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Case study: Configuring local maternity services

The RCOG undertook a major options appraisal across Cumbria and North Lancashire on behalf of two Clinical Commissioning Groups (CCGs), to provide independent advice on the provision of high quality, safe and sustainable maternity services for the future.

During a three-day site visit, our assessors spoke to almost 100 people involved with or having an interest in local maternity services. Most meetings were with clinical staff working in maternity and related services such as paediatrics, surgery, anaesthetics and intensive care. Our assessors also met GPs, ambulance service representatives, local commissioners, NHS Trusts, local MP’s, patient group members, the Health Scrutiny Committee and HealthWatch Cumbria.


Our report outlined six options for change, recognising that the geography, pockets of deprivation and poor transport infrastructure made decisions about service configuration very challenging and stressed the importance of engaging the local community in the development of future plans, increasing investment and the active recruitment of doctors.

Our assessors also recommended:

  • Establishing a project team to develop a detailed feasibility report on the cost, viability and risks of proceeding with any of the options
  • Integrating smaller units with community based services
  • Establishing new and variable ways of working so consultants working across sites can comply with evidence-based standards and maintain core competencies and knowledge
  • Gradually developing midwifery led unit to enhance the choice of birth for women
  • Nurturing leadership and management qualities in consultants across the maternity service and strengthening professional unity between medical staff across all sites

Elsewhere on the site

Audit & quality improvement
Find out about the College’s national audits and other projects aimed at improving the quality of women’s health services
Guidance for commissioners
Resources to support commissioners and health service managers with responsibility for commissioning high-quality women’s health care