Agenda item

This paper updates members of the Committee about the work currently taking place to improve maternity services across the B&NES, Wiltshire and Swindon as part of the Sustainable Transformation Partnership (STP).

The Senior Commissioning Manager for Preventative Services gave a presentation to the Select Committee. A copy of the presentation can be found on their Minute Book and as an online appendix to these minutes, a summary is set out below.

Future Service

Our Local Maternity System (LMS) vision is for all women to have a safe and positive birth and maternity experience and to be prepared to approach parenting with confidence.

Each LMS is required to produce a Local Maternity Transformation Plan. This was developed with the input and engagement of women and their families, clinicians, maternity staff, a range of partners (Health visitors, Family Nurse Partnership and Children’s Centres) and other stakeholders through a number of workshops. Informal engagement took place with more than 2,000 women.

Our future offer to our women and families will include:

•  Continuity of care (20% by 2019)

•  Improved personalised care and choice with parity of access

•  Creation of Clinical Maternity Hubs to provider ante and postnatal care close to home

•  Delivery of seamless pathways across organisational and geographical boundaries

B&NES, Swindon & Wiltshire (BSW) Local Maternity System

Maternity Transformation workstreams

•  Continuity of carer

•  Antenatal and postnatal care

•  Safer care

•  Personalised care and choice

•  Perinatal Mental Health

•  Workforce transformation

•  Working across boundaries / multi agency working

BSW LMS Maternity Services

•  Choice currently not equitable across the LMS footprint

•  Proposals for change will ensure choice options are met for majority of population across the LMS footprint

Choice of place of birth

•  11,247 births across the LMS in 2017/18, of which 85% were in an obstetric unit

•  7% were in a Alongside Midwife Unit (GWH) and 6% in a Freestanding Midwife Unit (RUH)

•  RUH has seen an increase in numbers of births at the Obstetric Unit and a corresponding decline in numbers of births in their FMUs / home birth

Councillor Lin Patterson asked why the numbers of women giving birth at home or in freestanding midwifery units had dropped and subsequently increased in the obstetric unit. 

The Senior Commissioning Manager for Preventative Services explained it was in part due to the increase in complexity of the needs of women giving birth, especially older women and women with a higher BMI. She added that access to pain relief and concerns about the need to transfer during labour to the obstetric unit in birth (which can be 30% - 40% of women having their first babies) were also factors.

LMS Challenges

•  Lack of parity of provision

•  Future sustainability

•  Workforce – Right staff, right place, right time

•  Delivery of Better Birth agenda

Clinical leadership

•  Strong clinical leadership of process

•  Dedicated LMS Midwife

•  Multi-disciplinary clinical involvement and staff engagement – obstetrician, neonatologist, midwives, MCAs and administrative staff

DadPad app

As part of the Local maternity transformation plan, a DadPad app was launched across B&NES, Wiltshire and Swindon in June and has been shared with a wide range of stakeholders including maternity services, community health services including health visitors and school nurses, children’s centre services, social care teams and the RUH, libraries, one stop shops and birth registrars. It is an easy-to-use up to date information tool for dads-to-be and dads with new babies which provides bitesize top tips for new dads to help them adjust to parenthood. The aim of the app is to enable new dads to feel more confident about fatherhood and to play an active role in supporting health and wellbeing outcomes of women, children and families across B&NES.  A digital tool kit is also available on the B&NES Family Information Online service.

Next Steps

•  NHS assurance process including stage 2 review

•  If assurance is provided, formal consultation will commence at the end of September and run for 12 weeks

•  Detailed proposals will be brought to the Health and Wellbeing Select Committee during the formal consultation period for a full discussion and feedback.

She explained that following a similar presentation on the Plan in Wiltshire they have requested that a Rapid Scrutiny Event take place involving them, B&NES and Swindon. She asked if any members of the Select Committee would be interested in taking part in such an event.

Councillors Gladwyn, Patterson and Haeberling all indicated that they would be interested in taking part.

Councillor Patterson asked if there were any issues in recruiting new midwives.

The Senior Commissioning Manager for Preventative Services replied that recruitment recently has been good, including midwifery.

The Chair thanked the Senior Commissioning Manager for Preventative Services for her presentation on behalf of the Select Committee.