We are incredibly proud of the maternity care we provide to local people.
The recent Ockenden Report that reviewed The Shrewsbury and Telford Hospital NHS Trust has understandably called into question parts of maternity care across the country.
Our maternity teams care committed to providing excellent care for our local community and are proactive in our approach to further tailor our service to their needs, based on best clinical practice and feedback from those we care for. When NHS England’s peer review into maternity services was launched, we successfully achieved full compliance to the seven immediate and essential safety actions set out in it. We have strengthened processes around escalating concerns, training compliance, and how women are involved in decisions around their care.
The full Ockenden Report was published on 30 March and additional safety actions have been recommended for maternity units across the country. These centre around seven immediate actions:
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Enhanced safety
- A plan to implement the Perinatal Clinical Quality Surveillance Model, further guidance will be published shortly
- All maternity SIs are shared with Trust boards at least monthly and the LMS, in addition to reporting as required to HSIB
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Listening to women and their families
- Evidence that you have a robust mechanism for gathering service user feedback, and that you work with service users through your Maternity Voices Partnership (MVP) to coproduce local maternity services
- In addition to the identification of an Executive Director with specific responsibility for maternity services, confirmation of a named non-executive director who will support the Board maternity safety champion bringing a degree of independent challenge to the oversight of maternity and neonatal services and ensuring that the voices of service users and staff are heard. .
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Staff training and working together
- Implement consultant led labour ward rounds twice daily (over 24 hours) and 7 days per week.
- The report is clear that joint multi-disciplinary training is vital, and therefore we will be publishing further guidance shortly which must be implemented, In the meantime we are seeking assurance that a MDT training schedule is in place.
- Confirmation that funding allocated for maternity staff training is ringfenced and any CNST Maternity Incentive Scheme (MIS) refund is used exclusively for improving maternity safety
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Managing complex pregnancy
- All women with complex pregnancy must have a named consultant lead, and mechanisms to regularly audit compliance must be in place
- Understand what further steps are required by your organisation to support the development of maternal medicine specialist centres
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Risk assessment throughout pregnancy
- A risk assessment must be completed and recorded at every contact. This must also include ongoing review and discussion of intended place of birth. This is a key element of the Personalised Care and Support Plan (PSCP). Regular audit mechanisms are in place to assess PCSP compliance
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Monitoring fetal wellbeing
- Implement the saving babies lives bundle. Element 4 already states there needs to be one lead. We are now asking that a second lead is identified so that every unit has a lead midwife and a lead obstetrician in place to lead best practice, learning and support. This will include regular training sessions, review of cases and ensuring compliance with saving babies lives care bundle 2 and national guidelines.
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Informed consent
- Every trust should have the pathways of care clearly described, in written information in formats consistent with NHS policy and posted on the trust website. An example of good practice is available on the Chelsea and Westminster website.
Our maternity team is currently reviewing these alongside hospitals across north central London, and will assess how these are to be met over the coming months. Rest assured that we will not be complacent and will continue to improve a service we know is vital for our local residents.