60 COVID Collaboration – NHS elective caesarean sections in a private maternity hospital setting – The portland hospital experience

Objective: To review the logistical utilization of private health care by the National Health Service (NHS) during the COVID-19 pandemic for maternity patients, in London. Design: Retrospective analysis of NHS elective Caesarean sections (CS) carried out in The Portland Hospital (TPH). Results: TPH carried out 214 CS delivering 216 babies between 31/5/2020 - 17/7/2020 for four local NHS Hospitals. The demographics of the patients mirrored the general obstetric population. 95.8% performed after 38 weeks gestation. 58.9% of patients the indication was previous CS delivery/deliveries. Parity ranged between 1-8. The average blood loss at CS was 388ml. One patient had a major postpartum haemorrhage, losing 1800ml with no serious sequalae. There were 216 babies delivered, with a mean weight of 3354 grams. Seven babies were admitted to the Neonatal Intensive Care Unit. One baby was transferred to Great Ormond Street Hospital due to a bowel obstruction. Enhanced recovery protocols enabled 90.7% of patients to be discharged on day 1, Inpatient stay ranged 1-3 days. All patients were swabbed for COVID-19 on admission, diagnosing five asymptomatic positive cases. There were no maternal or neonatal complications during their delivery or postnatal period. Conclusion: In 2020, delivering healthcare, especially in London was challenged due to the COVID-19 pandemic. TPH played a role in supporting the NHS; providing a pathway for selected patients undergoing elective c-sections and freeing up capacity. This collaboration resulted in a strategy to responding to unprecedented challenges. The utilization of the logistics and relevant skill-base in the private sector for maternity and neonatal care, and close team working between NHS and TPH staff ensured safe effective care for these women and babies. Informal feedback showed high satisfaction from patients and all staff involved.