When Solihull maternity unit was controversially downgraded last year, health bosses insisted it would make labour wards safer. Since then midwifery services have been pushed to breaking point and staffing levels may have contributed to the death of a baby at Heartlands Hospital. Health Correspondent Alison Dayani reports

Midwives have been pushed to the limit at Birmingham’s largest hospital trust following changes in maternity services, it has been revealed.

Figures obtained by the Birmingham Post show the extent of downgrading Solihull maternity unit in April last year, which saw an increase in births at Heart of England Foundation NHS Trust’s other delivery wards at Heartlands Hospital, in Bordesley Green.

Figures suggest the trust was slow to react to changes and did not boost staffing levels at Heartlands until eight months later, in December, despite seeing a 40 per cent increase in births.

It has also emerged an NHS investigation into the death of a baby boy born at Heartlands Hospital six months after the changes were made said staffing problems played a part in his death.

Emma Brown and Greig Carleton’s baby Tobias died at the hospital last October.

Miss Brown, a teacher from Yardley, said: “I hope that the trust learns lessons from what has happened and that no other family have to experience the tragedy of losing a child in such circumstances.”

Managers have admitted having 60 midwife vacancies at the trust last year, although this has now been reduced to five.

They also disclosed that despite the recommended ratio of one midwife to 28 births, Heartlands reached a ratio of one to 41 births last year and was currently still too high at one to 33 births.

In Solihull, there is a ratio of one midwife to 11 births and at Good Hope, one to 28.

Heartlands averaged around 400 maternity medical staff before the downgrade, this rose to around 420 medics until December when more midwives were hired and the staff figure rose to 465.

City MP Gisela Stuart (Lab Edgbaston) is now calling for a review of maternity services across Birmingham.

She said: “Heartlands is a maternity unit that is already overloaded, has midwives with higher than recommended case loads and is now getting more patients from Solihull.

"It is a bad thing. This is combined with a national shortage of midwives, which makes it difficult to recruit staff, and an increasing birth rate in Birmingham with a much younger population than other comparable cities.

“Before the West Midlands Strategic Health Authority is abolished, a successor needs to be identified to review all providers in Birmingham as a whole, not by trust, as a matter of urgency.”

Solihull Hospital stopped dealing with complicated and premature births from April last year when it was converted to a midwife-only unit with no specialist consultants – meaning most pregnant women are now transferred to Heartlands.

Trust executives had said the changes would lead to a fifth of births continuing at Solihull – about 600 a year instead of 2,700.

But figures show the new Solihull unit, which opened last July, has seen a 90 per cent drop in births between July 2010 and February this year from 1,769 to 168 compared to the same period the previous year.

At the same time, Heartlands maternity wards have seen a 41 per cent increase in births, from 3,298 to 4,652.

The trust’s other hospital, Good Hope, in Sutton Coldfield, 19 miles away from Solihull, has not been affected by the changes with figures virtually unchanged.

Despite the massive rise in births at Heartlands, the number of maternity medics increased only slightly – by five per cent or about 20 staff – in the first eight months following the downgrade. This then increased by 16 per cent, about 65 extra staff, from last December.

Patient complaints about clinical and nursing care in the department have risen by more than a third in a year. This increased from 37 complaints between April 2009 and March 2010, to 50 for between April 2010 to March 2011.

Health watchdogs on both Solihull and Birmingham health scrutiny committees have raised concerns over midwife numbers.

Joy Payne, the trust’s head of midwifery, said: “We had about 60 staffing vacancies at one point but have got these down to five. We have come a long way.