I wanted to write to you to update you on the work we have been doing since the Independent Review of Maternity Services at our hospitals, led by Donna Ockenden, which was published on 30 March 2022. I would also like to set out some of the improvements we have made, the ways in which you can contact us and also how you can get involved in our improvement work, should you wish to.

Donna Ockenden’s report highlighted significant failings in the Trust’s maternity services over the last two decades which we accept fully. 210 actions for improvement were identified which we fully support. We began work immediately on delivering and embedding these actions in a meaningful and sustainable way. This has been much more than just working our way through each action. We are determined to make this a permanent change to the way we work.

We have been updating the public on our progress through the Ockenden Report Assurance Committee for the last three years, which was live streamed to the public, at our Board of Directors’ meetings, and through our regular communications channels. Whilst we endeavoured to communicate this progress to the communities we serve, we recognise that we did not provide some families with the information or the direct contact that they would have liked in response to the harm they had experienced. I am sorry to those of you we have let down, as that has never been our intention, and we would like to address this.

We have had contact with many families affected by the Independent Review of Maternity Services and other families not included in the review. We would like to take this opportunity to hear directly from anyone who would like to engage with us and we will make all necessary arrangements for this to happen.

Please get in touch

We genuinely wish to engage with families more so that we can learn and improve further, and we are exploring more ways to do this better. If you would like to get in touch with us please do so via the following email address: sath.maternitycare@nhs.net and we will get back to you as soon as possible.

Significant changes

In my open letter to you of 14 April 2022, I gave my commitment that we would continue to build on the improvement work we had started already, to make our services safer and better for women and families, and that you would expect to see meaningful action and real change. I would like to highlight some of these changes and let you know what our quality regulator says about us.

In the last four years, we have focused on improving our maternity services and making them safer for women and families. It is important that we always remember that these improvements have been a direct response to families bravely coming forward to describe their experiences of care in our hospitals. As of today, through our Maternity Transformation Programme (MTP), we have implemented 195 (93%) of the 210 actions from the Independent Review of Maternity Services, and continue to work on the remaining 15 actions, with our colleagues and system partners. Staff have learnt to work in a different way, are better trained, use better guidance and listen carefully to families to make sure that care is as personalised, but also as safe as it can be. The following are some tangible examples of the real changes we have made to our services:

  • We are one of only a few hospitals to have a resident consultant obstetrician on duty on our delivery suite 24 hours a day, seven days a week to provide our staff with high quality medical leadership and support when it is needed.
  • Fetal monitoring training has improved and now includes a full day of face-to-face training with assessment at the end of the day. Training has a specific focus on listening to the baby’s heart rate (intermittent auscultation) and monitoring contractions (CTG monitoring). Only staff who are up to date with their training are permitted to work with women in labour or in any area requiring fetal heart rate interpretation.
  • A risk assessment is undertaken at every antenatal appointment, on admission during labour, and is undertaken as part of hourly reviews when a woman is in labour. This risk assessment is discussed with the woman and her support partner. Any identified deviation is escalated to an obstetrician for review and treatment in collaboration with families.
  • We offer a range of improved options of listening to women and families, including a birth options clinic and birth preferences card to help women decide on their preferred way to have their baby, enabling service users to discuss and amend their preferences with their care team throughout pregnancy and into labour. This innovation has been adopted by other trusts across the country.
  • For families whose mental health has been significantly impacted by their maternity experience, we work closely with Midlands Partnership University NHS Foundation Trust, with the option of referral to The Lighthouse Maternal Mental Health Service. This service offers highly specialist psychological interventions for difficulties relating to birth trauma, perinatal bereavement and loss, or where an individual is experiencing a profound fear of pregnancy and/or childbirth. Referrals to this service are through our midwives or other health professionals. Signposting is also available to other support offered within the community, for example through charitable organisations, depending on the level of need and wishes of families.
  • The service has seen a significant improvement in overall midwifery staffing levels.  We have enhanced our senior and specialist midwifery teams to provide additional leadership, expert advice, and support for women and families, and the clinical teams.
  • We now have in place robust training programmes that equip the maternity workforce with up-to-date skills, training, and development, including the management of emergency scenarios. The senior leadership team covers the service 24 hours, seven days per week, which facilitates an additional level of support for escalation of concerns and provides advice and guidance to the maternity workforce and service users.
  • We continue to collaborate with women and families on improving the culture of our services and organisation to ensure that all the people that use our services are treated with care, compassion, and respect, and look to learn and improve further when we do not get this right.
  • We have Maternity Safety Champions in the Trust including midwives, neonatal nurses, obstetricians, neonatologists, and executive and non-executive directors, which means we have a true direct connection throughout the organisation.
  • We have volunteers working with us who spend a proportion of their time on the wards working closely with support assistants and midwives. Many of our volunteers have secured careers in the NHS successfully or have gone on to study health-related courses.
  • Over the past two years we have made many changes in how we engage with families, including the introduction of fortnightly maternity tours of our Women and Children’s Centre for pregnant women and their families.
  • Our maternity services open days provide tours of our services, live simulation exercises, and an opportunity to meet our teams and ask questions. Our next open day is scheduled for Saturday 28 September 2024.
  • Our Birth Reflections service is available for any mother from six weeks after the birth of their baby to provide feedback on their maternity experience with a specially trained midwife using available hospital notes and records.
  • Our Facebook page, ‘SaTH Maternity Information Hub,’ provides service updates, general guidance, birth statistics from our Trust, and allows those using our services to ask questions and share their experiences.
  • The recently published results of the 2023 CQC (Care Quality Commission) Maternity Survey, which covers all aspects of maternity care, showed that women cared for by our teams felt involved in decisions about their care, listened to and treated with respect, dignity, kindness and compassion.
  • Following its most recent inspection of the Trust in 2023, the CQC’s published report (2024) rated our maternity services as ‘good’ overall, and as ‘good’ across all five measured domains of: Safe, Caring, Responsive, Effective, and Well-led.

As with all improvement work, there is always more to do, and this is where we would welcome your help and support to enable the Trust to make further improvements in the services we provide to our families.

How we work with the Maternity and Neonatal Voices Partnership (MNVP)

Our MNVP listens to and gathers feedback from families and communities across Shropshire, Telford and Wrekin about their experiences of maternity and neonatal services. This includes hosting focus groups, listening sessions, visiting community groups, and working with local voluntary and community groups to gather feedback from a diverse range of the population in our area. The MNVP conducts activities such as ‘Fifteen Steps’ to understand quality from the perspective of people who use maternity and neonatal services and ‘walking the patch’ as a way of collecting direct feedback from current service users on the maternity unit.  Feedback is provided to the local maternity and neonatal system and is used to influence improvements.

The MNVP acts as a critical friend within the local maternity and neonatal system (LMNS) and ensures service user voices are considered at the heart of decision-making and inform pathways and processes to improve the service and experience for women, birthing people, and their families.

We will continue to strive to give our communities the maternity services they deserve, and to ensure we have the right culture, support and environment for them and our staff. We are committed to working with and listening to feedback from women and their families as we continue our focus on improvement.

Thank you.

Yours faithfully

Louise Barnett, Chief Executive
The Shrewsbury and Telford Hospital NHS Trust

___________________________________________________________________

Support and resources

Local and national support systems are available for anyone to access:

  • For urgent help with mental health please contact the Mental Health Access Team on 0808 196 4501 or email shropshire@mpft.nhs.uk. The Access Team provides a single point of contact for all Midlands Partnership University NHS Foundation Trust’s adult mental health services, including people with dementia. The team is available 24 hours a day, 365 days a year.
  • NHS 111 select mental health

If you are experiencing a mental health crisis (something that makes you feel unsafe, distressed, or worried about your mental health), you can now contact your local crisis service in Shropshire, Telford and Wrekin by calling NHS 111 and selecting the mental health option ( 111. Your mental health needs will then be assessed by someone who will be able to listen to your concerns and help you get the support you need. They can offer advice over the phone, put you in contact with crisis services or refer you to most appropriate service. You can call for yourself, or someone else. NHS 111 is for all ages, including children and young people and those with neurodevelopmental needs.

NHS Shropshire, Telford and Wrekin Talking Therapies

Talking therapies are effective and confidential treatments delivered by fully trained and accredited practitioners. They can help with common mental health problems like stress, anxiety and depression. You can access talking therapies for free on the NHS. You can refer yourself directly to an NHS talking therapies service without a referral from a GP, or a GP can refer you. The service is open to anyone aged 16+ who is registered with a Shropshire or Telford and Wrekin GP and is not currently being seen by another mental health team.

You can self-refer to NHS Shropshire, Telford and Wrekin Talking Therapies in the following ways:

  • Email: STWTT@mpft.nhs.uk
  • Phone: 0300 1236020 (NB: the patient’s details will be taken and a telephone assessment arranged)

Help is available in person, by video, over the phone or as an online course. For more information click here.

  • Samaritans: 08457 90 90 90 – The Samaritans are there to talk to 24/7 and will offer help in tough times.
  • Mind: 0300 123 3393 – Mind is a mental health charity that provides support. There is a link at the top of their webpage titled “I need urgent help” which will ask a number of questions and provide you with advice in your situation.
  • Call 999 – For medical and mental health emergencies

Information and Support in Mid Wales

  • In Wales, NHS 111 Press 2 for mental health is available 24 hours a day, 7 days a week for people of any age who have an urgent mental health concern themselves or about someone they know. The number is free to call from a landline or mobile and is available for anyone living in Wales.
  • Information about mental health services available from Powys Teaching Health Board can be found on their website at https://pthb.nhs.wales/mental-health
  • SilverCloud Wales offers free online CBT for anyone living in Wales. A wide range of programmes is available including a dedicated focus on “space for perinatal wellbeing”. Find out more and sign up at https://pthb.nhs.wales/silvercloud
  • You can access mental health and support, including from the health board’s perinatal mental health team, by talking to your Powys midwife. You can contact your Powys midwife on 01874 622443

If you have a queries or concerns about your care, you can also contact The Patient Advice & Liaison Service (PALS). Call 01743 261691 for the Royal Shrewsbury Hospital or 01952 282888 for the Princess Royal Hospital. You can also email sath.pals@nhs.net.

When a family experiences baby loss during or soon after pregnancy, support organisations available locally and nationally include:

Specialist Midwives – Bereavement – The Shrewsbury and Telford Hospital NHS Trust
Office Number: 01952 565953 (Mon-Fri 0900-1700 hrs)
Urgent queries via the Delivery Suite (24hrs) 01952 565924

SANDS (Stillbirth and Neonatal Death Society)
Offers support and information for anyone affected by the death of a baby, before or after birth. National helpline, local parent-led support, literature, and online support.
www.sands.org.uk
020 7436 7940 (general enquiries)
0808 164 3332 (support)

Child Bereavement UK
When your baby dies.
Helpline: 0800 0288840
Email: helpline@childbereavementuk.org

Support Group for Dads
Dad Still Standing is an online group created as a way of helping other dads along their journey with grief. To discuss the difficulties you go through in bereavement, both in the immediate aftermath of baby loss and as time moves on.
https://www.dadstillstanding.com/

Lullaby Trust
Bereavement support after the death of a baby or child.
www.lullabytrust.org.uk
Support: 0808 8026868
Email: support@lullabytrust.org.uk

Hope House Children’s Hospice
Care for babies, children and young people who have life-threatening conditions and are not expected to live beyond 18 years of age.
www.hopehouse.org.uk
01691 671 999

IAPT (Improving Access to Psychological Therapies)
Telford and Wrekin: 01952 457415
Shropshire County: 0300 123 6020

Lily Mae Foundation
Baby loss support service.
www.lilymaefoundation.org
01676 535716

Miscarriage Association
www.miscarriageassociation.org.uk
01924 200 799
Email: info@miscarriageassociation.org.uk

Multiple Births Foundation (MBF)
Provides support and information for multiple birth families (including bereavement support).
www.multiplebirths.org.uk
07360 735050
Email: mbf@bcu.ac.uk

Aching Arms (Supporting Arms)
07464 508994
Email: support@achingarms.co.uk

Samaritans
Offers confidential support that is available 24 hours a day to people who need to talk.
116 123 (UK) freephone

Tommy’s
Miscarriage, stillbirth, and premature birth charity who offer support following a pregnancy loss.
https://www.tommys.org
Support: 0800 014 7800
Email: midwife@tommys.org

Twins Trust Bereavement Support Group
Offers support for families who have lost one or more children from a multiple birth pregnancy, birth or at any time.
www.twinstrust.org/bereavement

Winston’s Wish
Offer support to bereaved children, their families, and professionals.
www.winstonswish.org.uk
Helpline: 08088 020021

TFMR Mamas
Offering support for families who have experienced a Termination for Medical Reason.
https://www.tfmrmamas.com/

Petals – The Baby Loss Counselling Charity
https://www.petalscharity.org/
0300 688 0068
Email: counselling@petalscharity.org

Hugs Charity
HUGS offers a range of services for bereaved parents and their families.
https://hugs.org.uk/

Little Footprints Support Group
A monthly support group for anyone affected by the death of a baby at any stage in pregnancy.
Email: littlefootprintsmd@gmail.com
Little Footprints Support Group meet on the 1st Tuesday of every month 7:30-8:30pm at The Green Suite, Festival Drayton Centre, Market Drayton.

2Wish
Support for those affected by the sudden death in young people: https://www.2wish.org.uk/

Love from, George, (Shropshire based)
Supporting bereaved parents and families after losing their precious baby: https://www.facebook.com/lovefromgeorge

Ada’s Foundation (Shropshire based)
To provide empathetic and practical support to families affected by pregnancy loss and the death of a baby, helping them navigate through the challenges of grief and loss: https://www.facebook.com/adasfoundationuk

Saying Goodbye Charity
www.sayinggoodbye.org/
0300 3231350
Email: support@sayinggoodbye.org

For Staff employed by the Trust:

The SaTH Staff Psychology Service is available to support all current staff members who are affected in any way:

  • Staff can self-refer, or ask their manager to do this on their behalf, by emailing: staffpsychology@nhs.net (this inbox is checked daily Monday-Friday)
  • Staff will be contacted by a member of the team to arrange an appointment which could be face to face, on MS Teams or by telephone, to suit the member of staff. Appointments are during working hours Monday-Friday

An alternative confidential service is available through SaTH’s Employee Assistance Provider (HELP).

  • You can contact them by calling 0800 047 8843 or visiting: https://sath.workplacewellbeing.com and https://sath.optimise.health.  
  • HELP provide confidential, independent and unbiased information and guidance from a team of trained wellbeing and counselling practitioners. They provide support in relation to a range of social, emotional and health problems relating to home or work.