The IRP has reviewed contested proposals to reconfigure maternity and related services in East Sussex. The proposals included a single site for consultant-led maternity services in Hastings. The IRP is advising the Health Secretary to reject the proposals as they would reduce accessibility and choice for the people of East Sussex.

Dr Peter Barrett, Chair of the IRP, said: "The needs of local women and their families were at the heart of this review. Having considered all the evidence available, visited both hospitals and met with a wide range of local people, we concluded that women's access to, and choice of, services would be seriously compromised if the proposals were implemented.

"Consultant-led maternity services must remain at both hospitals and we strongly support the Primary Care Trusts' proposals to improve antenatal and postnatal care, as well as associated outreach services, which should be implemented without delay."

The IRP concluded that the proposals were principally driven by the Primary Care Trusts' (PCTs) attempts to address future medical staffing issues, as perceived at the time of consultation. The strong focus on staffing concerns meant that less consideration was given to the issue of accessibility and choice of services for local people.

Arguments that a single site solution would have compensating improvements in safety and sustainability were also considered by the IRP. The IRP does agree that some changes to the staffing of the units is required to continue to deliver safe, sustainable services, however it does not accept that the single site solution is the only or best option to achieve this.

The PCTs should consider alternative staffing models which have not been explored so far, such as using advanced midwifery practitioners to support junior and middle grade staff. It is incumbent on the local NHS to explore the potential of these roles to develop midwifery careers and support doctors' roles locally.

During the review the IRP considered the local geography and transport infrastructure, deciding that the journey from Eastbourne to the Conquest Hospital in Hastings posed a risk of incidents for women, especially during unexpected transfers. The IRP also recognised the potential time consuming and costly journeys to Hastings for both staff and women's families.

The PCTs must continue to work with stakeholders to develop a model of maternity care that provides choice for women and further enhances the safety, sustainability and quality of services. The IRP was impressed by the PCTs' commitment to support home births, which is likely to be further enhanced by the retention of consultant-led maternity units at both sites.

As a matter of urgency the PCTs must develop a comprehensive strategy for maternity services in East Sussex. The South East Coast Strategic Health Authority must ensure there is a sound strategic framework for maternity and related services in the area. The PCTs' plan and timescales to implement the IRP's recommendations must be published within a month.

Dr Barrett continued: "We were extremely impressed with the dedication of staff at both hospitals. It is now time to move forward and for the local NHS and its stakeholders to work together to develop ways of offering local people high quality healthcare. Our recommendations, if implemented, will offer people safe, sustainable and accessible services."