Cambridge Maternity Services Liaison Committee
We care about your care!
Cambridge Maternity Services Liaison Committee
We care about your care!
Sue Allen-Mills (Chair); Jan Butler; Nicola Clapperton; Kate Evans; Victoria Frost; Ashley MacDonald; Sue Prytherch; Anna Shasha; Heather Sturman; Emma Tregenna; Hannah Waters; Jo Watt
Guest: Sue Woolley
Apologies were received from; Cheryl France; Karen Holmes; Maddie McMahon; Perpetua Nicholas; Cassie Rason; Claire Thompson; Kate Wilson
Approved.
3.3.7 (i) - Research midwife Jane Ford has completed her analysis of the caesarean rate using the Robson criteria, and has offered to give a presentation of her findings to the committee at the meeting on January 24. Given that there are other issues relating to caesareans for the committee to discuss, including the new NICE guidelines, it was decided to devote the January meeting to the topic of caesareans. SA-M will check whether CP will be able to attend. NC will ask Helen Geall if she would attend, given the funding issues associated with caesareans.
ACTION: SA-M, NC
3.5 - SA-M has sent JB details for a link to the MSLC website to be set
up from the Rosie website.
SA-M has obtained a copy of the full CQC 2010 Maternity Services Report from the CQC, and has circulated this to the user reps. Acknowledging that the data in it date from nearly two years ago now, she asked whether there had been an action plan formulated in response to it, particularly with regard to the areas where the results fell in the ‘worst performing’ range. AS and KE reported that there had, though AS said that she would check on this. The draft report of the CQC’s recent visit is now available. AS will present the findings when the final version has been received.
4 - SA-M last week attended a community midwives team leaders meeting, to raise the question of midwives’ awareness of the MSLC. All the team leaders were familiar with the committee and said that the midwives were too, but that they would check on this. They suggested various ideas for promoting awareness of the MSLC, and securing feedback from users, including informing women about the committee at booking appointments.
4. Work plan update
MSLC operation
• Revive welcome pack for new members: VF had a copy of the previous pack which she has sent to MMcM for updating
• Member recruitment material: AMacD has produced a draft leaflet which SA-M has commented on. AMacD is about to work on formatting the document, which should be ready shortly.
Securing feedback from users
• Monthly visits to the antenatal clinic: These are continuing. The results of the first four visits will be reported on in December.
• SA-M has heard back from the County Council with regard to establishing links with Children’s Centres. The logical way to proceed with this is to link to the ‘base’ and ‘satellites’ groupings that the midwifery teams are working with. There are eight of these. SA-M has asked for volunteers from among the user reps to act as a link person for each of the groupings. Four people have come forward so far, and SA-M is hoping to secure further volunteers.
Service issues – maximising normality
SA-M and JB met last week to discuss the areas it has been agreed the committee will focus on with regard to maximising normality, in particular, antenatal classes and midwives’ practice with regard to facilitating measures in labour that can help to maximise the chances of labour proceeding normally.
• antenatal classes: These are currently under review by the Trust, with community midwife team leader Louise Mitton leading. The review is scoping knowledge and skills among midwives and looking at formalising a structure for classes. JB pointed out that currently the provision of classes is patchy, and access to them is inequitable. It was proposed at the last meeting that a sub-group of interested members be formed to make proposals about antenatal classes, but given that the review is underway, SA-M suggested that it makes more sense for the committee to feed into this. SA-M has e-mailed Louise to ask her in what ways it would be most helpful for MSLC might contribute to the review.
• midwifery practice with regard to facilitating measures that maximise normality: JB already has actions in the pipeline in relation to this, which she has been working on with SP. These include two study days for midwives next year on normalising birth, to be led by Denis Walsh and Diane Garland. A visit has also been made by Birthlight, to help to educate midwives about measures that contribute to normalising birth, and there are plans for a future rolling programme of visits. JB is keen to address the issue of normalisation for high risk women. SA-M asked if there was anything the MSLC could do to contribute to the normalising agenda. JB suggested that one way of helping would be to provide input into what was taught in antenatal classes about measures that can help to maximise the chances of labour and birth proceeding normally.
JB is also keen to work with supervisors of midwives on this issue.
JB raised the concern that the homebirth service is suffering because of the lack of staff resources in the community. She is working to address this.
VF, returning to the committee after the birth of her baby, has offered to lead a team to work on formulating and implementing a programme of publicity. Three user reps have volunteered to be part of this. Also, a student midwife who attended the AGM has expressed an interest in helping the MSLC with technical/IT/editorial issues, and would be able to support the publicity team.
VF produced a publicity plan earlier in the summer, about 25%-30% of which has been implemented. This now needs to be revisited by the team.
ACTION: VF + publicity team.
Over the summer, HW helped to try and get posters and leaflets into GP’s surgeries, through contacting practice managers, but responses were only received from six of them.
It was suggested that the e-mail to the practice managers be resent. NC suggested contacting Sue Last, Assistant Director of Patient Experience and Public Engagement, at the PCT to see whether material could be distributed through Gateway. It was also proposed that Wilma Smith, GP Liaison Officer, be asked if a representative from the MSLC could attend a GP Liaison Committee meeting to inform GPs about the MSLC.
ACTION: SA-M to follow up with HW, NC and Wilma Smith
The AGM was deemed to have gone well. There were 35 people in attendance. The presentations were well received, and the committee would like to record its thanks to the speakers. There was a good contingent of student midwives present, and it was felt that it was a good way for them to learn about the MSLC. It was also a good forum for women to meet and talk to each other, as well as to health professionals. AS suggested that it would be a good idea to hold a meeting before the next AGM to offer parents and professionals the chance to chat to each other. It was agreed to do this in March-April next year.
Sue Woolley spoke about the planned changes to maternity notes. The intention is that there will be three separate booklets, one for antenatal care, one for intrapartum care and one for postnatal care. Their format has been designed to tie in with the patient pathways that JB has been developing. They will be Rosie-specific. There were no national or regional models that were found to be suitable to follow.
A survey of service users (79 people) has been carried out. This showed that women want a clear timeline showing what happens when, clear information about whom to contact when, and space for test/scan results.
The possibility of giving women a folder in which all letters, scan results etc can be stored is being explored.
The intention is for the handheld notes to be a full record, including any in-patient or clinic records, with a ghost file being maintained at the hospital.
The notes will be professionally designed.
SA-M asked if the notes would include a model birth plan. There will be pages in them for a birth plan to be included.
SA-M also said that it had been suggested at the community midwives’ team leaders meeting that the notes could include information about the MSLC. SW said that this could be done.
The notes will be piloted in January, with the intention of adopting them in March. SW hopes to have draft notes available to show to the committee at the December meeting.
Item deferred because MMcM was not in attendance.
In MMcM’s absence, AMacD raised the topic of holding another doula ‘meet & greet’ session for midwives. The last one was in February 2010, and at the time it was agreed that it should be an annual event. It was suggested that a session be arranged for February. AMacD/MMcM to liaise with AS on this.
ACTION: AMacD/MMcM
AS presented the figures for September.
• There were 467 births.
• There were 9 homebirths, reflecting a decline in the homebirth rate.
• The caesarean rate was 26.5%, slightly down on August and July.
• The average VBAC success rate for the last six months was 62.7%, with an average uptake of 40.7%.
• There were 68 births on the Birth Centre, lower than in June and July. SA-M pointed out that the number of births overall was lower in September than in June and July, and that it would be interesting to see Birth Centre births given as a percentage of the total. AS to ask Emma Te Braake about this.
ACTION: AS
JB has been engaged in promoting the Birth Centre, including in John Lewis
• There was one unit closure in September, but for 28 hours.
AS reported on the complaints to PALS in the quarter April-June. There were 20 complaints, one more than the previous quarter. There was one serious incident, relating to the heel prick test. This led to a review of procedure.
Several complaints related to Lady Mary Ward. These included complaints about analgesia being given late, lack of support with breastfeeding, slow response to buzzers, staff attitudes, and communication problems. As a result of these complaints, the ward was visited by the PALS Patient Experience Satisfaction Team, who investigated the issues raised, and an action plan was formulated. The level of complaints about the ward has fallen subsequently. The practice has been introduced of the ward manager speaking to women on the ward every day. Also, the practice of intentional rounding has just been started. This involves maternity care workers speaking to each woman on the ward every three hours, to check whether they need anything.
Complaints were also received about being left on hold for a long time when calling to make a scan appointment. The procedure for appointments has now been changed, so that women are sent an appointment in the post, and only have to ring if they want to change it.
There were also complaints about information not being given in the community.
When complaints are received, these are investigated and an action plan is put in place.
Midwives are now receiving training in complaint handling and resolution.
There were 65 PALS enquiries, and 17 appreciations of care. A mother who had suffered the loss of her baby requested donations in lieu of flowers at the baby’s funeral, and donated £300 to the unit. Another mother donated pouches of toiletries to be made available to women who had to go into hospital in an emergency, and had no toiletries with them. Appreciation of these donations was expressed.
The structure of the building is now complete, and the construction of the interior is underway. As a result of mock-ups of the rooms having been constructed, changes have been made to some of the planned fittings.
AS reminded the committee that parents are now being charged £5 for scan pictures.
December 13, 2011, Rosie Maternity Hospital, Seminar Room 4, 12.00 – 2.00
Following the meeting, on JB’s behalf, SA-M showed the user reps present the colour swatches for the walls in the new Birth Centre. These were approved.
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