Minutes of Maternity Services Liaison Committee
Held on Wednesday, 8th June 2011 at Kingston Hospital
Present:
Trish Tang - NCT Celia Dunsire – KHT
Naomi Owen - NCT Elizabeth Peregrine- KHT
Louise Latham - NCT Kate Greenstock - NCT
Lesley Deacon - NHSK Anna Dellaway, KHT
Julia Gosden - NHSK Sally Tunna - HRCH
Hannah Smith – KHT
Apologies:
Tina Sinar Jane Scarlett
Wendy Cook Naz Jivani
Sarah Main Karen Hopkins - KHT
Hilary English Andrea Bennett -YHC
Lucy Symonds
1. Trish welcomed everyone to the meeting and introduced Naomi Owens (NCT Student Teacher) from Twickenham
2. Minutes of the last meeting
The minutes were agreed as a true record
3. Matters Arising
3.1 Epidural rate first time mothers – work in progress to split out from total epidural rate. Action: AD
3.2 Tongue Tied – impact on feeding. Refer to Hilary English – email from Jane Scarlett. Action: JG to progress
3.3 Kingston Activity / Statistics
Activity period to be confirmed.
Induction rate to be checked this was reported as 28%
3.4 Hep B Notifications
Discussed at Screening Committee – Hep B standard is that baby immunised and mother and family follow up where indicated
All mothers are tested but only Hep B positive mothers are offered the treatment and baby vaccinated. If mother wants baby vaccinated then this will be referred to GP
BCG – is targeted Action: AD / LD to report to September meeting
3.5 Home Births - Kingston Hospital Workshop
- Held on 2nd Wednesday of the month between 6-8pm
- First meeting no attendees, 2nd meeting 4 couples who gave positive feedback.
- Work in progress with West Middlesex Hospital to ensure coverage across Kingston/Richmond area for home births
- If woman is out of area and wants a home birth they will be signposted and booked into ANO unit.
- Home birth as an option is discussed and offered at booking and 36 weeks unless stated in the maternity notes and the labour section includes venue of delivery / birth.
- There is a single point of contact and dedicated phone line for home births.
- There is still some ambiguity from GPs regarding supporting and encouraging home birth.
NCT based workshop 1st Thursday every month in Hampton
There are a number of initiatives to increase home births rates and KH needs to evaluate whether there has been an actually increase the home birth rate conversion. Review in December.
Action: Information on home births to be shared with MSLC - AD
4. Kingston Hospital Update
4.1 Service Improvement
Triage service commenced 1st March 24 hour service with a dedicated phone line into Malden Suite and criteria for signposting woman to the appropriate place e.g.
- Delivery suite
- Malden suite
- Admission for observation
Month 1
- 840 telephone calls (proforma assessment)
- 432 face to face assessment
- 85% woman met the inclusion criteria decision made –
- 51% discharged home
30- 120 minutes time waited to discharge – 50% less than 1 hour
Positive feedback from the midwifery staff
Midwifery led Deliveries – 2.5% increase in deliveries for March and April.
Feedback from woman who have attended triage could be collected from the NCT reunion meetings.
Initial feedback – waiting times long, limited space to move around (2 bedded unit) but positive midwives reassuring and attentive.
There will be ongoing evaluation and audit of the service model.
4.2 New Maternity records
These have been in use for 3 weeks
An Audit of 1500 to be made
4.3 VBAC clinic
1st clinic has been held (Tuesday afternoons); women are referred by community midwife
Proforma assessment and audit tool to collect data on decision and actual delivery to enable evaluation
Plan to see between 24- 30 weeks
Review December 2011
Examples of ladies labouring in water in Malden suite
4.4 Workforce
Consultant Midwife – advertising post planned week commencing 4th July, interviews
Team midwives / staffing – 7 new staff joining July. August and September. Expect to be up to compliment subject to resignations but good numbers applying for vacancies
MSW – significant input 18hrs on breast feeding
- Increasing mental health provision to 1 wte post
- Safeguarding -= 1wte recruitment
- Bereavement – 0.5 wte
- Risk Midwife – changes to the team led by Hannah Smith with midwife support.
- Band 6 nurse to lead theatre team
- Data Manager post
4.5 Services Statistics
- One to one care in labour
- Summary statistics April 2010 – March 2011
- PET Tracker reports
- One to One in labour – snapshot of partner views to be collected
PET tracker – need to review some of the questions and to amalgamate the areas e.g. for post natal areas.
Actions taken forward to improve performance, one area is communication which is included in study days.
4.6 Summary Statistics
August/September – still birth volumes higher than rest of the year
These have been reviewed by the Risk Board and are not related to anyone factor
3rd /4th degree tear – new Consultant appointed who will start in post in September
5. Visits by Lay Representatives to Kingston children’s Centres
Visits are up and running but it is taking time to get dates for the visits to the Children’s Centre.
Trish visited has visited Chessington (May) and will circulate the feedback. The staff at Chessington were very helpful in facilitating the visit.
Visits are planned to
- New Malden in June
- Norbiton in July
The Group discussed whether we should consider holding MSLC meetings in Children’s Centre to enable other mothers to join the meeting the MSLC. This would require access to crèche facilities.
Action Trish Tang to Discussion with Sarah Reid the use of a Children’s Centre for a meeting / future meetings.
6 Feedback from Lay Reps
On the whole positive from mothers, issues continue to be received about advice on breast feeding.
7 Any other business
7.1 Breast Feeding Services in Richmond
There have been some changes to the times and locations. ACTION: Sally Tunna to provide details for circulation
8 Date and time of Next meetings
14 September 2011 12.30 -2pm Kingston Hospital
14 December 2011 12.30 -2pm Kingston Hospital