Please provide the following information to help us to assess variation in accessibility to maternal request caesarean sections.

 Request 1

Advise the total number of caesarean sections you have paid for in the year April 16-April 17. We would like you to provide a breakdown of the number of unplanned caesareans and the number of planned caesareans- both the actual number and the percentage of overall total births.

Response 1

Total births April 16 – April 17 Inclusive = 3050. This is based on acute hospital admissions with the following procedure codes –

R24     Normal delivery,

R18     Other caesarean delivery,

R17     Elective caesarean delivery,

R22     Vacuum delivery,

R21     Forceps cephalic delivery

R14     Surgical induction of labour

R15     Other induction of labour

R20     Other breech delivery,

R23     Cephalic vaginal delivery with abnormal presentation of head at delivery without             instrument,

R25     Other methods of delivery.

Total planned caesareans: 252. This is based on acute hospital admissions with the procedure codes R18 Other caesarean delivery and R17 Elective caesarean delivery, where admission is coded as elective. Percentage of total therefore: 8.3%.

Total unplanned caesareans: 555. This is based on acute hospital admissions with the procedure codes R18 Other caesarean delivery and R17 Elective caesarean delivery, where admission is coded as non-elective. Percentage of total therefore: 18.2%.

Request 2

In addition please provide any additional information/categorization of the reasons recorded for the planned caesareans. (We would like to find out how many planned caesareans were carried out primarily for a psychological reason and how many planned caesareans were carried out with no obstetric, medical or significant psychological reason)

Response 2

RCCG does not hold this data, however, you may wish to direct your request to our provider, The Rotherham NHS Foundation Trust via their FOI team at freedomofinformatio@rothgen.nhs.uk

Request 3

Are there any circumstances in which you as a CCG would refuse to fund a caesarean section? If so please specify what these circumstances are.

Response 3

The RCCG does not hold this information, as this is a clinical decision.

You may however, wish to contact the Rotherham NHS Foundation Trust via email Freedom of Information@rothgen.nhs.uk Please put ‘Freedom of Information Request’ in the subject line.

Request 4

What guideline or policy do you have in place with your providers on how they should deal with maternal request Caesarean sections. If one is in place please provide us with a copy.

Response 4

The RCCG does not have any guidelines or a policy as this is a clinical decision. Please see response 3.