Minutes of the meeting held on 15 April 2008
Present
Bob Dawson, Louise Mitton, Rachel OLeary, Rosemary Course, Sue Allen-Mills, Victoria Frost, Joanne Brown, Jo Sharman, Anna Richardson, Cheryl France, Lisa McKechie, Sharon Shipp, Wilf Kelsall, Penny Brett, Birte Harlev-Lam
1. Apologies
Apologies were received from: Annie West, Rita Levett, Leslie Kay, Maddie McMahon, Bridget Halnan, Nisrin Marcus, Angela DAmore, Charlotte Patient.
2. Minutes of Last Meeting and Matters Arising
2.1 JS presented a new flyer re breastfeeding support groups. JS to send to BD for the minutes.
2.2 AGM Agreed date of 7 October 2008 for AGM at Fields Childrens Centre.
2.3 DARZI deferred to future meeting.
2.4 East Cambs Representation LM to confirm email addresses for Leslie Kay.
3. Head of Midwifery Report
BHL DoH has produced C Section Tool Kit. Rosie has started using it. DoH looking for early implementation. This will result in support from DoH.
MSLC to support? Yes
Stats
Bookings are on an upward trend
2% increase 2006/07 07/08
home births increased by 18% on previous year
C Section reduced by 3 1/2%
MLBU increased by 46% over the years 06/07 07/08
Establishment 28 vacancies:
new recruits are coming
permission to over recruit to address turnover
Infant feeding m/w re-advertised
Senior midwife post natal/antenatal
Resuscitation m/w
Trust commitment to midwifery is very strong enabling the HOM to review birth rate and recruit accordingly
quality indicators see the report
MRSA very low numbers
Neonatal re-admissions mainly feeding problems
BHL to send to BD
Penny Brett and C Section
Prevent first cs working party to look at who should have
- previous c sections
- no indications medical/obs
Consultant m/w clinic focuses on planning births outside current guidelines - feedback is very positive for this clinic
Integrated care pathway in development
vaginal birth after cs good success rate, low uptake
continued obstetric/consultant m/w clinic is optional
natural birth
- submitting early adopter bid
- practice development capacity increased
- PB lead role in MLBU
- new build birth centre
Need to discuss C section and breastfeeding infant feeding midwife will have a role
4. Perinatal Centre Project
Lisa McKechie in attendance.
LM is reviewing pathway for women and babies updating facilities, addressing facilities that are not fit for purpose.
LM seeking user views as well as staff to input into future vision.
End of February focus group, 25-30 attended. Issues raised:
Reception areas, especially out of hours, not good need someone to greet
Heat in wards
Parking facilities
Scan waiting room too small
No child care facilities/play area in outpatients.
Committee asked for opinions on:
Positive aspects of service
What aspects of service could be improved
2 things to change - what would be priority
LM will produce service model followed by an options appraisal. MSLC to provide 2 members to assess 7 benefit criteria.
Time frame
Outline case to Board 1 July
Options appraisal 15 May
Positive Aspects:
Community neonatal team excellent
Milk kitchen
People feel well cared for
Staffing of a high quality
Baby checks are done before they go home very positive
MLBU is very well thought of as a resource as:
- Emphasis on natural birth
- Midwife led
- Environment is less clinical
- More re-assuring
- Encouraging staff
NICU
- Cannot praise it highly enough
- Staff excellent
birth afterthoughts service
psychological support access postnatally
Fetal medicine very professional staff willing to give time to women
Fetal medicine very quick to respond
Homebirths are well supported
Improvements:
Difficult to get appointments with community midwives, access to scheduled appointments
No continuity of contact
Community midwife very busy
No visits postnatally
too busy to see me
Fetal medicine
- Staff not as attentive and friendly as needed
- Scan booking telephone very frustrating could take a long time
Child care facilities linked to out patients/fetal medicine
Consistency between obstetricians in terms of birth options
Staff ratio to mothers too high
Transfer to other hospitals from SCBU way it happens and why it happens
Separation of multiple births in special care units
Wilf Kelsall reported on proposed changes to neonatal care following the neonatal network review
Need to communicate clearly with parents, antenatally, as to potential for transfer and separation of special care babies,
Improve communication re risks and implications for parents.
BHL need to discuss what ifs
How best to highlight information and discuss what ifs antenatally
When would it be best to discuss
? discuss this at 36 weeks this is too late
PB need to do brochure re neonatal services and range of services and the potential for transfer
WK we will come up with perinatal network
Need to have enough beds
Yes, help people to understand the process better
Need space for dads/siblings in the birth centres
Building
Postnatal beds need more space
More pools are needed in MLBU
MLBU pool is not as good as the delivery suite pool more cramped
Awkward lay-out
Parents rooms near special care cots
Temperature and circulation of air pool
Food on ward needs to be more variety/substantial
Beds need to be improved
2 things to suggest re-design
achieve Baby Friendly standard across the community/hospital
nice environment, not too clinical safe place to birth, 5* level
homeliness, encouraging to families
milk bank more visible raise profile of human milk
parking near to birth unit
Feedback from other MSLC members BD to send out LM to send BD the form.
5. Supervisor of Midwives (SoM) leaflet
LM wants to raise profile of the supervisor.
LM referred to the hospital rolling information that will include info on the supervisor.
SoM is an additional quality measure
Each m/w has an allocated supervisor and is available on call
SoM could have a role if a woman wants to change her midwife
SoM provides clinical expertise to help guide and support in complex situations both for mother and m/w
SoMs are responsible to the SHA
Focus is standards and protection of mothers and babies
6. Kingston Baby Guide
Agenda to next meeting
7. NICE Nutrition Guidance
Breast-feeding peer supporters job for the new nutrition midwife
8. Chairperson Arrangement
SA-M will take this on proposed by ROL, seconded by all.
9. Any Other Business
Hospital Open Day 10 May 2008
B/F awareness week same day.
10. Date and time of next meeting
27 May 2008
12.00pm 2.00pm
Rosie Seminar Room 4
