Meeting documents

For Committee Members to receive an update on maternity services which will include the following.

1.    An overview of maternity services in Buckinghamshire against national and local performance targets;

2.    Understanding how choice is managed and met;

3.    How services are meeting current demand and modelling to meet future demand for ante-natal & post-natal support services.

Attendees:

Carolyn Morrice, Chief Nurse, Bucks Healthcare Trust

Andrea Anderson, Deputy Head of Midwifery, Wexham Park Hospital

Monica Warren, Matron for Intrapartum Maternity Services

Dal Sahota, GP, Clinical Commissioning Group

The Chairman welcomed the following people Mrs C Morrice, Chief Nurse (Bucks Healthcare Trust), Ms A Warren, Head of Midwifery (Bucks Healthcare Trust), Ms L Duncan, Deputy Head of Midwifery (Bucks Healthcare Trust), Dr D Sahota, GP (Clinical Commissioning Group), Mr N Flint, Head of Commissioning for Planned Care and Maternity (Clinical Commissioning Group), Ms M Warren, Matron for Intrapartum Maternity Services (Frimley Park Trust) and Ms L Patten, Chief Executive (Clinical Commissioning Groups).

The following main points were made during the presentation:

·         Between April 2015 and March 2016, Buckinghamshire Healthcare Trust (BHT) provided labour care to women who delivered 5,541 babies.

·         30 complaints were received last year compared to a total of 13 this year.  Lessons had been learnt and the aim was to reduce the number of complaints still further.

·         Sharing information and ideas for improvement was an important consideration.

·         A tool called "Birth rate plus" was used to establish the correct staffing levels.

·         BHT had a slightly higher than national benchmark best practice rate for Caesarean sections and was currently looking at ways to reduce the number.

·         BHT had been accepted to participate in a pilot labour ward leadership programme which promoted team working.

·         In partnership with Oxford Health NHS Foundation Trust, BHT had made perinatal mental health a priority and had employed a specialist mental health midwife.

·         Wexham Park Hospital and Frimley Health merged in October 2014 and since then much work had been undertaken to bring the two units together.

·         A total of 35 guidelines had been ratified and adopted across both sites and it would take approximately three years to complete all 92 guidelines.

·         The CQC inspection in October 2015 rated the Women and Children Services as "Good".  There had been a shift in leadership and culture of the organisation.

·         There was a reported shortage of 10 midwifes within the unit.  Consultant cover to the Labour Ward was now 132 hours per week.

·         The current midwife to mother ratio funded at 1:30 with a 90/10 split between midwife and healthcare assistant.

·         A Perinatal Mental Health specialist midwife, a Diabetic Midwife specialist and a Clinical Skills facilitator had recently been recruited.

·         The biggest challenge for the Trust was around capacity of the ultrasound scanning.  There was a national shortage of sonographers as well as a shortage of midwifes.

·         Maternity Services had been given a focus within the Sustainability and Transformation Plans.

·         An Open Day was being planned to find out the views of women.

·         Ms Morrice confirmed that the transfer of care back to the Wycombe Maternity Unit was on track for 31 October with the Unit re-opening on 1 November.

·         In response to a question around the challenge of an older workforce and recruiting new midwifes, the maternity team at BHT confirmed that they had two intakes each year – May and September and the challenge was to ensure they remain with BHT.  BHT had over-recruited this year.

·         A Member asked for the percentage of women in Bucks giving birth where English was not their first language.  Nationally it was around 25% but in Bucks, the percentage was around 6-7%.

·         A Member asked for more clarification on the data that was presented and Dr Sahota explained that there was a dashboard of data which contained around 32 parameters.  There was a public facing page which provided headline figures for new mothers.  It was agreed to share commissioner data with the Committee Members which could then be tri-angulated with providers.  It was agreed that the traffic light system for reporting trends was very important.

ACTION: Committee & Governance Adviser to discuss further with the Clinical Commissioning Group

·         In response to a query around why the figures provided by BHT in relation to vaginal birth rates and Caesarean section birth rates did not add up to 100%, Dr Sahota explained that the remaining % would be births requiring assisted deliveries, such as forceps.

·         A Member asked for more information around a new mother’s post-natal care and Ms Warren explained that the Community midwife would see the new mother on day 1, the new mother would receive a triage call on day 3, be invited to a drop-in session at day 5 and then be signed off at day 10 whereby the new mother would be handed over to a Health Visitor and their GP for ongoing care.

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