Cambridge Maternity Services Liaison Committee
We care about your care!
Cambridge Maternity Services Liaison Committee
We care about your care!
In Attendance:
Sue Allen-Mills (Chair); Callie Copeman-Bryant; Angela D’Amore; Kate Evans (for Annie West); Boo Newns; Pablo Newns; Sue Prytherch; Jo Sharman; Anna Shasha; Heather Sturman
Apologies were received from: Joanne Brown; Jan Butler; Nicola Clapperton; Julie Gardiner; Maddie McMahon; Charlotte Patient; Sarah Ockwell-Smith; Jo Watt; Annie West; Kate Wilson
Agreed as a true record.
3.3.4(i) - JG and SA-M have still not yet been able to meet Ben Myer from the Ambulance Service to discuss what guidance community midwives should give to parents about providing information to the ambulance service if they need to call an ambulance when there is no emergency, but a midwife is not expected to arrive in time for the birth. SA-M is waiting to hear from Ben on this.
3.3.5 - SA-M has been unable to get any feedback from Sheila Reed on the outcome of the fetal medicine meeting at which trialling the use of Paling Palettes as a tool for discussing risk with parents was to have been discussed. KE said that Sheila is currently on long-term sick leave. SA-M to contact her again in August.
3.8 - SA-M has heard back from the Family Nurse who reported the feedback from young women about their experiences in the scan department. The young women concerned were unable to recall why they had felt negatively about their experiences and considered that subsequently their care had been excellent. SA-M has passed this on to Trish Chudleigh. The Family Nurse said that she had found that when young women reacted negatively to their care, this often reflected other things that were going on in their lives at the time, and this should be borne in mind when processing their feedback.
3.11 - Neither KW nor JW were at the meeting to report on any discussion about the training of breastfeeding peer supporters.
4 - SA-M has e-mailed Andrew Lansley several times to invite him to act as guest speaker at the AGM, but has received no reply. She therefore called his constituency office and spoke to his assistant, who said he would bring the invitation to the attention of Andrew Lansley’s diary secretary. It was agreed that we should have a back-up speaker or speakers in case Andrew Lansley is unable to accept the invitation, or needs to back out at the last minute. As this would be on a ‘reserve’ basis, it was felt that it would not be appropriate to approach an outside person, so it was agreed that AS would arrange something, possibly with JB and/or Birte Harlev-Lam (now at the SHA).
5 - SA-M had sent AS some suggestions about updating the Rosie website. AS regards this as a priority, and wants to arrange for an interested midwife to be given some dedicated time to work on the update.
10 - JW was not present to report on her investigation into breastmilk donation procedures.
Pablo Newns was welcomed to the meeting, as a father with recent experience of using the service. He said that generally his experience had been good, and that this had been the case for other fathers he had spoken to. He did raise various issues, however: (i) being given contradictory information in pregnancy, e.g. on when to go to hospital in labour; (ii) finding it very upsetting to have to go home and leave his wife and baby in hospital after the birth; (iii) some aspects of their birth plan were not adhered to (e.g. his being asked to cut the cord when he didn’t want to, and not being left to tell his wife the sex of their baby); (iv) professionals’ attitude and choice of language not always being inclusive and involving of fathers.
These points were discussed. (i) AS emphasised the importance of parent education; (ii) it was suggested that guidance on writing a birth plan could be provided on the Rosie website, including a birth plan template. JS raised the question about parents with low literacy levels writing birth plans. KE said that in this situation, community midwives would help; (iii) the problem of fathers being unable to stay in hospital after the birth is recognised, but cannot be resolved because of lack of space. It will be more possible in the new unit; (iv) the need for professionals to avoid language that is exclusive of fathers was acknowledged.
HS circulated some feedback she had received from fathers. This was also positive – fathers reported midwives/sonographers being open and answering their questions and that they were encouraged to be involved and treated as equals with their partners. Issues raised were (v) long clinic waits; (vi) the need for a quiet area on Lady Mary; (vii) the amount of time it takes to get from the car park being a concern when you’re having to take time off work for antenatal appointments. One father said that he would not be interested in any extra services for partners as he did not consider this a good use of NHS resources.
SA-M reported feedback she had received. Again this was overwhelmingly positive. Care was described as excellent, friendly, helpful, reassuring, and the fathers reported that they’d felt involved and welcome. Issues that were raised (in addition to those listed above) were (viii) lack of preparedness and not knowing what to expect, especially after a caesarean; (ix) lack of support for fathers postnatally (lots of women’s groups but few for men); (x) long clinic waits when having to take time off work; (xi) the cost of parking when partner and baby are in hospital for 2-3 days.
JS said that a lot of the Children’s Centres had groups for fathers. AD’A pointed out that there is a dads’ group on NICU/SCBU. The issue of clinic waits was discussed. It was acknowledged that these may be unavoidable, but it was felt that parents should be made aware that delays might arise, so they’re prepared for this. With regard to parking, reduced charges are made in some circumstances, but the shortfall to the company who runs the car parks has to be made up by the hospital. This is something that is discussed on an ongoing basis. It was pointed out that the issue of hospital car parking charges is a national one.
CC-B said that she has recently been asked by her clients about GBS screening, and asked what is happening with regard to this. She said that women are buying private screening kits on-line because routine screening is not offered. (GBS is a common bacteria which is carried vaginally intermittently by around 25% of women. It can be picked up by the baby during labour, and while most babies are unaffected by it, a small minority become very ill, or even die.) KE and AS said that the Trust follows the national recommendations in not offering routine screening, as the HVS screen provided by the NHS is unreliable. Instead, women are offered intravenous antibiotics in labour if one or more circumstances apply in which there is an increased risk of the baby developing GBS infection, should the woman be a carrier, as a way of helping to prevent the baby from acquiring an infection. CC-B made the point that the use of antibiotics is not without controversy and that a 2009 Cochrane review found that giving antibiotics is not supported by conclusive evidence.
SP confirmed that being a known GBS carrier is not an exclusion criterion for women using the Birth Centre, and that antibiotics can be given at home if a woman who carries GBS chooses to have a homebirth.
There is an information leaflet on GBS available for women.
AS presented the figures for June, which have become available since the meeting’s agenda was circulated.
There were 485 births in June, slightly down on May.
The homebirth transfer rate was 2, but in May it was 9, and the reasons for this higher figure are being looked into.
The caesarean rate was 27%, an increase over the April figure of 24.5%. AS reaffirmed the Trust’s commitment to bringing this figure down. SA-M asked whether as the second highest reason for EMCS was poor/no progress (the highest being suboptimal CTG), it should be investigated whether anything else could have been done in those cases to assist progress. AS agreed that it should. She also remarked on the number of ELCS performed on maternal request. KE pointed out that the collection of data on the reasons for caesarean sections did not always reflect the background to the reason.
There were 58 births on the Birth Centre. The Centre is working to increase the numbers of women who use it, and to make it the default for women who don’t have any complications. CC-B reported difficulty in finding the Birth Centre’s phone number. SP said that there are stickers providing the Centre’s contact details that should be attached to the handheld notes. She will check that this is happening.
ACTION: SP
The midwife to birth ratio is currently 1:37.1, but 18 new staff have been recruited and should be in post by the end of the summer, which will reduce the ratio to the target of 1:34. The intention then is to move towards the ratio of 1:30, as recommended by the SHA.
A lot of compliments have been received. Complaints received related to (i) lack of support with and conflicting advice on breastfeeding (two complaints); (ii) the attitude of an MCA; (iii) difficulties booking scans by phone – this is being changed so that women are sent appointments by post.
SA-M said that a message had been posted on the website commenting favourably on the care provided by community midwife, Ailsa Potter, and asked for Ailsa to be told about this, which AS will do
There was no one present to provide a report.
AS tabled some drawings of the proposed finish and fittings for the birth centre rooms, with samples of the finishes. She, JB and SA-M had attended a meeting with the architects to discuss the plans, and other options for colour schemes etc are going to be provided for consideration. It is still the expectation that building will start in November.
10.1 - KE: the Young Families Baby & Toddler Show in October is going to be donating proceeds from the door to the Rosie. She has been asked by Young Families if the MSLC wish to have a stand at the show. SA-M has already contacted them about this. At the committee meeting following last year’s show (organised by the NCT), it was suggested that the MSLC and the Rosie share a stand for this year, but as the Rosie has already made arrangements to have their own stand, SA-M will request an adjacent one for the MSLC.
10.2 - CC-B: was told by a mother that a GP in Sawston had given her very inaccurate information about breastfeeding. AS said that all health professionals at the Rosie will be given breastfeeding training, but GP training comes under the PCT. She will contact the BFI representatives on the PCT to let them know about this incident.
ACTION: AS
10.3 - AS: red books are now being given out at birth.
10.4 - AS: VTE risk assessment is up and running. Women who are found to be at high risk of DVT are being given an anticoagulant to self-administer postnatally.
10.5 - AS: formula milk is no longer being provided on the unit, except in extremis.
10.6 - AS: midwives started the new long shift rotation on July 5.
10.7 - AS: a DVD about the Rosie has been produced, and will be shown to the MSLC for comment in due course. It received a favourable response from antenatal in-patients who watched it. It needs a map of how to get to the Rosie adding, which will cost £120. AS asked whether it would be possible for this to come out of the MSLC budget. SA-M will ask NC.
ACTION: SA-M
10.8 - AS: invited 2-3 user reps to spend time on Lady Mary to talk to women about what they think of it, and to sample the lunch. SA-M will contact the user reps about this.
ACTION: SA-M
10.9 - SA-M: need to make arrangements for an MSLC stand at the Addenbrooke’s Open Day. KE believes that this is not now happening. SA-M to check.
ACTION: SA-M
10.10 - SP: planning to raise the profile of the Birth Centre by putting posters up in all the GPs’ surgeries and Children’s Centres.
7 September, 12.00 pm – 2.00 pm
Addenbrooke's Treatment Centre 4
The next meeting will review the committee’s activities over the past year.
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