APPG Maternity Summer Reception 2007 - 11th July 2007

This year’s reception was chaired by the Group’s outgoing Chair, Laura Moffatt MP. She welcomed the delegates and thanked the Executive Committee and the reception’s sponsors for their support. This year, it was sponsored by The Birth Centre Ltd and the National Childbirth Trust.

She highlighted that the Group holds the reception in order to:

• highlight key maternity issues

• offer an opportunity of you to meet the new Minister with responsibility for maternity services

• share good practice and give awards for excellence, and

• say thank you to those who work so hard for women and their families all year.

She then introduced Ann Keen MP, the newly appointed Parliamentary Under-Secretary for Health who is responsible for maternity services. Ann spoke briefly before presenting the awards about looking forward to working with health professionals and users to deliver the important changes outlined in Maternity Matters. As a former nurse and someone who had worked for most of her adult life within the health service, she was honoured and humbled by having the opportunity to serve as a Minister in the Department of Health.

2007 Awards

As in 2006, the APPG wrote to all Heads of Midwifery asking if they would like to nominate their unit for an award where they felt they had practices that promote:

• Inclusive services for disadvantaged groups and communities

• The normality of childbirth or

• Involvement of women in improving local maternity services

Over 50 maternity units nominated themselves, with over half of the nominations being made for ‘inclusive services for disadvantaged groups’ category. In making the awards, the All-Party Parliamentary Group on Maternity 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.

Practices to promote the normality of childbirth

Midwives from East Cheshire NHS Trust, with local MP, Sir Nicholas Windterron & Ann Keen MP

The submission entered by this Trust showed a range of measures that had been put in place with the aim of increasing normal birth. These included: 

• advertising and promoting the home birth service, including setting up a Home Birth Support Group and website

• surveying women and using the results to formulate an action plan for promoting the use of the water pool for labour and birth

• working with GPs to formalise the availability of direct access to a midwife in early pregnancy and the promoting of it through GP, chemists etc

• mandatory ‘active birth’ study day for midwifery staff

• action plan to reduce caesarean rates

• revamping of the parent education programme.

Many of the measures have only been introduced in the last year and as a result, substantial changes to the Trust’s normal birth rate have not yet been seen. However the Trust’s home birth rate has doubled to 3% and 97% of women receive 1-1 care in labour. The judges were very impressed that all of the actions described above had been well thought through with user involvement at all stages and positive examples of multi-disciplinary working and clear action plans drawn up. The judges were in no doubt that the strong foundations that the service has put in place will improve the culture at the unit and the opportunities for more women to experience a straightforward and positive birth in the future.

Leeds Teaching Hospitals NHS Trust (8410 births in 2005-6)

Members of the winning Leeds Teaching Hospitals obstetric and midwifery team

Leeds Teaching Hospitals are tertiary referral centres with a diverse client group. The judges were very impressed by a substantial reduction that had been achieved in their caesarean rates in three years through a variety of measures but with a strong emphasis on multi-disciplinary working. In 2003-4, rates were between 24-27% and in 2005-6, they had been reduced to 18-20%. Normal delivery rates have increased from 60-62% to 67-69%. This has been achieved through:

• Robust risk assessing around decision to deliver by c-section

• Evidence based midwifery care guidelines

• Active Birth group started in partnership with NCT teachers

• Introduction of birth aids onto labour wards

• Increased consultant cover on labour ward

• Daily consultant-led case reviews

• Linking Active Birth groups with Sure Start

• Setting up VBAC clinics

St Mary’s Hospital, Central Manchester and Manchester Children’s University Hospital NHS Trust (5073 births in 2005-6)

Winning Refugee Midwife, Sandra Cahill, and the team from St Mary's Hospital, Manchester with Ann Keen MP

 The midwifery service for refugees has been running for around two years and is lead by a refugee midwife. The midwife saw 143 refugee women during 2005-6. In addition to documenting the need for services, she co-ordinates the care given to pregnant asylum seekers. A maternity care pathway for refugees is used and a research project to evaluate the service has been submitted to the University of Salford. Key to the project working well is the use of interpreters and the result was virtual full attendance at appointments with the midwife. She also advised the women about their entitlements and acted as a link between the women and other agencies.

The judges were impressed that this service had been set up in the first place. They were also impressed with the good outcomes for the women, whose needs were often much more complex that non-refugee women, and who may well have ‘fallen out’ of the system without this specialist assistance.

Highly Commended

The Pennine Acute Hospital NHS Trust - Rochdale, Bury and Oldham (10,490 births in 2005-6)

Teenage Pregnancy Midwives from Pennine Acute Hospital NHS Trust with Ann Keen MP and Laura Moffatt MP

Although many trusts now employ teenage pregnancy midwives, the judges were impressed with the submission from this trust that employs three midwives. The midwives supported 300 young women in 2006. The midwives are all trained in smoking cessation (rates amongst the clients are as high as 70% in some areas), family planning and participate in the chlamydia screening programme. Particularly impressive and thought provoking were the case studies submitted as part of the bid, and also the ‘counter case study’ that may have been the case, were the teenage pregnancy midwives not involved in the lives of these vulnerable young women. All pregnant young women in this Trust area seem to be in the capable hands of midwives who can ensure all the relevant agencies are involved in the care of the young woman and her baby to ensure the best possible outcomes.

Kings College Hospital NHS Foundation Trust – the Brierley Midwifery Group Practice (4925 births in 2005-6)

Staff and users of the Brierley Midwifery Group Practice

The Practice provides individualised care to women with severe mental health problems, ensuring their care is well planned, all relevant agencies are involved and a high level of support is provided. Each woman has a named midwife plus two associate midwives so there is continuity of carer antenatally, during the birth and up to 28 days postnatally. Women receive more visits, of a longer duration antenatally to ensure all their needs are being metand discussed. All women are visited at home in labour and choice of place of birth is kept open until that time. As a result the practice has a 57% home birth rate with 17.5% water births and c-section rate under 12%.

The practice cared for 72 women with mental health problems during 2005-6 (plus 98 further women). The judges appreciated the way the midwives aim to keep birth as normal as possible in order to give these vulnerable women the best start to parenthood.

Practices to promote the involvement of women in providing local maternity services

Winner

East Lancashire Hospitals NHS Trust (Burnley General Hospital and Royal Blackburn Hospital) (6450 births in 2005-6) 

Staff and users of the breastfeeding services at East Lancashite Hospitals NHS Trust

A range of initiatives within the Trust area to support and encourage more women to breastfeed were very impressive. The involvement of women as peer supporters and through a user forum in each area clearly put women at the centre of the strategy to reach out and support breastfeeding mothers. Twelve trained volunteers from the peer support programme work within the hospital wards to give breastfeeding information and support to new mums. A training strategy brings midwives and mothers together to be co-trainers with the aim of reducing conflicting advice being given to mothers. By using volunteer mothers on the wards, the Trust has increased the workforce and improved services without cost to the Trust. The Little Angels peer support group sees every breastfeeding mother at home (around 1700 mothers per year) and is there for support until the point that she stops breastfeeding. The whole package of measures in place at the Trust gives excellent support to women who are thinking about breastfeeding and a strong network of trained peer supporters to be there for the women in the postnatal period.

Queen Elizabeth Hospital NHS Trust, Woolwich, South London (3862 births in 2005-6) 

Although a very simple idea, it was one the judges wanted to promote as it seemed a simple but effective way of involving more service users in decision-making. The Trust established the Patient Information Group in 2006 – it is a virtual email group bringing together health professionals and women who have had their babies at the hospital. Anyone who contacts the service with a comment, compliment or complaint is invited to join the group. It provides information for women and uses their opinions to ensure leaflets etc. are written by women for women. Many women feel unable to get involved with a MSLC or other committee at the hospital but through setting up an email group, it allows a wider group of women to contribute to hospital publications. The judges felt this could be a low-cost, low workload way of increasing women’s involvement in their maternity services.

Highly Commended

The Princess Alexandra Hospital NHS Trust, Harlow, Essex (3301 births in 2005-6)

Bereavement Specialist Midwives Andrea Brewis and Caroline Nelson from The Princess Alexandra Hopsital reveive their award

The Trust has re-developed their service for families following the death of a baby which involves a comprehensive support service and training package. It ensures all staff working with bereaved parents can offer a high quality service. Users were consulted and involved throughout the re-development of the service, through channelling donations to completely refurbish two bereavement suites and in the annual memorial service planning. The bereavement group that includes parents wrote a guide to be given out and bereaved parents have been involved in talking at study days to improve training for staff. There is strong evidence of multi-disciplinary working including a glowing testimonial from the local funeral director. He has been involved in the study days organised by the two lead midwives and was very positive about how it has benefited his company in their dealings with bereaved parents. The service is clearly giving parents going through a traumatic time a supportive environment and that is happening through the hard work of the service re-design and the two lead midwives.