Joint statement from Gloucestershire Hospitals NHS Foundation Trust and NHS Gloucestershire Integrated Care Board (ICB) about maternity care.

The NHS in Gloucestershire is totally committed to providing high-quality, safe and compassionate maternity care that delivers the best possible outcomes for women, birthing people and babies. This will always be our guiding principle in the decisions we make.

Extensive work is underway across the system to continue the improvements and ensure services meet national standards and local needs.

The Trust is working with service users, staff and partners to strengthen and improve their maternity and neonatal services and ensure any developments reflect clinical evidence, national best practice and the experiences of women, birthing people and families.

Local Health Needs Assessment for maternity services and the National Investigation

A Health Needs Assessment for maternity services in Gloucestershire is underway and will help to inform the future of our services and the care we provide.

The assessment is a systematic process and involves a review of national and local data, trends and outcomes, along with the views of women, staff and stakeholders. It is used to identify the health and healthcare needs of women and birthing people. This includes changes in population health, needs and care that need to be considered to support equitable, safe and personalised services that are fit for the future.

In addition, a national investigation into maternity and neonatal services and the establishment of a national taskforce to share learning and best practice has been announced by the Department of Health and Social Care. Gloucestershire Hospitals NHS Foundation Trust is one of 12 Trusts included in the investigation and will work to ensure improvements already made continue and will implement any further recommendations and best practice.

It is vitally important that the local Health Needs Assessment, the national Maternity and Neonatal investigation and its recommendations, together with the views of service users and families, directly inform our approach to service provision in the future.

Temporary suspension of the home birth service

The recent decision to temporarily suspend the home birth service was made following safety concerns raised by midwives and a robust risk assessment. This decision was made after careful consideration to ensure the safety of women, birthing people, babies and staff.

The decision was based on a combination of factors:

• Staffing and skill mix: While overall midwifery recruitment has improved, there is a high proportion of newly qualified, less experienced midwives who are not yet able to support home births as they require significant autonomy, and therefore a degree of experience. The Trust has also found it challenging to cover the on-call home birth rota without compromising staff wellbeing and safety, with staff being at risk of fatigue.
• Following national guidance: We have seen an increase in the number of home birth requests ‘outside of guidance’. However, there is currently no clear, consistent, evidenced-based national guidance for home births and in particular those ‘outside of guidance’. The lack of national guidance means there are differing models of care, which is causing inconsistencies in clinical risk assessments, supportive informed decision making, birth planning and clear considerations of the ethical responsibility and proportionality of offering a home birth service, particularly if considered too high risk, which can reduce the ability to provide safe care.
• Safety and national learning: Home births are intended for low-risk pregnancies and are safe when supported by experienced midwives. However, recent national learning highlighted the need for all home birth service provision to be assessed for safety. The Trust is reviewing its processes in light of these lessons.

Whilst women and birthing people have the right to choose where they give birth, the provision of home birth services is contingent on availability, service capacity, but ultimately safety.

We recognise the disappointment and worry this will cause women and birthing people who had planned to have a midwife attend their home birth. The Trust has contacted everyone who has told us they planned to have a home birth to individually discuss their options.

Women and birthing people with low-risk pregnancies can continue to access midwifery-led care at Stroud Maternity Unit and Gloucester Birth Unit, both of which offer birth in a low-risk setting, homely environments and have ample capacity. For those who are assessed as a ‘high risk’ pregnancy, care is recommended within the central delivery suite at Gloucestershire Royal Hospital under the care of obstetric doctors and neonatologists, which ensures access to quick, appropriate and safe care for women and their babies.

If women have any questions or concerns about their birth choices, we encourage them to speak to their midwife who will be able to talk with them about their options.

Independent midwives

The Trust is monitoring the home birth suspension, learning from other areas, with the aim of reinstating the service as soon as it is safe and sustainable to do so.

An option that has been suggested is commissioning independent midwives to enable the service to continue.

Bringing independent midwives into the Gloucestershire NHS maternity services is complex and requires thorough governance processes to ensure safety.

Increasing staffing by using independent midwives would not resolve the issues relating to our current safety concerns.

Other temporary service changes and next steps

Decisions on the other current local temporary service changes (including Aveta Birthing Unit and post-natal beds in Stroud) can only take place once the local Health Needs Assessment and National Maternity and Neonatal Investigation have been completed.

When the findings of these reports are available, they will be shared publicly. The system will then explore, with service users, local people and communities, ideas about how services could be developed in the future, including all potential new models of care, including Aveta Birthing Unit and Stroud.

Listening to service users

Listening to what matters to service users is vital to ensuring maternity care reflects their needs and experiences, and despite recent challenges, the Maternity and Neonatal Voices Partnership (MNVP) has continued to share your feedback with the Trust. You can share your experience and feedback about your maternity and or neonatal care with the MNVP here MNVP Gloucestershire Have Your Say Form

From January 2026, the MNVP will return to full strength, strengthening collaboration and co-design of local maternity and neonatal services.

Local people can keep up to date with the Trust’s improvement journey and get information about the support available to service users at Improving our maternity services.