For many years, midwifery cover on the Isles of Scilly has been provided by a part time post, reflecting the average on-island birth rate. The midwife provides antenatal care, and is on call when a woman is 37 weeks pregnant or over. At other times, telephone on call support is provided from Cornwall. All antenatal screening and obstetric services are provided in Cornwall.
Occasionally, feedback indicated concern about these arrangements, with regard to limited local cover. When the resident midwife retired in May 2014, recruitment was initially unsuccessful and the period of interim cover extended to a year. This increased fears about the sustainability of the local service, alongside comments about lack of continuity and consistency.
The service provider was responsive in meeting these concerns, within the current model of provision. There were few negative comments about the quality of care and no suggestion, in our monitoring of provision, that the service was unsafe.
A new resident midwife took up post in 2015 but resigned within a year. Given the difficulties regarding recruitment and sustainable provision of cover we made a recommendation to the commissioner and provider that the service model should be reviewed. We submitted a report which detailed the historic concerns we had raised and which asked a number of questions about current arrangements.
We received a full response to all our questions and details of enhanced arrangements within the current model.
A review of the on island service is now underway.