The Royal College of Paediatrics and Child Health (RCPCH) will undertake an independent evaluation of the changes in women and children's healthcare services in Pembrokeshire and Carmarthenshire, Hywel Dda University Health Board agreed at a board meeting last week.

The RCPCH team will provide an impartial and expert evaluation, including representation from the Royal College of Obstetrics and Gynaecology, plus a midwifery, paediatric and neonatal nursing view, and a lay representative.

The evaluation is being commissioned by Hywel Dda University Health Board following a request by the Welsh Government Health Minister in January 2014 for a formal evaluation after 12 months of the service change on the 'the impact of the revised neonatal service on newborn outcomes and patient experience'.

Changes to neonatal and maternity services were made in August 2014, when the University Health Board created a single site Special Care Baby Unit at Glangwili Hospital, Carmarthen, and established a Midwife Led Unit in Withybush Hospital, with all high risk pregnancies being scheduled for birth, or transferred as necessary, to a Consultant Led Unit at Glangwili Hospital.

In October, the University Health Board also made changes to paediatric services, establishing a Paediatric Ambulatory Care Unit (or assessment unit) in Withybush Hospital, open 10 am -10 pm seven days a week, and a PACU and inpatient paediatric ward at Glangwili Hospital, Carmarthen.

Chief executive Steve Moore said: "For our assurance, we have widened the scope of the evaluation from looking at the neonatal service, to also include an independent view of paediatric, maternity and obstetric services.

"We acknowledge that there has been significant public concern over the changes we made to some women and children's services last year, particularly for our population in Pembrokeshire. For this reason, as well as assurance for us as a board and our patients, an independent expert evaluation is essential."

The evaluation, which will begin imminently, will:

• Assess the services against the benefit criteria identified in 'Your Health Your Future' and the rationale for change

• Review the impact and outcomes of the neonatal service change

• Determine how the current services meet recognised Royal College standards

During the same board meeting, executive directors and independent members received a report on the ongoing internal monitoring of service change.

Since the service change:

• 16 per cent of births are being led by Midwife-Led care (including home births) - one per cent above the target set by the health board for the first year

• there has been an upward trend in women choosing to give birth in the Midwife Led Unit at Withybush Hospital (apart from April which corresponds with a lower overall birth rate)

• 24 women have been transferred from the MLU at Withybush Hospital to the labour ward at Glanwgili Hospital, with the majority of transfers at the request of women for additional pain relief, and average transfer time of 62 minutes

• Withybush Paediatric Ambulatory Care Unit has seen 1,718 children between the hours of 10 am and 10 pm, with an average of just more than one child a day being transferred to the inpatient ward at Glangwili Hospital

• the Dedicated Ambulance Vehicle (DAV) has transferred a total of 487 patients between Withybush and Glangwili hospitals

• there has been an increase in the number of incident reports that staff make referring to access, appointments, admission, transfer and discharge - this is to be expected as every transfer is logged and investigated

• there has been a decrease in the number of incidents that refer to labour or delivery since the service change

• three new paediatric consultants have been appointed, however recruitment in paediatric nursing and midwifery remains challenging and is not yet at full establishment

The Health Board acknowledged there remains concern amongst the community about the changes. Patient complaints and feedback is already being gathered, and responded to, with improvements made where they are identified. A staff, patient and family experience group is also being put in place to capture and consider feedback from users. Anyone wishing to share their experience as a patient, or family member/carer, can visit http://www.hywelddahb.wales.nhs.uk/myexperience">www.hywelddahb.wales.nhs.uk/myexperience and fill in a survey. You can also pick one up from the main reception at hospital or request one by calling 01554 899 056.