Can you select a London hospital if you live in Kent?

[Duv]

I live in Kent, not near London tbh, but I commute there, and I don't live that near any of Kent's maternity hospitals. I can't drive, so either way I'm looking at between 1-1hr 40 to get to appointments.

I've previously given birth at a London hospital and my care was amazing, and I selected that hospital because it's maternity unit was rated outstanding, as are many central London Hospitals. I've been quite shocked however at the disparity to Kent, where hospitals seem both few and far between as well as all currently rated inadequate.

Does anyone know if I can just opt for a London hospital, even though it's ridiculously far away as the crow flies (although as I say, not actually that different for me time-wise on public transport). Do the hospitals have to accept you if you self-refer or can they reject you on grounds of being too far away?

I would almost certainly be opting for a planned C-section, so hopefully this would somewhat mitigate the risk of trying to get to hospital quickly whilst in labour.

Ask your GP. They can only say no.

My understanding is that whilst you theoretically could, you would need to think about logistics carefully - not just about how you got there for a planned c-section, but how you would get home again with a freshly newborn baby with hardly any immune system and who isn't supposed to be in a car seat for long periods. I doubt your midwife would be encouraging a significant commute. However, not all Kent hospitals are currently rated as inadequate for maternity services? For example, Medway Maritime and Darent Valley are both CQC rated as good for maternity.

However, I wouldn't just go off the rating, particularly if you are looking at a planned c-section. Read the actual CQC reports of the hospitals local to you, discuss with your midwife, and see how you feel after that.

If you live in East Kent, I don’t blame you! Makes sense for appointments in any case. If you can sign up to a London hospital, I would. Just as long as you’re prepared to go to your local hospital if things are moving fast at the delivery end.

Not sure about maternity but my stepdad had to have heart surgery. Lives in Taunton but elected to go to a London hospital. All you can do is ask.

Lots of the most high risk pregnant women in Kent end up being referred to Kings, as it's the nearest place setup to deal with them. Even if the journeys aren't ideal, they must be possible.

You can self-refer to wherever you like. Whether the hospital chooses to accept that referral will be based on their own capacity and criteria.

Yes - self referral. I self referred to UCLH as we were renting and I didn’t know where we’d be by the birth.

Yes, you can. You can self-refer where you like - but needs to be before 30weeks into preg.
Some hospitals like Chelsea and West are over subscribed, so they might not accept your case.

Yes you can self refer there. I gave birth twice at St Thomas’ despite living in Kent. I did this as dd was treated (and died) there and I wanted to have involvement from consultants that knew her condition. It was the right thing but became a faff when I was being monitored 2 x week in later pregnancy, and not commuting for work.

I would seriously consider whether its a good idea, as a hospital close to home is likely to be practically better. The drive home after my c sections was awful and I wished we were closer. The other thing to consider is postnatal care if you are out of borough.

A lot of the London hospitals are also suffering from the crisis in maternity / midwifery so carefully check when they were last inspected, if that's what you are going by. We are SW London, but loads of the ones nearby have all been downgraded in their most recent inspections.

I agree with pp (especially @anicecuppateaa). In my most recent pregnancy, I had to finish work due to BP issues and go every 2 days from 36w for monitoring. I then developed preeclampsia at 39+2 and went into spontaneous labour at 39+3, even though my c section was booked for 39+5. My labour was fast - my first was 14hrs but this one was less than 4hrs total and only 1hr active labour (went for vaginal delivery in the end). If you do go to a London hospital, I think you need to be prepared to leave immediately - so if that's the middle of night, will you be able to get transport (taxi?) to the hospital? And how much longer would it take in comparison to when public transport is running in the day?

But in principle, you can register wherever you like.