Nevaeh Stewart FAI: Neonatal transport boss denies postcode lottery

Montrose Maternity Unit
Montrose Maternity Unit

One of Scotland’s largest hospitals had its role in the transport of critically ill babies ended because of staffing issues at the facility, an inquiry into the death of a newborn heard today.

Nevaeh Stewart died three-and-a-half hours after she was born at Montrose Royal Infirmary’s community midwifery unit in September 2012, despite the efforts of midwives based there and specialists who rushed from Dundee to her aid.

Her father Gary Stewart earlier described the unit as an “emergency response blackspot” during a fatal accident inquiry being held at Forfar Sheriff Court.

Today (Monday, January 12), the head of neonatal transport at ScotSTAR, Scotland’s paediatric transfer team, said Ninewells Hospital in Dundee, one of the largest in the country and a base for teaching for Dundee University’s medical school, had to stop operating as a neonatal transport team base around the time of her death.

The Aberdeen-based team who now cover the Tayside region were on a call in Caithness when Nevaeh fell gravely ill.

However, Anne-Marie Wilson vehemently denied there has been any reduction of service or increase in response time since the team’s permanent move to Aberdeen in 2014.

The probe heard the arrangement had been run until 2014 by the Scottish Neonatal Transport Service, which was a joint arrangement funded by all health boards.

There were three teams – west for Glasgow and the Highlands and Islands, north for Aberdeen and Dundee from the River Tay up to the north coast, and southeast for Edinburgh and Borders.

She said: “We no longer have a service running in Dundee from Ninewells Hospital.

“This is purely down to covering their neonatal unit.

“There were difficulties in staffing a rota on the neonatal transport and the hospital, which meant they withdrew when it became ScotSTAR.”

She told Sheriff Pino Di Emidio: “They came out in April 2014 and in the 18 months before that, they’d started to come out of the service because they had difficulties with numbers at the alongside midwifery unit.”

Ms Wilson (58) said that on September 30 2012, when Nevaeh died, the north team was on a call in Wick, Caithness.

However, nobody had contacted their colleagues in Edinburgh or Glasgow when the “pale and floppy” baby was born in Montrose.

She said: “I couldn’t say what the local teams were doing.

“No one made contact with the north or west teams.”

Depute fiscal Andrew Hanton asked Mrs Wilson: “How frequently would that situation arise, that a team would be so far away from a unit?”

She responded: “It can occur because of the geography of Scotland, but it would have been very unlikely all three teams would have been out.”

Mr Hanton said: “Had that call been made today, is it possible a team from another area could have been closer?”

Mrs Wilson confirmed this and said ScotSTAR carry out around 1600 transfers each year. Only five percent would be said to be time critical.

Mr Hanton asked: “Do you consider there is any postcode lottery in Scotland, that better services are available to the central belt?”

Mrs Wilson said: “I wouldn’t say there is a postcode lottery.

“People who live in more rural areas understand that where they live is rural, and that travel time (for ambulances) will be a factor.”

Nevaeh’s father Gary Stewart, representing the family at the FAI, asked whether Mrs Wilson’s role to maintain service levels had been affected by Ninewells leaving the rota.

She replied: “Our response times have proven, compared to the other system, the other teams have always responded faster than the Dundee team had.”

Nevaeh Stewart died just three-and-a-half hours after she was born in a birthing pool at Montrose Royal Infirmary’s community midwife unit on September 30, 2012.

A fatal accident inquiry into her death is being held at Forfar Sheriff Court - where her father, Gary Stewart (30), of Auchenblae, Aberdeenshire, earlier described the unit as an “emergency response blackspot”.

That was after notes made by midwives showed they had noted a neonatal transport team as being “en-route” from Ninewells in Dundee at 5.40am - but didn’t arrive until 7.15am.