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), Nicola Clapperton, Angela D’Amore, Jo Goddard, Birte Harlev-Lam, Maddie McMahon, Sarah Ockwell-Smith, Anna Richardson, Sharon Shipp, Gillian Thomson (for Jo Sharman)
Apologies were received from:
Penny Brett, Jo Brown, Cheryl France, Sue Prytherch, Jo Sharman, Shahida Trayling, Jo Watt
The minutes of the previous meeting were agreed as a true record.
The DoH User Involvement Audit Tool, elements of which have been reviewed individually over the last year, was re-applied in full. Scores were (on a scale of
1-6, low to high):
Element 1: Information available to individual users - Level 4
Element 2: Structured asses to users’ views and feedback - Level 4
Element 3: Existence of MSLC involving users – Level 5
Element 4: User involvement informing service development – Level 5
Element 5: Information available to enable effective user involvement – Level 4
Element 6: Financial support for users – Level 3
Element 7: Training available to MSLC - Level 3
Element 6 requires confirmation as to what is available from the PCT. Formal budget set-ups will be looked at in the January meeting.
The overall score was 28 (21-28 = encouraging performance/28+ = excellent). This is a good improvement on September 08’s score of 20 (room for improvement).
4.1 The postnatal booklet
The postnatal booklet is now completed and is being distributed to all mothers following delivery.
4.2 Use of codeine by breastfeeding mothers
An information sheet on the use of codeine by breastfeeding mothers still needs to be completed. A search for a similar leaflet used in other services has not been successful. BHL will discuss with Nigel Gooding to get one drafted.
4.3 Baby Friendly Initiative
The Rosie has registered their intent to go for Baby Friendly Status and Jo watts is working towards getting the certificate of commitment by end of this year.
4.4 Rosie website
SA-M has had a meeting with the Addenbrookes webmaster. He acknowledges that the Rosie website has some shortcomings (some of which relate to it being shoe-horned into the wider Addenbrooke’s site structure, and some of which are to do with parts of it being outdated) but improving it is a problem because of lack of staff. In general, updates to the Addenbrooke’s site tend to be made only when driven by specific parts of the Trust. A three-stage strategy for improving the Rosie’s site was agreed on. Stage 1 is for obvious errors or misleading information to be flagged up by users. RO’L has offered to help SA-M with this. These will need to be looked over by someone from the Trust before being changed on the site. Stage 2 is for the content to be updated and extended, as has been done with the neonatal services information. This should be done with user input, but would need to be led by someone within the Trust so a volunteer is needed for this (as happened with neonatal services). Stage 3 would be for the Addenbrookes site overall to be revised, but this is a much wider issue.
4.5 Use of complementary therapies
SP is looking into introducing aromatherapy on the Birth Centre but will provide feedback on this at a later date. Baby massage is being taught weekly in the Rosie. It is planned to offer complementary therapies in the new build.
4.6 Doula-provider co-working
Doula relationships with midwives, particularly in hospital, remain open to improvements. MMcM suggested an open session for midwives to meet the Doulas and ask questions. This led to discussion about the Goodwin Doula Project (a project to train volunteer doulas, which started in Hull and which has received government funding for it to be extended to other areas). BHL to arrange with MMcM dates for an open session with midwives.
4.7 Services to teenage parents
JG provided an update. DoH target for 2010 is to halve the rate of teenage pregnancies; Cambridgeshire is on target for this.
2008/09 – get stats for bookings of teenagers.
Pathways have been developed for pregnant teenagers, with two options depending on whether the mother is low to moderate risk, or high risk. Low to moderate risk mothers will be under the care of community midwives, while high risk mothers will receive care from a teenage pregnancy midwife. There are three new teenage pregnancy midwife posts (2WTE) based in the areas where the rates of vulnerable teenagers are highest.
It is hoped that these pathways will be in place by the end of the year.
Shazia Bhatti is the obstetric lead on teen pregnancy.
4.8 Publicity/website
Publicity material is at the printer and should be ready for next week. MSLC will be having a stand at the NCT baby show.
The MSLC website is in the process of being updated and given a fresh look. The new version should be live at the beginning of October.
Self-assessment of progress on meeting the requirements laid down in Maternity Matters has been done through the PCT. The SHA has made recommendations for the following areas: direct access to the midwives, choice of PN care, 1:1 care in labour, midwife ratio, Maternity Services spec. PCT and Trust action.
BHL reported that the PCT leads on this across Hinchingbrooke and the Rosie. The PCT has scored itself on an audit tool which reviews progress. Score of 1-10 = poor to excellent.
Access to a midwife – 4
Booking by 12/40 – 10
Choice of place of AN care – 5
Homebirth clinics/Birth Centre choice – 9
PN care – 4
1:1 care in labour – 8 (Hinchingbrooke – 6) This means women in established labour have one midwife who is not caring for anyone else.
Continuity of care – 7
Provision of PN care - 7
Development of whole Maternity Pathway, this is under construction.
Meeting EWTD – 7
MW – birth ratio – 8
Vulnerable groups – 7 Travellers is an area with room for improvement.
Developing maternity networks – 7
Consumer satisfaction surveys – 8
NC: key issues from SHA to work on – i) Direct access to a midwife ii) North East Essex PCT – have cards in pharmacies.
SA-M raised the issue of repeating the survey of women’s experiences of Lady Mary Ward which has been carried out among members of the NCT, and women using the services of La Leche League and Doula UK, in October for the last two years, and asked whether instead a more structured survey should be done, as BH-L had suggested when the results of the October 08 survey were presented. It was agreed that a structured survey would be preferable,
BHL to email EoE Heads of Midwifery for existing surveys for women.
The new build is on schedule and the design has been signed off. In the vacated space in the existing build, there will be expansion of the theatres. The creation of a triage area on Delivery Unit is currently being addressed.
Figures were presented for August.
There were 422 births which is the lowest monthly number for about three years. There are 530 bookings for September. There remain a low number of twins.
13 homebirths.
Caesarean section rate is 25.8%. A weekly c-section meeting is being held to review all the c-sections with multi-disciplinary team.
RBC was closed for 22% of the time.
Breastfeeding and smoking rates are on target.
PPH on target.
Doing some work on 3rd & 4th degree tears.
No up-to-date data on staffing.
SA-M asked if data could be provided on the incidence of normal birth, as defined by the national Maternity Care Working Party.
There were seven complaints in quarter 1 (Apr-June) which is a decrease since the previous quarter.
2 in April – One person was unhappy with advice given over phone; one was unhappy with the content of antenatal classes.
2 in May – A grandmother complained about breastfeeding advice that had been given. The other complaint was regarding a 20 week scan – a problem was picked up but the sonographer was felt to be dismissive.
3 in June – The Unit closed as there were no available beds. One couple rang in and were asked to go to Hinchingbrooke but came here anyway. The Rosie has closed eight times this year so far which is an 8% increase since last year. The second complaint was about Group B Strep management – the baby was given IV antibiotics. The third was about cord blood harvesting.
No compliments data available. There was some discussion about cards and other compliment letters. A very positive letter had been received from a woman who was in the Rosie for some weeks. Her partner works in a Trust in London. Very detailed letter complimenting all aspects of the service.
Deferred because of lack of time.
SA-M asked everyone present to advertise the AGM as widely as possible.
NCT baby show 11 October. The MSLC is sharing a stand with Doula UK. Looking for volunteers to man the stand.
At the next meeting, topics for meetings in 2010 need to planned, so please bring suggestions.
17 November 2009
12.00pm – 2.00pm
Seminar Room 4, Rosie Maternity Hospital
