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); Angela D’Amore; Kate Evans; Karen Holmes; Maddie McMahon; Perpetua Nicholas; Cassie Rason; Heather Sturman; Claire Thompson
Apologies were received from: Jo Brown; Jan Butler; Nicola Clapperton; Cheryl France; Ashley MacDonald; Anna Shasha; Sharon Shipp; Emma Tregenna; Hannah Waters; Jo Watt; Kate Wilson
KH was welcomed to the meeting as a new user rep.
At the last meeting CC-B queried whether item 5 of the minutes of the meeting of May 24 correctly reflected what CP had said about the association between induction and the caesarean section rate. CP has confirmed that she said that after 41 weeks there is no significant difference in the rate of caesareans between women who go into labour spontaneously and those who are induced. The minutes of the May 24 meeting have been modified accordingly.
3.7 (i) - With regard to the question whether the scale of the Rosie’s caesarean section rate is a result of the proportion of high risk women in its population, research midwife Jane Ford has been analysing the rate using the Robson criteria, but her first attempt was unsuccessful, and she is repeating the analysis. SA-M reported having read a BMJ article on variations in caesarean rates among Trusts in England, which examined the question whether differences in caesarean rate were a result of differences in the level of risk factors among the women served by each Trust. The authors found that when the rates were adjusted to take account of variations in maternal characteristics and risk factors, the variation in caesarean rates between Trusts remained virtually the same (there was around a 1% difference), suggesting that variations are not a result of population differences. As the difference between Trusts in emergency caesarean rates was greater than for elective caesarean rates, the authors concluded that attempts to reduce caesarean rates should examine issues relating to emergency caesareans.
5 - AD’A has spoken to the play specialists who provide childcare for parents who have babies in NICU and they are in principle willing to offer care for MSLC meetings. NC has contacted them to find out about costs and how many children they are able to take, but has not yet had a reply There is also the issue of finding an available room, preferably in proximity to wherever the committee meeting is being held. AD’A said that this might be feasible in the ATC. SA-M said that most meetings next year will be in the ATC.
JB had said that she would arrange for links to the MSLC website to be set up from the Rosie website, but this seems not to have been done. SA-M to check with JB.
ACTION: SA-M
AS had offered to make the full CQC 2010 Maternity Services Report available to the MSLC but this has not yet happened. KE will look into this. KE reported that the CQC had just made another unannounced visit to Lady Mary Ward. The MSLC will be informed about their findings in due course. (Reports are usually produced six weeks after a visit.)
ACTION: KE
AD’A said that BLISS will shortly be publishing a UK-wide report on neonatal services.
SA-M tabled a draft work plan for the coming year to report on action so far with regard to this, and to plan future actions.
MSLC operation
• Revisit and clarify Terms of Reference: Scheduled for January 2012 meeting. Lines of accountability also need clarifying
• Revive welcome pack for new members: MMcM has agreed to do this, and hopes to have it completed by the beginning of November.
ACTION: MMcM
• Member recruitment material: AMacD is working on this and hopes to have a draft available shortly.
ACTION: AMacD
Securing feedback from users
• Monthly visits to the antenatal clinic: The first of these took place at the beginning of September, and will be continuing during the first week of every month. The results of the first four visits will be reported on in December.
• Visits to parent and baby groups at Children’s Centres: NC contacted Jo Sollars, County Council Children’s Centre Support and Strategy Manager, to let her know that the MSLC is interested in visiting new parents groups. SA-M has been in touch with Jo to ask about setting up a formal channel for arranging such visits, but has so far had no response. SA-M to chase.
ACTION: SA-M
SA-M proposed that the Children’s Centres are divided out between the user reps, with each rep taking responsibility for visiting maybe three or four Centres two or three times a year. MMcM said she has links with Homerton and Linton Children’s Centres.
• MSLC web presence: SA-M had a meeting with CC-B and AMacD about this, with particular reference to growing the Facebook page, and CC-B and AMacD will work on this. MMcM offered to be an additional administrator for the page to extend links. SA-M to set this up. CR will promote the MSLC alongside her publicity work for Bliss.
• Promote awareness of the MSLC: SA-M proposed having a sub-group to plan and implement MSLC publicity. VF was at one point keen to do this, but has been out of action recently following the birth of her new baby. SA-M to circulate the committee to establish who would be interested in participating in such a group.
ACTION: SA-M
MMcM mentioned that awareness of the MSLC among midwives needs to be raised. An invitation to the AGM invite has been sent to all midwives. KE said that there is a monthly meeting of the community midwives team leaders, and that an MSLC representative could go along to one of these to talk about the committee. SA-M to contact the community clerk to arrange this.
ACTION: SA-M
• Investigate development of user questionnaire: SA-M has been in touch with the Chair of the MSLC for Queen’s Charlotte’s and St Mary’s Hospitals in London, which has an on-line questionnaire set up for them on a trial basis by a market research company (Brainjuicer). The Chair is going to ask the company if they would operate a questionnaire for us on a similar basis, but this is likely to take some time to establish. SA-M has also looked into the SurveyMonkey service, which we could use for a year for £199. It was agreed to pursue this option. SA-M to investigate further.
ACTION:SA-M
SA-M pointed out that the Queen’s Charlotte’s and St Mary’s Chair had told her that although the hospitals have 9000-10000 births a year, the questionnaire had only received 120 responses in a year.
Service issues – maximising normality
At the July meeting, it was agreed that in the coming year we would focus on three main issues drawn from the list of practices identified in the NCT document ‘Normal birth as a measure of quality of care’ (2010) as increasing opportunities for normal birth without compromising safety
• antenatal education: This is currently under review by the Trust. SA-M has had a meeting with midwife Allison Ryder, who has been looking into it, and was concerned about what she was told. It was agreed that the MSLC would like to have some input into the review of classes, and that a sub-group be formed of members who would like to contribute to this. SA-M to circulate members to see who would be interested in being part of this sub-group.
ACTION: SA-M
• midwifery practice with regard to facilitating measures that maximise normality: This needs to be discussed with JB, who was not at the meeting. SA-M to arrange to meet her to talk about it.
ACTION: SA-M
• continuity of midwifery care ante and postnatally: This similarly needs to be discussed with JB. SA-M has begun collecting literature about it. There is also a need to collect patient experiences.
Neonatal service issues
• CR raised the issue of the need for ongoing care for parents of babies who have spent time on NICU, as they often require additional support several weeks, or months, after the birth of their babies
• AD’A referred to postnatal care of well babies needing to be reviewed in order to reduce/prevent readmission for feeding problems or jaundice.
Actioning of these to be discussed at a future meeting.
CC-B has revised the poster, a proof of which was circulated at the meeting, and approved. A quote for printing has been obtained, and the order will be placed as soon as a purchase order number has been supplied by the PCT. HW is helping with arrangements to get posters distributed to GPs surgeries.
CR suggested that MSLC leaflets could be put into the Bliss going home bags.
MMcM requested information about the Baby Milk Trial, which is ongoing in the area, and questioned whether it was in accordance with BFI. Those present at the meeting were not familiar with the details of the trial, but CT offered to forward what information she had about it, and PN said that she thought she could find out more. It was also suggested that MMcM speak to Jo Watt.
ACTION: CT, MMcM
Arrangements are all in place for the AGM on October 5 at The Fields Children’s Centre. SA-M asked if those attending would be willing to stay behind afterwards to help clear up.
In AS’s absence, KE presented the statistics for August, with reference to those for July and June.
• There were 509 births in August, 505 in July and 517 in June.
• There were 7 homebirths in August, 17 in July and 10 in June.
• The caesarean rate for August was 27.6%, for July 27.1% and for June 23.6%. SA-M asked if there was anything particular about June which caused the rate to be lower. KE speculated that it could have been due to the consultant ‘hot weeks’ (weeks when a consultant is on the DU full-time, without any other commitments, e.g clinics)
• There were 80 births on the Birth Centre in July and 79 in June. This is close to capacity. Figures for August were not available.
• There were no unit closures in July and one in June. Figures for August were not available.
Tours of the MLBU are now running again.
Unavailable in AS’s absence
SA-M reported on feedback that had been left on the MSLC website or received by e-mail since July. This was mostly positive. Three members of staff were praised by women they had cared for, and KE was asked to let them know about this. However, one user raised concerns about keeping curtains open on Lady Mary ward, which she had read about in the minutes of a previous meeting, and another commented about lack of continuity of midwifery care antenatally.
SA-M is now receiving minutes of the DU Forum, so that any items from these that are of interest to the MSLC can be brought to the committee. At their June meeting, user rep Alison Marcus raised the issue of having volunteer birth companions, as happens elsewhere (such as Homerton Hospital in London, about which Alison had heard a radio programme). KE is looking into this.
The new build is on schedule. Mock-ups of the rooms have been constructed to allow for details of fittings to be worked out.
MMcM asked if anything had been done to prevent Bounty photographers going into rooms on the DU at an inappropriate time, especially as concerns about these photographers have been raised in the Press recently. KE said that she would remind midwives that photographers should not be allowed into DU rooms without women’s agreement, but she did not feel that they should be banned from the DU altogether.
ACTION: KE
CR mentioned that Bliss will be offering training to midwives on caring for women in preterm labour.
November 1, 2011, Addenbrooke's Treatment Centre, Seminar Room 4, 12.00 – 2.00
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