FOI 26-281 NHS Highland Maternity Incidents

Freedom of Information Request

Request Date

24 Jun 2026

Response Date

22 Jul 2026

Information Requested

This request concerns maternity transfers from island communities served by NHS Highland. These communities have no practical alternative provider and rely on the Scottish Ambulance Service and ScotSTAR for emergency and planned transfers for delivery and complications.
The challenges facing remote and island maternity services are well documented, and the Scottish Ambulance Service plays a critical role in the safe transport of mothers and babies.

**** Please provide the following information: ****

1 - The total number of pregnant women transferred by the Scottish Ambulance Service or ScotSTAR from all islands served by NHS Highland between 1 January 2023 and 31 May 2026, broken down by island and reason for transfer. Please answer with the exact figures where held.

2 - The number of adverse clinical incidents or outcomes recorded during or immediately following these transfers (including but not limited to stillbirth, neonatal death, maternal complications, or deterioration in the patient’s condition). Please answer YES or NO to whether such records exist. If yes, provide a high-level anonymised summary.

3 - Whether the Scottish Ambulance Service or ScotSTAR has undertaken or received any risk assessments, safety reviews or internal briefings since 1 January 2023 concerning the risks to mothers, babies or clinical staff arising from maternity transfers from island communities. Please answer YES or NO. If yes, please provide a brief summary of the main findings, including any actions recommended or taken and whether any such actions have been implemented.

4 - Any and all correspondence, emails, briefing notes, meeting notes, position papers or other recorded information shared between the Scottish Ambulance Service / ScotSTAR and NHS Highland, the Scottish Government or Public Health Scotland since 1 January 2023 in which risks to patient safety, capacity pressures, or sustainability of island maternity transfers were discussed, assessed, or considered.

5 - The total cost to the Scottish Ambulance Service of carrying out these island maternity transfers (including staffing, aircraft, road ambulance, and any other associated costs). Please provide in spreadsheet format if possible.

6 - Any complaints or serious adverse event reports received from island residents, NHS Highland staff, or other parties specifically related to maternity transfers from island communities.

For the purposes of this request, “all islands served by NHS Highland” includes (but is not limited to) the Isle of Bute, Mull, Islay, Jura, Colonsay, Tiree, Coll, Skye, Raasay, and the Small Isles (Rum, Eigg, Muck and Canna).

**** Date range: 1 January 2023 to 31 May 2026. ****

Response

Q1 - Please see the table below, which provides the number of attended incidents recorded under the chief complaint category of “pregnancy”. These figures include admission journeys where applicable.

Please note that this data should be interpreted with caution. The figures may not capture all journeys involving patients who were pregnant and attended or transported by the Scottish Ambulance Service. Some hospital transfer journeys are recorded under a general transfer category and, while they may relate to pregnant patients, we are unable to separate these from other transfer activity. As such, the figures provided should not be considered a definitive total of all pregnancy-related transfers or attendances.

Journey type	Number of incidents
Admission Journey	15

We are unable to provide a further breakdown by individual island or reason for transfer because the numbers involved are very small. Disclosure at that level would create a risk that individuals could be identified, particularly when combined with island population. We therefore consider this information to be exempt under section 38(1)(b) of FOISA, as disclosure would constitute personal data and would be contrary to the data protection principles.

Please find below a list of islands included in the figure provided.

Island name

Bute

Easdale

Isle of Mull

Isle of Skye

Q2 – Yes, the Scottish Ambulance Service does record adverse clinical incidents. However, none have been identified that relate to NHS Highland for the time frame requested.

Q3 - No, the Scottish Ambulance Service does not hold any formal risk assessments, safety reviews or internal briefings specifically relating to maternity transfers from island communities for the period requested.

However, the Scottish Ambulance Service and ScotSTAR work with midwifery services, GPs, families and other relevant partners to develop individualised care plans and risk assessments where required. These arrangements take account of factors such as location, accessibility, staffing and family preferences to support safe and appropriate maternity care.

Q4 - The Scottish Ambulance Service has identified a limited amount of information falling within the scope of this request.

The relevant information consists of two email exchanges between NHS Highland and the Scottish Ambulance Service, dated 2025 and 2026.

The correspondence relates to the healthcare provision of identifiable patients. Information which would identify, or could lead to the identification of, individual patients, together with details relating to their health and care, has been withheld under section 38(1)(b) of the Freedom of Information (Scotland) Act 2002 as personal data.

Having reviewed the correspondence, we are able to disclose the following extracts of the remaining information. The wording below has been extracted directly from the emails, with only exempt personal information removed.

Email Correspondence (2025)

What emergency support, if any, is available on….itself? Is there a first responder?

If we needed support in an emergency who would respond? Coastguard, air ambulance, lifeboat?

What are the potential barriers/problems that might affect this response? Are they weather dependent? (EDD end of March) Could there be availability issues?

What would be the likely timeframes…. know these are likely to be very variable but I suppose knowing the minimum timeframe would be helpful at least.

What would the approximate transfer times be, once picked up depending on the route?

Would there be any difference in this response for maternal or neonatal emergency? Or of still in labour?

Normally on the small isles Eigg. Muck, Canna, and…. would fly our air ambulance in as a response and retrieve, that is dependent on Weather, other option is ambulance staff respond on the lifeboat and the patient comes back on the lifeboat, this is not ideal and protected time in each case…..

In summary, …. an island is particularly challenging if it becomes an emergency situation and Weather is a huge factor in the type of response. …….

Many thanks for including ScotSTAR /Air Ambulance into this email….

From an air ambulance perspective weather and tasking workload is always one to consider with risk assessments and whether the air ambulance or a coastguard search and rescue aircraft are available and can get in to provide paramedic support and transfer.

These are always challenging, high risk situations….. ScotSTAR neonatal team would not be able to be there for delivery on 'stand-by'…….there is a high risk at this time of year of the teams being unable to attend due to weather and inability to fly. The team can be activated within an hour our of hours. The team has a national workload, and we only have 2 teams to cover the entirety of Scotland. There would be a consultant available to give advice to clinicians on scene and we could use telemedicine to assist……..

Email Correspondence (2026)

From:……

Sent: 28 May 2026 09:26

To:….

Cc:….

Subject: Guidance regarding request for midwives to attend call out to obstetric cases.

It has come to light that on occasions community midwives….The on call community midwife has been requested to attend a call out with SAS for obstetric case, the request for this seems to be when coastguard either by sea or air.

Community midwives are on call for triage within…. and for scheduled local

births either in…. a home birth. Supporting initial call outs by SAS or Coastguard is not part of their roles and responsibilities and although the midwives have historically supported this request, it leaves them in a vulnerable position and leaves the area of responsibility vulnerable with no or one midwife covering the area.

It would be good to understand the historical picture and any guidance you have relating to this….

From:….

Sent: 28 May 202610:55

To:….

Cc:….

Subject: Re: Guidance regarding request for midwives to attend call out to obstetric

cases.

…. arrange midwife support in cases of home births in rural or remote locations for their patients…..Expected mothers are in the care of NHS

Highland, we become involved at the point of call for response and transport, although…. good at notifying of high risk patients in particular home births.

….There are high risks with home births in remote areas.

….our response to any call including maternity calls on the small islands. would be a) SAS crew going over on lifeboat

The Scottish Ambulance Service contributes to these meetings and discussions. Minutes, reports and supporting documentation are published by NHS Highland and are publicly available via its website. In terms of section 25(1) of FOISA, information which is otherwise reasonably accessible to the applicant is exempt from disclosure. Relevant publications can be accessed at: Skye, Lochalsh and Wester Ross Publications and Meeting Documents

Q5 - While the Scottish Ambulance Service may hold some recorded information relating to individual elements of activity, such as operational records, staffing arrangements, aircraft use or road ambulance involvement, we do not hold a single recorded dataset or spreadsheet which identifies the total cost of each island maternity transfer across all of the categories listed in your request.

To provide the information requested, the Service would be required to create new information. This would involve identifying each relevant incident, reviewing incident-specific records, determining which elements of staffing, aircraft, road ambulance and other associated activity related specifically to each transfer, and then applying cost calculations or apportionments to those elements.

This would require a detailed manual review of operational and financial information, together with the exercise of complex skill and judgement to determine which costs should properly be attributed to each individual transfer.

The Freedom of Information Scotland Act 2002 provides a right of access to recorded information held by a public authority at the time a request is received. It does not require an authority to create new information in order to answer a request. It is for these reasons we have applied section 17 of the Freedom of Information Scotland Act 2002 to this question of your request, as information not held.

Q6 - While the Service holds records of complaints and Serious Adverse Event Reviews (SAERs), these records are not categorised, indexed or tagged in a way that identifies whether they relate specifically to maternity transfers from island communities.

To determine whether any complaints or SAERs fell within the scope of your request would require a manual review of individual complaint files and SAER records. This would involve examining the circumstances of each case and applying judgement as to whether it related to a maternity transfer from an island community. Such an exercise would require the creation of new information through analysis of incident-specific records rather than the provision of recorded information already held.

FOI 26-281 NHS Highland Maternity Incidents

Freedom of Information Request

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