The findings are based on a national survey of maternity and neonatal services, which found that 42 per cent of units were classed as “operational” but in need of “major repair or replacement… soon”. A further seven per cent were assessed as being at “serious risk of imminent breakdown”. Around 155 maternity units and a similar number of neonatal services were surveyed nationally.
Across London’s maternity and neonatal estate, NHS England reported that 68 per cent of units were categorised as either ‘category C’, meaning they require major repair or replacement in the near future, or ‘category D’, indicating a risk of serious and imminent breakdown.
The report also noted that doctors and midwives were losing “significant time” as a result of the condition of buildings. Water, sewerage and drainage issues, including leaks and flooding, were identified as the most common causes of disruption to services.
According to the review, “much of the current maternity and neonatal estate lacks sufficient physical space to operate in accordance with best practice under current activity levels”. The survey formed part of a commitment made by NHS England in its 2023 improvement plan for maternity and neonatal services.
Other commonly reported issues included inadequate space, insufficient storage, a lack of staff rest areas and poorly maintained buildings.
More than 590,000 babies are born in the UK each year, placing ongoing demand on maternity services. NHS England’s report highlights how the condition and capacity of the estate can affect the delivery of care, particularly as estates age, building materials such as RAAC require remediation, and local pressures such as workforce availability and changing birth rates vary by region.
The report raises questions about how services can be maintained when existing maternity spaces need to close temporarily or permanently, for example due to refurbishment or infrastructure failure, and how additional capacity might be provided where needed.
Vanguard Healthcare Solutions points to mobile and modular clinical facilities as one option for providing temporary or additional maternity capacity. The company cites a case study from Wilhelmina Hospital Assen (WZA) in the Netherlands, where a mobile theatre was introduced as an additional delivery room for around 26 weeks. According to Vanguard, the facility was used as a fourth delivery room and supported 125 births during that period.
Vanguard says similar solutions have been used by NHS trusts and health boards in England and Scotland to supplement existing maternity theatres and ward space, including at Kettering, where a modular facility has been used flexibly to support maternity services.
Simon Squirrell, National Sales director at Vanguard Healthcare Solutions, said mobile and modular facilities can be deployed quickly and may be used during unplanned disruptions, such as those caused by flooding or fire, or as part of planned refurbishment or relocation programmes.