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| High caesarean section figures in Northern Ireland questioned | High caesarean section figures in Northern Ireland questioned |
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| Health trusts need to pay closer attention to the number of caesarean sections in order to improve the quality and cost-effectiveness of maternity care, a report has found. | Health trusts need to pay closer attention to the number of caesarean sections in order to improve the quality and cost-effectiveness of maternity care, a report has found. |
| NI hospitals carry out the highest number of caesarean sections in the UK and the Republic of Ireland. | NI hospitals carry out the highest number of caesarean sections in the UK and the Republic of Ireland. |
| The auditor-general questioned whether this was often down to saving time rather than saving money. | The auditor-general questioned whether this was often down to saving time rather than saving money. |
| Hospital maternity services currently cost about £90m. | |
| The number of caesarean sections varies widely across maternity units in Northern Ireland. | |
| For instance, Belfast's Mater Hospital has the lowest rate with about 23%. | For instance, Belfast's Mater Hospital has the lowest rate with about 23%. |
| However, in Daisy Hill Hospital in the Southern Trust, almost 36% of births are by caesarean. | However, in Daisy Hill Hospital in the Southern Trust, almost 36% of births are by caesarean. |
| Auditor-General Kieran Donnelly advised that all trusts should be using the same framework to record information. | Auditor-General Kieran Donnelly advised that all trusts should be using the same framework to record information. |
| That framework, or model, known as the Ten Group Classification System, was developed by Dr Michael Robson of the National Maternity Hospital in Dublin. | That framework, or model, known as the Ten Group Classification System, was developed by Dr Michael Robson of the National Maternity Hospital in Dublin. |
| Mr Donnelly said it allowed standardised auditing within and between maternity units. | Mr Donnelly said it allowed standardised auditing within and between maternity units. |
| The model, applied in several countries across the world, is unique in that it only compares the outcomes of women with similar obstetric characteristics. | The model, applied in several countries across the world, is unique in that it only compares the outcomes of women with similar obstetric characteristics. |
| Mr Donnelly said: "Caesarean sections undoubtedly save lives and should be performed in all cases where there is a clinical need. | Mr Donnelly said: "Caesarean sections undoubtedly save lives and should be performed in all cases where there is a clinical need. |
| "Caesarean sections typically cost the health service almost twice that of a normal delivery - £3,724 compared to £1,933. | "Caesarean sections typically cost the health service almost twice that of a normal delivery - £3,724 compared to £1,933. |
| "In the current financial climate, it seems particularly important that clinical managers in the HSC trusts understand and manage the cost implications of different modes of childbirth." | "In the current financial climate, it seems particularly important that clinical managers in the HSC trusts understand and manage the cost implications of different modes of childbirth." |
| The report advises that health trusts should have a broader knowledge of why caesareans are being carried out. | The report advises that health trusts should have a broader knowledge of why caesareans are being carried out. |
| This includes asking if they were clinically necessary or just because staff simply were not available to cover long labours. | This includes asking if they were clinically necessary or just because staff simply were not available to cover long labours. |