Agenda item

Rotherham Maternity Services

To consider a presentation in respect of delivery of maternity services in Rotherham

Minutes:

Consideration was given to an update in respect of maternity services presented by the Deputy COO and the Head of Nursing and Midwifery of The Rotherham NHS Foundation Trust (TRFT). The update explained the recent journey and new approaches undertaken by the service in respect of continuity of care, as well a challenges, risks, and future goals for the service.

 

In discussion, Members requested clarification of the difference between numbers of women who book into the service versus those who give birth with the service. The response from the Head of Nursing and Midwifery was that many women book in because of the neighbouring catchments, and roughly one tenth may lose an early pregnancy. It was noted that efforts were made to market the success of the maternity unit to be able to make women feel more comfortable birthing in Rotherham. If births do go up at the unit, midwives will need to increase as well.

 

Further details were requested in respect of the six actions recommended by the CQC upon the recent inspection. The response described each of the recommended actions, indicating which were “must do” and which were “should do.” Timescales and progress in respect of each were described as well as which had been completed and signed off. Comparison with other similar units suggests these were not bad results at all.

 

Clarification around benchmarking of continuity of care operations as also requested. Targets and what would be required as far as midwife resource were described. It is estimated that in the region 100 midwives are needed, which is a lot of midwives. The model could not be run if maternity units were not safely staffed.

 

Further clarification was also requested around “complexity” of cases. It was acknowledged that it is known to practitioners which cases needed to be referred elsewhere, but many ambitions and workstreams had to be placed on hold during the pandemic, which was responsible for the percentages reflected in the report.

 

Assurances were requested around instances of particular conditions and risks associated with childbirth, as well as vital scores for babies immediately after birth. Details were provided in respect of how the unite performs in respect of each type of condition and assurances were given that the unit is not an outlier for infant brain injury.

 

Further assurances were requested around the wellbeing and retention of staff.

Details were given in regard to the Professional Midwifery Advocates and leads in each area who provide support for staff and safeguarding supervision. The continuity of care model would allow flexibility of scheduling for midwives which was believed to be attractive to the workforce in terms of fatigue. Working patterns were being examined with a view to getting the two models working well together.

 

Members requested further information around recruitment strategies.  Student placements had been increased, and the model whereby trainee nurses are paid is returning. This is not an immediate solution for the workforce. A big impact had been felt as a result of staff sickness. Staff turnover occasionally had had an effect, but there had been recent consultant recruitment to urgent care. The staff wellbeing and fatigue had been a concern following on from the pandemic.

 

Further details were requested around feedback from service users in respect of post-natal care. It was noted in response that women surveyed have indicated high satisfaction with the post-natal care they received. Details of post-natal care timescales and areas for improvement were cited, specifically, developing models through which those best positioned to provide that support are the ones providing the post-natal care, tailored to target those who are more vulnerable or at risk.

 

Additional assurances were requested around the provision of maternity services to teenagers. Details of dedicated staff leads and approaches to support were described in response, as well as challenges around collection of feedback, which is especially important for this specialised area of service.

 

Assurances were requested in respect of the service’s response to the MBRRACE report in provision of maternity services to women of ethnic minority backgrounds. Assurances were provided that the reports had informed the transformation of the services to ensure those communities were being served well and outcomes were improving for BAME women. Work with partners such as Rotherham Ethnic Minority Association (REMA) had been undertaken to understand the perspective of service users. The service’s rates of risk assessments were at 100%, which reflects the service’s efforts to ensure that women at risk are identified so that they can receive targeted care. The Trust had also recruited an Access and Inclusion Lead and had commissioned a task and finish group to focus on health inequalities, particularly around elective access.

 

Resolved:-

 

1.    That the report be noted.

 

2.    That the improvement journey of maternity services in Rotherham be commended.

 

3.    That the service liaise with Rotherham Healthwatch on inclusive future consultation work.

Supporting documents: