Issue - items at meetings - Maternity Services

102.1  Kathy Felton and BSUH colleagues, Heather Brown, Consultant Obstetrician & Gynaecologist, Chief of Women and Children's Division, Tosin Ajala, Consultant Obstetrician & Gynaecologist and Jenny Davidson, Acting Deputy Head of Midwifery & Gynaecology presented a summary of maternity services in the city. This had been prepared in response to a question from HWOSC about what had happened with regard to services at Eastbourne and the impact on RSCH.

102.2  Ms Felton mentioned that there was a very active Maternity Services Liaison Committee (MSLC) made up of parents who had used the service, they were a key factor in providing valuable feedback on services. IT was CCG funded and the CCG provided a crèche for members. They had hoped to come to the HWOSC but had not been able to provide a representative due to the timing of the meeting.

102.3  Maternity services were closely monitored through a number of metrics; the report to HWOSC included some of the more challenging indicators or those which had changed recently. This included the increase in staffing numbers to meet national targets, and a renewed uptake in homebirth rates, following a decline.

102.4  There had been queries about the c-section rate, and RSCH was above the national average. There is a difference between elective c-section rate and maternal request c-section rate. Locally there is not much demand for maternal request c-sections.

102.5    With regard to the temporary closure of the obstetric led service at Eastbourne, arrangements had been put into place in RSCH to accommodate the extra parents. There had not been as great a take up as had been anticipated so far. There were regular monitoring conversations across Brighton and Hove and East Sussex to check that arrangements were adequate.

102.6    Councillors asked questions and commented on the report

102.7    There was a lack of continuity with community midwives, which might be one of the reasons that women did not opt for home births; how was this being addressed?

Ms Davidson said that this had been addressed through an increased number of staff working an increased number of hours including overnight care,  to offer a more complete service. They were also trying to increase the number of support workers in the community including breast feeding support

102.8    How is the MSLC promoted?

The MSLC is a very healthy group but work is underway to try and promote diversity. The main BSUH website links to the MSLC website (http://brightonandhovemslc.com/). The group participates in all relevant clinical audits and developing protocols.

102.9    What is the position on Bounty reps working in the maternity ward?

The Bounty representatives give new mothers goody bags including samples of different products, health information and Child Benefit forms. The idea is to help new mothers. The company pay the hospital a small amount of money to be on the wards. Mothers have reported a wide range of experiences, some positive and others less so.

BSUH has talked to Bounty about the training that their staff receive and are happy with the response received. They have also carried out spot checks and MSLC have monitored the situation too. BSUH is happy to go forward with Bounty as things are, but will monitor this.

102.10                        What were the factors that allowed the homebirth rate to reach a high of 9% and why did it drop so dramatically?

Ms Davidson said that in the past community midwives offered the homebirth service and could provide more continuity of care as they provided antenatal, labour and birth and postnatal care, and this led to a higher take up. The system was then changed where labour and birth cover for homebirths was covered the majority of the time by hospital midwives who were not as familiar with the parents which could have accounted for the drop. Since earlier this year the service has been re-configured and is similar to the original model where community midwives offer the homebirth service and provide antenatal, labour and birth and postnatal care, leading to better continuity of service and care.

102.11 The Chair thanked the CCG and BSUH staff for attending; the report was noted.