Kingston vs Royal Surrey, Private vs NHS

[samanthahall11]

Hi,
I've hardly used the NHS, I am not native British, I have no immediate family here and this is my first pregnancy, so I feel absolutely clueless. I have a load of questions and need some advice. I've read many posts that have been helpful - thank you - but some quite old so I wanted to get some more recent advice.

My priorities are:

• Vaginal birth (assuming I'm healthy, if I experience any complications through pregnancy I will book a section) but I want an epidural or similar.
• Safety of my baby and the absolute best care. I really don't care about food, and it doesn't bother me if I have to share a bathroom. I want to ensure I have my baby in a good hospital with sufficient well trained staff.
• I can afford some private care but having read various posts and assuming I don't discover any complications, it doesn't sound like I need to pay for full private care. I could afford it but it will be a stretch and at this stage it doesn't sound like its necessary.
• All my friends who have had NHS births have had bad tears. (Note I don't know anyone who has gone private so maybe its the same). I've gathered that this is because they were sent home and then by the time they came back to the hospital they were so far along that the baby comes quickly and the tear occurs. I have ZERO interest in being sent home when I am in labour.

So my questions:

• Should I use Kingston or Royal Surrey?
• Which have more staff? Which have better staff?
• Am I going to get turned away if I arrive in labour and its busy?
• Is it normal to tear during vaginal birth?
• Can I easily have access to a private obstetrician or independent midwife at both hospitals if I want?
• Having read about IMs isn't it better to pay for this so that you have continuity throughout rather than different MWs who are passing your information to each other?
• I'm having a private scan at 8 weeks at Window to the Womb Chessington to check for viability. How do I know the sonographer knows what they're doing? Should I be worried?

Thank you

It isn't the case at all that the best doctors are available in private hospitals. Also, if you get a consultant you are unhappy with on the NHS you can ask for someone else. That's not quite the same as being able to choose, but it means, in most cases, you won't be stuck with someone you don't like.

OP, I think you're trying to control things that unfortunately just can't be controlled -- private care will give you a nicer environment and potentially more choice on things like CS dates. But I have a feeling it is still not going to give you the control that you're seeking. It isn't going to reduce the chance of bad things happening.

Have you had a booking in appointment yet? IMO you may be best having a chat with the midwife and talking through your anxieties.

Ok, thank you

As I understand you can request an elective c-section within any NHS trust. If a consultant refuses you, the NICE guidelines state that they have to refer you to another consultant who will carry our the procedure. I'm not sure if this link will work but it outlines Ashford St Peter's approach to it all www.dropbox.com/sh/demednh4n33w1zk/AADgXHDRtShXQwFGqoWBZglSa?dl=0

Excuse my ignorance but is there a difference between private medical care and NHS medical care - isn't it just the same doctors in an emergency? Or will the better doctors go to private care hospitals?

In a real emergency, all healthcare in this country is NHS.

why do people not elect to have the epidural?

It increases your risk of tearing. Also, even if you want one, you can’t always have one. Getting to the hospital too late in labour or else if the anaesthetist is busy (there might just be one on duty and they could be in theatre) so it isn’t possible to give you one in time.

RSCH overall is considered a good hospital and especially so in its maternity care. However, it only has a SCBU if your baby is poorly after birth and they will call an ambulance to transfer to St Peter’s - if you have an ELCS you will not be able to travel straightaway with your baby so you will be in separate hospitals if you baby is so unwell s/he needs extra care.

In a lot of cases all of the staff you will see "privately" are the same staff you will see on the NHS.
In most hospitals private means that you get a nice room, better food, continuity of care and generally as has been said the same OB.
In the unlikely event anything changes your care will be done in the same theatres etc as everyone else by the same people as everyone else. If you are having an elective you might get the same ob doing to op but potentially you'll get someone different.
The Paediatric care will be done by the same doctors as on the rest of the wards.
Giving birth is a risky thing, wether you tear or not is done to many factors. Almost all will be out of the control of anyone.

I'm just 6 weeks so no appts yet. I'm going to self-refer to St Peters (based on discussions above) and I have a private scan in 2 weeks time. I have also contacted a private midwife for a once off appointment to see if thats a good option for me. I will take it from there.
Really appreciate all the advice above - its been very helpful.

If you rocked up in labour to an NHS hospital with a private midwife in tow, they will not be allowed to do anything other than than emotional support and certainly wouldn't be allowed to deliver the baby. So better to go for a doula.

@Toddlerteaplease - ok got it, thank you

@samanthahall11 I'm due in 2 weeks and Kingston is my hospital. I've opted for a home birth but if there are any issues I'll be transferred in to Kingston.

I'll try and come back & update if I remember!

Thank you! All the best!!

There are risks associated with epidurals, more likely to tear, more likely to need intervention, more likely to need an emergency caesarian. No birthing pool, have to be on a hospital ward, usually longer until you go home. Do your research before you decide. Also they’re not always an option, so better to prepare yourself not to have one. I’d hate to be reliant on that option and then not have it.

@IsTheRainEverComingBack: Ok, thank you for the info! I should have set my username to absolutelyclueless!!
The whole process seems so overwhelming, there's so much to decide and the stakes are so high if you make the wrong decision. It feels like it shouldn't be this difficult. Anyway I think once I see a midwife and can ask all these questions I will feel a lot better.

I had first child at NHS hospital and the 2nd at the Portland. Some of the responses stating you will get the same staff whether you go NHS or private - not you wont! Paying privately means that you have the same consultant for the length of the pregnancy. He/she will be called when you go into labour. I didn't have to write a birth plan. We had already discussed what I wanted.

The NHS - I saw a range of different people every single time, I had to explain my case to a new person at every appointment and in one case to someone who looked like he was about 12 and kept saying he would have to check etc. I also hung around for hours when clinics ran late - something I couldn't afford to do.

What private care gives you is some control. Some doctors don't like C sections, some like epidurals etc. All the doctors will have their own preference. Now imagine seeing say 6-8 different people all with their favourite way of doing things and a huge difference in experience.

Everything was fine with both births and I did get a private room at the NHS hospital (I paid for it) because that side of things was important to me.

If I had to do it all over again I would go private without a doubt. What you will get is someone who will know exactly what to do - you are hopefully going to be easy for him but I wanted someone who in an emergency would make a decision based on their experience.

Hi OP, I was originally booked at Royal Surrey NHS and switched to private at Kingston. When I had DD in 2017 RS had stopped doing private so they must have started it up again. I had an ELCS but I’d be happy to try to answer any questions you might have if you want to PM me.

@sunglasses123: I was afraid someone might say that :)
"What you will get is someone who will know exactly what to do - you are hopefully going to be easy for him but I wanted someone who in an emergency would make a decision based on their experience."
This is exactly my concern - I want expert and immediate care on the day. I want to minimise the risk to my baby. I guess I have a better chance of that going private (although not guaranteed of course).

I wanted someone who in an emergency would make a decision based on their experience

I'm not going to knock anyone going private, having the same people caring for you all the time is ideal, but I don't agree with the above. Experience will generally depend on years of practice and the range/type of births they have assisted with. Working at a private hospital doesn't necessarily mean that the consultant will be more experienced than a NHS consultant.

And for me the appeal of going private was mostly:

1. the reassurance of knowing by baby would be delivered by the experienced consultant I trusted and saw at every appointment
2. if I had questions or concerns I had my consultant and his midwife’s mobile numbers so I could great straight in touch
3. brilliant after care- private room, en-suite bathroom, extra bed for DH, good food, 1:1 midwife care, no issue getting pain relief, overnight nursery care for DD so I could rest

I spent 4 hours on a post natal ward at Kingston waiting for the ok to be transferred to the private wing and it was awful, I could not have been more pleased to get out of there.

I can't answer you on the NHS vs Private question as I went NHS with my children and was very happy.

I live near you and had be choice between RS and Kingston. I chose Kingston based on their level 2 status. If I lived a little closer to St Peters I would have chosen there for its level 3-but I live just a little bit too far. Having said that, I was very very happy with my experience at Kingston, and will be going there again for my next in a few weeks (hopefully).

I think you will find people have had good and bad experiences in any hospital.

I had DD at Kingston, I had to go to labour ward as I needed antibiotics sonI wasn't able to have an epidural. I had a small tear.

Had my son at a different hospital, laboured in the pool, got out to ouch him out, didn't need an epidural this time and didn't tear at all.

No complaints about Kingston.

Thank you all for sharing your experiences! Very helpful.

@samanthahall11. Royal Surrey Hospital offers a 24 hour advice line run by qualified midwives. Please feel free to call us on 03001235473 for informed advice regarding your questions. We look forward to hearing from you.
The Advice Line is supported by experienced midwives for women and their families delivering their babies at The Royal Surrey, Ashford & St Peters, Epsom & St Helier maternity units. Busy times on the line are between 08:00 and 12:00 and 17:00 and 20:00.

Regarding your question about why some people don't have an epidural - they aren't a magic bullet for all women. I had one with my first, and had a bad experience with it (incomplete pain relief, painful pressure, gave me the shakes, and other stuff), so for my second I knew that an epidural would be a last resort and didn't have one. Same this time around, an epidural is a last resort for me personally, because of my experience. My SIL on the other hand, thinks they are the bees knees as she had one and sat relaxing reading a magazine for most of her labour.

You could not pay me all the money in the world to go to St. Peter's. I feel really mean saying this as I've had no experience of their maternity care, but within the rest of the hospital I've witnessed some truly disgusting care, and their CQC report is something to be desired. I just wouldn't feel safe in their hands at all.

We've just moved house so our local hospital is now Frimley which has inspected far better with CQC. I'm just approaching 20 weeks with my first baby and can honestly say the care and support I have received so far is truly outstanding. Appointments are arranged quickly with short waiting times, there's always someone at the end of the phone and any necessary referrals or tests are arranged quickly and explained fully.

I'm an anxious first timer and feel very well supported by everyone I have come in to contact with.