Cambridge Maternity Services Liaison Committee
We care about your care!
Cambridge Maternity Services Liaison Committee
We care about your care!
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In Attendance:
Sue Allen-Mills, Geraldine Bradford, Penny Brett, Joanne Brown, Angela D’Amore, Bob Dawson, Cheryl France, Victoria Frost, Birte Harlev-Lam, Sara Harris, Maddie McMahon, Jenny Patton, Anna Richardson, Sharon Shipp, Jo Watt, Annie West
Apologies were received from Helen Fairchild, Bridget Halnan, Wilf Kelsall, Sarah Lumley, Sarah Ockwell-Smith, Sue Prytherch, Jo Sharman, Shahida Trayling
Item 10: Date of Annual General Meeting: 7th October 2009 was proposed.
ACTION: BD to confirm
Ideas for speakers were sought and CF suggested having presentations on the new build, including services for the future. This was agreed to be a good idea.
It was suggested that presentations could be from the leads for each planning group. These are PB, Gerry Hackett and Edile Murdoch.
SS suggested also inviting Kevin Brennan (project manager).
ACTION: SA-M to contact Gerry Hackett, Edile Murdoch and Kevin Brennan to ask them to speak
Item 4: A letter from WK regarding aspects of care on Sara Ward that were raised at the last meeting was tabled. The committee thanked Wilf for addressing these issues, which will be explored in more detail at the June 2 meeting.
We welcomed Trish Nolan to the meeting. She is a midwife who works with teenage parents, mostly through Romsey Mill. Also in attendance was one of Trish’s clients, Marie, and her baby son.
The item was tabled by BH-L, who raised the question of what improvements were needed to the services provided to young parents, where they were needed and how they could be made.
Trish described the work she does with the young parents (aged 13-19) whom she works with. She works within a limited geographical area, and there are many areas which do not benefit from the sort of service she provides. She is not formally trained in the area of working with young parents, but she specialises through the desire to help (she was a teenage mother herself, so can relate to them).
MMcM queried the possibilities of training other midwives in this area. BH-L replied that she thought all midwives are different and therefore have their own preferred specialities.
PB made the point that teenagers are often affected by their peers, so work with them would be more successful where there are more of them together.
Trish has between 5-10 attendees at her antenatal classes. She tends to direct her clients to MLBU for their births, which consequently means that there is little feedback on experiences by teenage parents on Lady Mary ward.
Marie expressed her frustrations regarding lack of state benefits due to her age, as she is not eligible for anything other than Child Benefit. Trish is trying to include relevant information in an information pack that they provide (Connexions), and all teenage parents are given Connexions details.
SA-M showed the committee a copy of a form that all teen parents are given antenatally.
BD feels that a specialist lead is necessary, so they can take overall control of what happens across this area. This way all organisations can be linked to work together, building on Romsey Mill’s successes. BD said that all areas should be looked into, to allow maximum success, e.g. locations, links, accessibility, transport to facilitate.
MMcM mentioned the possibility of having mentors – women who may have been teenage mothers themselves - to support young parents throughout pregnancy, labour and birth, perhaps if they have lack of support from their family.
The PCT already has money allocated for funding services like this.
Between October and December 2008 there were eight complaints. This was slightly lower than the previous quarter (when there were ten complaints) despite an increase in the number of births (December was the busiest month ever). Three were Orange level complaints and five Yellow. There were no Red level complaints.
Pain relief remained an issue that was complained about. It also continues to be the case that some complaints derive from inadequate communication, rather than from inappropriate practice.
Complaints go to the member of staff involved, so that they can be dealt with.
AW said that some members of staff who have received complaints have been quite upset, not realising that the issue involved was an issue at the time.
AW said that she and SS regularly communicate, to try and ensure consistency is maintained.
Feedback is received in various ways:
Thank you cards – these are kept on a specific noticeboard in the wards, or given to the relevant member of staff if specified.
Formal letter – these are sent to PALS and then logged under compliments.
Formal letter (unhappy) – these go to BH-L/the ward/PALS/chief executive, depending on who needs to deal with the issue.
‘PALS concerns’ – informal complaints, which are usually received by people just popping in.
MMcM suggested that perhaps more ‘informal’ debriefing opportunities may be needed, so the person involved can reflect on their experience and feel more satisfied, rather than feeling the pressure of making a formal complaint, or the birth being categorised as ‘traumatic’.
Many DU midwives do visit the mothers again after the birth to see how they are.
BH-L receives quite a lot of positive/negative comments cards from patients.
An update on the new build was provided.
The design team are now on board and they made a visit the previous day to the new build committee meeting (20th April 2009).
The strategic output has been agreed – what goes in and where.
The project will be brought to the board in Sept/Oct.
The question was asked about what will be in the existing building, once the new one is finished. There will be a new theatre, a triage area (so women can be assessed there, rather than in DU), a bereavement area, and a High Dependency Unit. There will then be more room in NICU, so what to do with this is under consideration.
The plan for the new build is:
MLBU – on the top floor, with 10 birth/postnatal rooms, which are double rooms, to allow room for partners to also stay.
Fetal Assessment – on the middle floor.
NICU – on the top floor.
There were 5710 babies born in the period from 1/4/08 – 31/3/09, which is a 7% increase. It is still looking busy for the time being.
The home birth rate has dropped from 226 the previous period to 211 in this period.
The transfers-in figures have dropped from 33 to 16.
The total caesarean.section rate has increased slightly from 25.8% last period to 25.9% this period.
A new consultant obstetrician has been appointed.
There will be consultations with mothers who have had caesarean sections following their birth, to explain why the caesarean was required, and reassure them that one may not be necessary in a subsequent birth.
There were 588 deliveries in the MLBU, but it has been closed more frequently, due to staff shortages.
Of the women who labour on the MLBU, 95% will have a vaginal birth, and only 5% will go on to have a caesarean. There is less intervention on the MLBU.
VBAC data will be available in October, when the VBAC clinic will have been running for 12 months.
To help ensure that women go into the Rosie at the appropriate time, they are asked to phone the hospital so that it can be established what stage their labour has reached. It may be possible for women to call a community midwife and ask her to visit to check.
Quality Indicators:
Staffing improving
Deliveries outside unit rates improving
Caesarean rates are up slightly
3rd and 4th degree tear rates are improving
Breastfeeding data is based on the mother putting her baby to the breast, not necessarily establishing breastfeeding.
The smoking rate is 8%, which is about half the national average.
One to one care – the Rosie will be piloting a new tool for collecting data on this, and collection will commence shortly.
No meeting was held, so there is nothing to report.
When the tool was applied in September 2008, the committee was assessed as being at Level 3 (‘MSLC meets at least quarterly with good attendance and is actively chaired’) to Level 4 (‘MSLC meets at least quarterly with over 70% attendance and has an active work programme’). It was agreed that we are now at Level 5 (‘MSLC meets regularly, has strong attendance and active work programme, and incorporates at least one third user representatives’), although not yet at Level 6 (‘MSLC meets regularly, is well attended, and has an active work programme, including sub-groups with input from medical, audit staff and users’).
There are four more committee meetings this year, and topics for these were planned.
SA-M felt that each agenda should contain no more than one substantive issue, as experience has shown that there isn’t sufficient time for adequate discussion when more than one is included.
The following schedule was agreed:
June 2: feeding of infants being cared for other than on Lady Mary
July 14: caesarean section rates (PB); VBAC clinic (PB); WK’s research on caesareans and breastfeeding
September 8: review meeting – re-application of DoH Audit tool; review of progress on all items discussed so far during the year.
November 17: management of breech presentation
SA-M proposed that the MSLC should have a stand at the NCT Baby Show on the 11th October, which is being held at Sawston Sports Centre. The costs are £50 for a small stand or £90 for a larger one.
MMcM said that she has already reserved a larger sized one and suggested sharing with the MSLC and splitting the costs, as was successfully done at the Show last year. This was agreed.
ACTION: MMcM to send cost info to BD
MMcM mentioned that as Rachel O’Leary can now no longer attend meetings, the committee lacks a breastfeeding representative, and proposed that JW be invited to fill the gap. JW accepted the invitation.
VF showed drafts of new MSLC promotional material. There are posters, A5 flyers which are printed on the front and back, basic but informative business cards and a new welcome pack for new members. The intention is for these to be made available to parents via, for example, Health Visitors, libraries and Children’s Centres.
SA-M has set up a new e-mail address for the MSLC, as another way for service users to get in touch with the committee. E-mails received on this address can be accessed by any committee member who has the password.
Rosemary Course has retired, and the committee would like to express its appreciation of the work that she did on the MLBU, and her input into the MSLC.
On Wednesday 13th May, there is to be a roadshow in the Rosie, from 1.00 pm – 3.00 pm, in Seminar Room 5 for Breastfeeding Awareness Week, and to launch the new breastfeeding guide. There will also be a stand in the Rosie’s main reception. It is also hoped to get something into the main hospital.
It is National Midwifery Day on 5th May, and there will be a display.
AW reported that three out of 12 new height-adjustable cots have now arrived. The nursery has also been decorated in Lady Mary ward, and is now known as ‘Parents Room’.
Tuesday 2nd June, 2009, 12.00 – 2.00pm
Seminar Room 4, Rosie Maternity Hospital
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