29 March 2023

The Shrewsbury and Telford Hospital NHS Trust (SaTH) has delivered 77% (162/210) of its actions from the first and final Ockenden Reports, putting it ahead of its projected delivery schedule for March 2023, the Ockenden Report Assurance Committee (ORAC) has heard.

ORAC is a monthly meeting, set up in 2021, to obtain and provide assurance in relation to the delivery, evidence, sustainability and impact of the implementation of the actions arising from the first and final independent reviews into Maternity Services at SaTH. To promote transparency and accountability, all meetings take place online in public.

ORAC committee members include the Trust’s Chief Executive, Louise Barnett, and representatives from partner organisations, including Shropshire and Telford & Wrekin Maternity Voices Partnership, Powys Community Health Council, NHSE/I, the Integrated Care Board and Healthwatch. It is co-chaired by SaTH Chair Dr Catriona McMahon and Maxine Mawhinney, a former BBC journalist and news reporter.

 

Improvements made following the publication of the first and final Ockenden Reports, include:

Workforce

  • The Trust has invested in a further eight consultant obstetricians, which now enables on-site consultant obstetrician cover 24/7, based on the Delivery Suite. We remain one of only a few trusts in the country to have this level of staffing.
  • Investments have been made in the Clinical Governance Support Team, and two new specialist fetal monitoring lead midwives have been appointed alongside a lead consultant to focus and champion best practice in fetal monitoring.
  • 100% of the Trust’s 2021 cohort of registered midwifery preceptees – progressing from Band 5 to Band 6, have remained with the organisation.

Governance and Assurance

  • SaTH is working hard to ensure that positive achievements are sustained and can be evidenced. Governance and assurance systems and processes in Maternity Services have been revised to ensure they are robust. This includes making progress on improving transparency and accountability at all levels of the organisation.
  • ImproveWell has been introduced in Maternity Services. ImproveWell is a digital engagement platform that enables colleagues on the ‘shop-floor’ to share their feedback and improvement ideas. The app provides a conduit for staff voices to be heard and for meaningful change.
  • The introduction of ‘The Shrewsbury and Telford Hospital NHS Trust Maternity Information Hub’, the Trust’s Maternity Service’s Facebook page.

Improvements in Care

  • Women with pre-existing co-morbidities are seen by a specialist multi-disciplinary team
  • Appointment of a lead midwife and obstetrician for bereavement care
  • A multiple pregnancy specialist has been recruited
  • Maternal medicine specialist clinics are in place
  • Improved management of birth options for women and associated risk management, including the introduction of birth option clinics and review of birthing plans/preferences at every contact and a named consultant for ‘high risk’ pregnancies
  • The Baby Buddy app launched in 2019 and Badgernet, an online portal and app that allows service users access to their maternity records, was rolled out in 2021 to provide support and information and to give women greater control over their pregnancy record and care notes
  • We focus on listening to women and families and we have a close relationship with our Maternity Voices Partnership (MVP), co-working on initiatives including the User Experience (UX) system which captures positives and areas for improvement from our current and former service users
  • A birth place choices leaflet has been produced
  • A Birth Preferences Card has been co-produced to enable service users to discuss and amend their preferences with their care team throughout pregnancy and into labour
  • Working together with the MVP on the Fifteen Steps for maternity improvement initiative. Suggested ideas that have been implemented to date, include:
  • Triage phonelines have been relocated to a private office
  • A video walkthrough from the carpark at the Women and Children’s Centre, through to Delivery Suite is now on the Trust’s maternity website
  • Lights with Bluetooth speakers and soft glow are in place on Delivery Suite.

Regulator feedback

  • The 2021 inspection of our hospitals by the health regulator, the Care Quality Commission (CQC), highlighted “outstanding practice” in our Maternity Services and set out how maternity staff “showed immense levels of resilience as they were able to continue to provide high levels of care to women and babies and maintained a positive and caring attitude during extremely challenging circumstances.”
  • The latest CQC Maternity Patient survey – which is based on direct feedback from those we care for – showed SaTH was better or somewhat better than most other trusts in six questions and the Trust had the highest score in the region for the theme ‘Feeding your baby’. None of its results were below the average benchmark of the other 120 trusts surveyed in England.
  • NHS England recently assessed how well we have delivered the Immediate and Essential Actions from the first Ockenden Report (they are doing this for all maternity providers), using a panel of experts from outside the Trust. These are called the Insights assessments.  They gave us a rating of 89% compliance and many positive comments. The actions we haven’t yet delivered are primarily dependent on external organisations to deliver.