Back to the floor - Maternity
I go back to the floor twice a month to find out what it’s like for our patients to be treated here, what it’s like for our staff to work here and to see if there is anything I can do to make it a better place for both patients and staff. Our hospitals are enormous places and not all of our staff know what happens in different departments so part of my blog is also aimed at making it a bit easier to understand for our staff, our governors, our volunteers and anyone else who reads it! I hope my blog gives you a tiny flavour of the fabulousness that I saw!
The maternity services are based over two sites, Chorley Birth Centre and the Sharoe Green Unit at Royal Preston Hospital. We deliver quite a lot of babies and last year we helped 4,461 little ones to join the world. We also provide community midwifery services to quite a wide area and the team are currently looking at the possibility of using electric cars. One of our consultants Mike Woodruff has been doing a project as part of a leadership programme that we run and his project is about use of electric cars and charging points. Through his passion and enthusiasm he’s also managed to fire up our Chairman Stuart Heys so watch this space for further developments!
Last year we won a bid from the Department of Health for £750,000 to do two things; the first was to refurbish the freestanding birth centre at Chorley which now looks incredible and has since seen an increase in births by 100%, 82% using water in labour and 56% having a water birth. Such things had not been invented when I had my children. Well water had obviously been invented …but you know what I mean! We’ve also had some international recognition; the World Health Organisation recently published a Manual of Good Nursing and Midwifery Practice across Europe and Chorley Birth Centre has been identified as an example of good practice in the manual. There were only four cases of Nursing and Midwifery within the UK included in this document and we were one of them. Excellent and well-deserved!
The second thing we did with the money was to build an along-side Birth Centre at Preston which will open in October this year and we think it will see about 1,000 births. All women with uncomplicated pregnancies will be able to have their babies in the Birth Centres or at home. We have got some superb facilities that allow birth partners to stay with mum and baby for 24 hours after the birth in the Birth Centres if they wish. That hadn’t been invented either when I had my children! Because not all births are straight-forward we have concentrated all our high risk obstetric care on one site at the Sharoe Green Unit.
We have 168 midwives and 33 support staff – and more to come. We have a Head of Midwifery, 1 Matron, 7 Obstetric Consultants, 1 Consultant Midwife, Risk Manager and a lead midwife for Quality and Safety. There are 4 inpatient department managers and 6 community/birth centre team leaders. A Band 7 co-ordinates the Delivery Suite on every shift.
We have a number of Specialist Midwives; the Vulnerable Women Team looks after women with really complex social needs, alcohol and substance misuse, mental health, teenage pregnancy, safeguarding and domestic violence. I was in clinic when one of our midwives told me that 1:4 pregnant women suffer some form of domestic abuse irrespective of social status, a statistic that I found quite shocking. They told me that they pride themselves on following up every non-attender to make sure we keep them and their babies safe. It’s a team you want by your side. As you would expect, a large part of their job is to work closely with external agencies like Public Health Specialist Midwives but as well as all the patient-facing work like tongue-tie clinics, stop smoking initiatives, breastfeeding support, ante-natal programmes they do an awful lot of other work behind the scenes that isn’t visible to most of us like writing guidelines, staff education, creation of information leaflets. It helps us to create standards and train all our staff to the right levels so all our mums and soon-to-be mums can expect the same high standards wherever and whoever cares for them. Our Practice Educator Midwife supports our new staff, especially Band 5 midwives and keeps training records of all staff – things move so quickly we have to make sure everyone is up to date with the latest thinking, guidance and procedure and this is part of how we do it.
Our Diabetes Specialist Midwives co-ordinate care for women who are known diabetics and for women who develop gestational diabetes during pregnancy. Our Antenatal Screening Specialist Midwife for antenatal and newborn screening co-ordinates the national screening program and has input into staff training and monitoring data.
Our Bereavement Specialist Midwives co-ordinate care for women with predicted poor neonatal outcomes or who have experienced pregnancy loss. I know the team are working on a development to improve services for bereaved women and their families on the delivery suite.
Last year we won a bid from the DOH for £25,000 to help partners or carers to stay with women who are in-patients with mental health issues. We have just been testing out recliners and chair beds on the ward before deciding which type to buy. They’re getting pretty good at winning bids aren’t they?!
They’re also getting pretty good at winning awards and in no particular order:
- Achieved CNST level 3 in February 2014, passing 49 out of 50 standards.
- Maternity ward and delivery suite achieved a Beacon award in April 2014.
- Women’s health governance team and the Public Health Specialist Midwives received a commendation at the trusts quality awards in March 2014.
- Midwifery student Rebecca Knapp received second prize in the student midwife of the year category at the British Journal of Midwifery Awards 2014.
- Midwife from the community midwifery team Alyson Freeman received third prize in the community midwife of the year category at the British Journal of Midwifery Awards 2014.
- Angela Phillipson in the research team received a Gold award for recruitment to the 35/39 trial
- Katrina Rigby received a further award for recruitment to the OPPTIMUM trial in 2014. Katrina was a top recruiter in the country for the CHIPS trial. Incidentally she is our very first research midwife and has been instrumental in integrating research into the unit working alongside the midwives.
I spent some time with Neesha and Emma who are both qualified midwives and are the Safety & Quality leads for Maternity. After we got CNST level 3 accreditation, they launched the Safety and Quality (S&Q) group to build on the momentum and to continue with the great work. They now have a huge group of committed people from HCAs, student midwives, junior doctors, consultants, midwives from all clinical areas and managers working together. Staff members from the neonatal unit, theatres, ultrasound and anaesthetics also attend. Neesha told me about the Maternity Safety Thermometer pilot trial which we are a part of. This is similar to our trust Safety Thermometer, but is just for maternity patients and helps us to reduce harm and risk to our patients. We have only taken part in this pilot trial for 3 months, but we had the highest number of submissions within the Northwest last month and third highest in the country.
They also have ‘lessons learned’ which is fed-back to the group and more widely via a summary from the Birth Afterthoughts service and in a Governance newsletter. We talked about our Trust values and taking personal responsibility; this team has a very no-nonsense take on it 'if you permit it you promote it'. I really like the way they have sharpened the focus and I’m going to think how we can use that strap-line to focus attention for a variety of things.
It was then time to go to the maternity ward and see if there were any new mums or dads who would take pity on me and let me hold their new born treasure. I was in luck! I met a wonderful couple called Sarah and Eddie who kindly let me hold their one day old baby James 7lb 10oz. I’d forgotten the delicious smell of a new baby and it brought memories flooding back. James, a real cutie, slept all the way through the cuddles and passing him back and forth, I hope he’s still as good several weeks on! Sarah and Eddie told me their story and experience of the hospital which was fantastic feedback for us and made me feel very proud of all of you.
When I was at the Chorley Birth Unit I was delighted to be with Sue Williams while she booked in an expectant mum. What a long laborious process this is for the midwife! I did however, come in very useful because Mum and Dad had brought their two other young children with them and I became chief entertainer for about 30 minutes! I couldn’t find any toys so I made them both balloons out of rubber gloves and played cuckoo. ….my children would have been appalled by my lack of imagination! The little ones were delightful but don’t you forget just how exhausting it is to have toddlers?! The family told me they live in Chorley but had delivered both of their children at Preston. However after the tour of the new birthing unit as part of their visit they decided to book into the unit. Great result because the facilities are so good and so family friendly!
All the midwives I met had such a positive can-do attitude and want to help mums be confident in their own ability to give birth. Tracey Cooper our Consultant midwife has a passion to break down myths and is currently focussed on why expectant mums need to see a GP in order to be referred to the Birthing Unit? Why can’t they have direct access? So her plan is to invite GPs to the unit for a tea party, let them see the superb facilities and care provided, perhaps have it CPD accredited and see if we can change things together with our GP partners. She also wants starry lights on the ceiling of our birthing rooms so mums in labour have something pretty and interesting to distract them during those moments of brief respite! She’s pretty determined ….I wouldn’t like to get in her way!
Everyone I spoke to told me how much they enjoy working in the maternity directorate, there’s an open door policy, a great team in place and more staff yet to come. We know the skill mix will change as new recruits are mostly newly qualified staff but the team seem excited at the prospect of nurturing our new talent. Sue Sherlock (is there anyone in this whole trust she doesn’t know?!) was so complimentary about her staff and told me that everyone is doing extra to plug gaps till people come into post.
It was a great experience for me but I haven’t yet seen everything so they have kindly invited me back for a 3rd visit and I will definitely take up that offer. We have a great deal to be proud of in our maternity services and it is wholly due to the passion and commitment of staff that work there. It shines through!