Table 3 Possible solutions to mitigate potentially adverse consequences of the reconfiguration

Antenatal care

Clear targeted investment of ante natal care in the most deprived areas.

Links to Children's Centres and other agencies.

Investment in alternative models of care, e.g. peer educators, health trainers, in addition to community midwives.

Hospital and labour care

Robust supervision of midwives on the MLU.

Strict protocols for identification of high-risk pregnancies antenatally and advice to mothers not to use the MLU.

Strict protocols for rapid identification of labour complications and rapid transfer.

MLU midwives to be trained in neonatal life support.

Resuscitation equipment available on the MLU.

Telemedicine links with the obstetric-led unit.

Transport

Implementation of a range of travel support schemes particularly targeted to low-income groups, e.g. improved bus routes, taxi vouchers, national travel tokens, free shuttle service.

Sustainability of MLU

Ongoing hospital trust board support for the MLU and development of skills and capacity within it.