All Party Parliamentary Group on Maternity

This 2008 Awards were presented at the APPG on Maternity Summer Reception at the Atrium Restaurant, Millbank, Westminster on Monday 7th July.

   

The reception gives us the opportunity to highlight areas of good practice in England and for the winners to be presented with their awards by the Chair of the APPGM, Emily Thornberry and the Minister reponsible for Maternity, Ann Keen MP. 

As with previous years, Head of Midwifery were contacted in early 2008 and asked to nominate their units for innovative practice in the following areas:

  • Inclusive services for disadvantaged groups and communities
  • Normal Birth
  • Responsive, women-centred, family focused postnatal care
  • Involvement of women in improving local maternity services

This years event was hosted by Emily Thornberry MP, who has been Chair of the APPGM for the past year.  The event was kindly sponsored by NCT (National Childbirth Trust) and Pregnacare 

After thanking the APPGM Executive Committee and Members, the sponsors of the event and attendees, Emily said:

"It is a great privilege to present these awards to such deserving and exemplary maternity units.  All the entries were very impressive.  The winning units are doing innovative work which will act as an inspiration to other Trusts."

Ann Keen, Parliamentary Under Secretary for State in the Department of Health was then introduced and said a few words before presenting the awards.

She spoke about the 60th anniversary of the NHS and the launch of the new standards for maternity and gynaecology by the Royal College of Obstetricians and Gynaecologists.  The standards are distilled into 30 titles and follow the woman's journey through the amternity pathway; beginning with pre-pregnancy care through to the transition into parenthood and the care of a newborn baby.

Maternity Services Awards 2008

50 maternity units nominated themselves this year with the majority being made in the 'inclusive services' category.  In deciding on the awarsd, the APPGM looked for evidence that the initiatives were making a real difference to local women and for an innovative angle that we felt would be inspirational to other units.  We recognise that it is often difficult to demonstrate hard evidence that services are making a difference, particularly when numbers are small or projects are fairly new. 

It was a difficult decision to make in all the categories, as there was such a wealth of exciting projects going on that are making a difference to our communities.  It was also difficult to decide on those projects that were good, but showed best practice and what should be happening in all maternity units across England

Inclusive services for disadvantaged groups and communities

Joint Winners

Hull and East Yorkshire Hospitals NHS Trust - Hull Women & Children's Hospital

Heather Barnes, Sallie Ward, Ann Keen MP, Karen Thirsk, Emily Thornberry MP         and Zoe Ashton

The Goodwin Volunteer Doula Project was developed through a local Sure Start programme and Matenrity Services in 2005.  Due to its success it has now developed into a city wide project jointly funded by the local authority and Hull Teaching PCT.  One of the main aims is to listen to the needs of local women from disadvantaged communties to ensure they are meeting their needs.

They developed a training course to train the volunteers covering child protection, domestic violence awareness, hospital tours, antenatal and postnatal roles, health & safety and breastfeeding.  They also recruited local women to become volunteer doulas and developed a support package for these volunteers.  The contact the volunteers have with the expectant mothers is focussed around accompanying them to antenatal or hospital appointments, discussing and helping them write their birth plan, breastfeeding discussions and information, giving them information around other services available and helping them get practically prepared for labour and the new baby.  They also provide postnatal support for the 6 weeks after birth.

Ashford and St Peter's Hospital NHS Trust - St Peter's Hospital

Theresa Spink, Jane Pickett and members of the winning team with the Minister and Chair of the APPGM

HM Bronzefield Prison, which opened in 2004, is the largest female prison in Europe and houses a 12 bed mother and baby unit.  At the time of opening there was no provision for maternity services within the prison and women had to be transported to attend the community midwifery services and the hospitals ultrasound and obstetric clinics.  As only 2 women were allowed to be transported at any one time, visits were prioritised by severity, leaving routine antenatal as a lesser need. This led to persistent non-attendance for vital antenatal care and screening.

Prior to the prison opening, the Head of Midwifery and the prison directors had regular meetings to discuss the care pathway for pregnant women within the prison.  This developed into a strategy group which included the PCT and commissioners.  Funding was obtained in April 2007 and included the purchasing of an ultrasound scanner and computer software package, 2 midwifery sessions per week, 1 ultrasound sonographer session per week and 1 consultant obstetrician session per month.

The service provides appropriate antenatal care and advice on any interventions or screenings required.  Attendance has increased, with only 1 missed appointment in the last 8 months.  Steering group meetings continue to take place with all those involved in the service to ensure all needs are met.

Highly Commended

The Pennine Acute Hospitals Trust - Rochdale Infirmary, Royal Oldham Hospital

Faye Wanless, Ann Keen MP, Johura Bibi, Emily Thornberry MP and Eileen Stringer

The maternity service at Pennine Acute Trust used external funding to employ an ethnic health worker in an area where there is a high percentage of mothers from Pakistani and Bangladeshi communities.  The ethnic worker works closely with a group of communtiy midwives to provide antenatal care in a Children's centre setting in addition to work in the home and at the hospital.

The ethnic worker, Johura (pictured) has been trained to be a breastfeeding support worker, a smoking cessation advisor and also provides advice and information to mothers on nutrition, co-sleeping and welfare benefits.  Since the reorganisation, Johura has reached over twice as many mothers as previously reached.  Due to difficulties in recruiting two ethnic workers - one for the Bangladeshi community and one for the Pakistani community - Johura, who speaks Bangla, learnt to speak fluent Urdu as well.

Barking, Havering and Redbridge Hospitals NHS Trust - King George & Queens Hospital

Claire Homeyard (centre), Consultant Midwife and Supervisor of Midwives, with members of the teenage pregnancy midwifery team; Natalie Sutton, Michelle Hanson, Stella Wright and Lucy November; Ann Keen MP and Emily Thornberry MP

The teenage pregnancy midwifery team worked closely with young parents to determine what was needed to provide a high standard of holistic care to pregnant teenagers, encompassing continuity of care and support. They also consulted and worked in partnership with other professionals and community groups involved in supporting young parents to develop an integrated service such as Connexions, reintegration teams, family centres and the voluntary sector.

They set up clinics in venues that provided other services for, and were endorsed and used by, young people.  They run interactive and dynamic parent education sessions for young parents to prepare them for labour, birth and the postnatal period.  They also place a strong emphasis on promoting normal pregnancy and birth. In 2006, 84% of young women in their caseload had normal births.  There is also a peer support breastfeeding programme to facilitate young mothers who have successfully breastfed, to support other young mums.

The normality of childbirth

Winner

Royal Wolverhampton NHS Trust - New Cross Maternity

Amanda Costello, Kathryn Rickers, Ann Keen MP, Lyndsey Durkin, Emily Thornberry MP, Tracy Palmer and Sandra Orton

The submission entered by this Trust showed a range of measures to introduce a new Waterbirth Service and promote waterbirth with the aim of increasing normal birth. The team wanted to introduce a safe service, provide good training and an ongoing programme of support for midwives.  85% of midwives have now received training and support and a second birthing pool is being installed due to the success of the service.  The team also encouraged women who have used the pool to feedback within the antenatal education session which has encouraged future user involvement and a Q&A session is held with midwives and previous waterbirth parents.

They are also forming a mutlidisciplinary Waterbirth Forum to discuss and assist women who want to use the pool but do not initially fit the inclusion criteria.  They have held specific sessions for teenagers and their chosen birth partners and have organised interpreting services for women who wish to attend the preparation classes.  They have also designed a patient information leaflet and presented a service summary at a multi-disciplinary education meeting and a Supervisor of Midwives led study day.

280 couples have attended antenatal education and preparation for birth classes.  220 women have used the pool for relaxation and/or pain management and November 2007 saw the 100th waterbirth.

Highly Commended

Shrewsbury and Telford NHS Trust - Shrewsbury Midwifery-led Units: Oswestry, Ludlow, Wrekin & Bridgnorth and Shrewsbury MLU

Anthea Gregory-Page, Ann Keen MP, Angela Hughes, Emily Thornberry MP and Susan Dapaah

The team developed a work based accredited innovative midwifery module, which focuses on promoting and facilitating normal childbirth, providing other midwives within the West Midlands the opportunity to address the rising trend in caesarean section rates and low normal birth rates within their units.

The Module commenced in March 2008 with 9 midwives who were required to reflect on the care and management of 10 women and compare this with the policies within their own Trusts.  It is the first type of Midwifery Module open to external participants which incorporates recognition for work based learning and accreditation for promoting normality of childbirth, using a midwifery model.  Consultant obstetricians have also been fully supportive and have spoken at events demonstrating that it is possible to have an effective working partnership between the Consultant and the Midwives.

Responsive, woman centred, family focussed postnatal care

Winner

Burton Hospitals NHS Trust - Queen's Hospital Maternity Unit

Carol Barley, Clare York, Ann Keen MP, Catherine Askey, Emily Thornberry MP, Gillian Salmon and Fran Wood

The team developed a bereavement support service within the Department of Women and Children which focuses on putting the bereaved family at the centre of care.  The team wanted to improve the choices available and ensure that all staff received appropriate training to provide consistent advice and care in all areas caring for women with a pregnancy loss.

An extensive training programme was developed to target all staff that may come into contact with bereaved parents and is facilitated by the bereavement team.  Two midwives have a flexible jobshare maximising the availability of any one bereavement midwife and enabling the two midwives to support eachother in this demanding role.  There are now two suites for bereavement care positioned off the main delivery suite with an ensuite bathroom and sleeping facilities to ensure a partner can remain with the mother.  This also avoids having to receive care in the Labour Ward.

A guideline has been designed to support parents who wish to take their deceased baby home from the hospital and arrangements were made to ensure that the Registrar of Births and Deaths visited the bereavement suites to complete statutory paperwork and avoid the need for the parents to visit other parts of the hospital.  Parents and families also have open access to the bereavement support midwives for advice, support or a listening ear.  In response to parents requests, a Certificate of Early Pregnancy Loss is offered and funerals are provided at no charge to the family, which take into account religious and cultural requirements.  

Val Finigan, Ann Keen MP, Louise Gardiner, Emily Thornberry MP and Rob Vale

The Royal Oldham Hospital has produced a light-hearted book that aims to challenge the myths about breastfeeding called 'Saggy Boobs'.  The project was driven by women who attended the local Baby Bistro breastfeeding support groups and had shared stories of the negative effects of hearing breastfeeding myths.  They wanted to challenge the myths and raise awareness of the facts about breastfeeding amongst the public and professional bodies.

Focus groups were set up across the Pennine Acute Trust and the artist attended the groups encouraging women to share stories of the myths that they had heard about breastfeeding and the impact that had on either initiating or continuing to breastfeed.  The artists then took their stories and depicted them, with constant consultation from the women involved, in a book and as an arts display in local hospitals and children's centres.

Involvement of women in providing local maternity services

Winner

Calderdale and Huddersfield Foundation NHS Trust - Huddersfield Family Birth Centre and Midwifery-led Unit

Members of the winning team including Helen Shallow, Gina Augarde, Jackie Gerard and Paula Dickinson

Despite initial widespread internal grassroots opposition to the birth centre, and negative press during the public consultation, the Birth Centre opened. A key to its success was user involvement and listening to what women would value in a local facility, especially partners staying overnight.  The obstetric unit is moving to Calderdale in August 2008, so the opening of the Birth Centre ensured there was a facility for well women to birth their babies safely in Huddersfield.

One of the key aims was to build awareness and confidence in the Birth Centre concept for the public and local midwives.  A set of evidence based, but bespoke, protocols and pathways were developed by the Consultant Midwife, widely consulted upon and agreed by the multidisciplinary team.  Focus groups were held to ensure that women's views were represented from the outset including involvement in recruitment, planning and design of the centre.  The Birth Centre is now becoming accepted as an integral part of the whole maternity service.  Focus groups with local women were held prior to the actual building project and some of the women were also invited to be involved with the recruitment process.

Highly Commended

East Sussex Hospitals NHS Trust - Eastbourne District General Hospital

Ann Keen MP and Emily Thornberry MP with members of the team involved in the Women's Focus Group; Victoria Baum, Nicky Mason, Jenny Carapiet, Debra Young and Debs Pawley

A Women's Focus Group has been running since March 2001 and is facilitated by a senior midwife.  The group of user volunteers meet monthly to support their local Maternity Services and work in partnership with the maternity services staff.  They also contribute to service development within the maternity department.  The group gathers women's experiences, views and suggestions so that they can review practices to ensure the services continually evolve to meet local needs.

So far the group has provided evidence to the CHI review on user involvement leading to a 'notable practice award' for the Trust; produced a care philosophy that is included in hand held maternity notes; produced interviews for the staff newsletter; produced posters to highlight issues of baby safety and hygiene to women on the unit; contributed to discussions on major maternity service reconfiguration; provided feedback on the labour ward environment; contributed to the development of a User Involvement strategy for maternity; and is currently working on the development of the 'maternity' part of the Trust website to reflect the recommendations of Maternity Matters (2007).

Highly Commended

Portsmouth Hospitals NHS Trust

 Sarah Roberts, Kaljit Chauhan, Ann Keen MP, Emily Thornberry MP and Carmel Crabtree

The Trust was nominated by those involved in the 'Save the Grange' Campaign for involving women and families in the improvement of Maternity Services in Petersfield with the reopening of the Grange Maternity Centre.  The Centre is now open 24 hours a day, 7 days a week.  The Trust was particularly responsive to calls from local families and was prepared to actively encourage user involvement in the development of the Centre.

The Trust were praised for attending public meetings and being continually open to dialogue via email, telephone, letters and face-to-face meetings.  The Trust also invited users to sit on the Maternity Development Group which led the development of the centre.