NHS leaders will make a decision next week which will shape the future of maternity and neonatal services across North London for generations to come.
If approved, the proposals would see four maternity units serve Barnet, Camden, Enfield, Haringey and Islington, as well as those in neighbouring boroughs who choose to use North Central London services.
One existing unit, at the Royal Free Hospital, would eventually be subject to closure. Services at Whittington Hospital would remain open.
Local specialist doctors, midwives and NHS managers have been working on the ‘Start Well’ programme for over three years, to inform decisions about how best to deliver sustainable, high-quality, clinically excellent services, improving health outcomes for all.
It has involved a comprehensive programme of planning, research and population modelling, together with engagement and consultation with thousands of people including key community groups, service users, parents, the public and staff.
Dr Josephine Sauvage, a local GP and Medical Director for the Start Well programme, and the North Central London Integrated Care Board, said: “We want to consistently provide the very best quality services for babies, children and parents – wherever they are – across our communities.”
A further part of the proposals would see the expansion of antenatal and postnatal care services out of Edgware Birth Centre, and the closure of the birthing suites at Edgware Birth Centre (which see fewer than 50 births a year, and just 28 in the last financial year), with the space used for additional antenatal and postnatal care.
Dr Sauvage adds that the changing needs of local people have been at the heart of the proposals: “These are difficult decisions. We know how hard staff work to provide services which are highly valued. However, the current arrangements cannot continue as they are.
“We have a declining birth rate in our area, and the need for more complex support for mothers, pregnant people and their babies is growing.
“Our services are not currently set up to meet the needs of everyone that uses them. Doing nothing is not an option and we have carried out extensive work to make sure we are able to make the right decision for local families.”
Public feedback supports the need for change – a 14-week public consultation delivered in 2024 received over 3,100 responses (as well as nearly 200 events which reached just under 3,400 people). Two thirds of service users (66%) agreed that changes to maternity and neonatal services were needed.
Dr Sauvage adds that the consultation raised some important issues and questions which would form the focus of the next phase of work: “We heard some very important feedback, questions and challenge during the consultation and have taken this on board.
“If a decision is made next week we are committed to continuing the conversation, working with local residents to ensure our services meet the different needs of our communities, as well as supporting staff who would be impacted in the future.”
Dr Clare Dollery, Acting CEO, Whittington Health, said: “We are very proud of our maternity and neonatal services, and our teams who deliver them. But we know we need to invest in our current facilities and estate so we can provide our services in a high quality, modern healthcare environment.
“These changes would be transformative in improving the care and experience of pregnant women and people and of babies and their families.”
Will Huxter, Regional Director of Commissioning, NHS England, responsible for overseeing the planning, commissioning and delivery of specialist neonatal services across London, said: “We’d like to thank everyone involved in the delivery of the project to this point, and critically, the public, service users and staff who have taken time to give their views.
“This has been a robust and comprehensive process, which is important. The depth and breadth of feedback and input is extremely valuable.
“The right long-term decisions about these key services can only be made on a strong base of evidence, consultation and engagement, as this has been.”
David Probert, Chief Executive, UCLH, said: “A huge amount of work has been invested across our area to make the Start Well programme a thorough and effective process. We have welcomed the opportunity to work with local colleagues to ensure that the right capacity and level of care are available where they are needed most.
“Our shared goal is to ensure the highest quality care for pregnant women and babies in our maternity and neonatal services, and the Start Well programme would help us to achieve this.”
Peter Landstrom, group chief executive of the Royal Free London, said: “These are difficult decisions, and we know that there will be uncertainty felt by the public and staff who would be impacted by the future closure of the unit at the Royal Free Hospital, and the birthing suites at Edgware Birth Centre.
“Both units provide excellent care but we also know that the current arrangements across North Central London are not sustainable in the long term. We will be supporting colleagues and working with partners across North Central London to ensure that if approved, there is a detailed and thorough implementation plan to minimise the impact on staff and service users.
“For now, and the immediate future, all our services are open, unchanged and will be for some time, as changes such as this would rightly take several years to put in place.”
The meeting will take place on 25 March 2025 at The Greenwood Centre in Kentish Town to make their decision. The agenda and full decision-making business case is available here on the NCL website and included below.
You can find out more about the Start Well programme here.
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