highlighted by the confidential enquiries.”
10 August 2011
The RCOG and RCP have submitted a joint letter to the BMJ in response to the commentary. The rapid response can be found here.
'Maternal mortality in the UK and the need for obstetric physicians', Catherine Nelson-Piercy, Lucy Mackillop, David J Williams, Catherine Williamson, Michael de Swiet, Christopher Redman
BMJ 2011;343:doi:10.1136/bmj.d4993 (Published 9 August 2011)