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The maternity team at Northampton General Hospital NHS Trust discuss how they've improved the safety of their maternity services and why they joined The King's Fund's Safer Births programme.
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Helen McCarthy - Matron Lead MidwifeOwen Cooper - Consultant Obstetrician
Sue Lloyd - Consultant ObstetricianLinda Matthews - Supervisor of Midwives
NGHT 2009 ‘Pre Safer Births’Birthrate: 4700 births per yearLSCS 27.6%Triage access for all women admitted to Labour WardLow midwifery staffing numbersPoor skill mixHigh turnover of Senior MidwivesInsufficient Consultant Obs presence on Labour WardInconsistent verbal and written communication
Why Safer BirthsNetworkingEngage maternity stakeholdersEngage staff in the process of changeUse The King’s Fund expertise in process mapping,
recommendations, support and adviceUnique opportunity to share practice
ObjectivesKey aspects to implement:Increase recruitmentSupport for newly qualified midwivesDevelopment programmes Roles and responsibilities for all staff Consultant rounds Triage Working Party
RecruitmentStrict shortlisting criteria and scoring assessmentRobust interview questionsSmall recruitment senior midwifery team
Measures of success:Recruitment and quality of applicants – assurance
and increased staff moraleVacancies reduced Put in eg, of questions used and CTG
Interview questionSCENARIO: You are the midwife working
on Labour Ward, and are asked by another midwife to do a ‘fresh eyes’. The client is a primigravida and undergoing an induction of labour for postmaturity.
What is your interpretation of this CTG?
In the event of an abnormal CTG, what would you do?
Staff developmentPractice Development teamPreceptorship packageDevelopment programmeMSW NVQ level 3 programme Labour ward consultants appointed
Measures of success:Preceptorship Programme Funding was secured for NVQ programme Dedicated time for professional development
Roles and ResponsibilitiesMaPSaf visit February 2010Representation from Consultants, Clinical Director, Directorate
Manager, Senior Midwives, Midwives, SoM, Risk ManagerDo staff know their roles?Actions – devise ‘Roles and Responsibilites’ for all staff on Labour
WardForms part of induction programme for all new starters
Measures of Success:To repeat the MaPSaf in 12 monthsIncreased staff awareness through the roles and responsibilities
Labour Ward Rounds
Driven by need to improve communicationDeveloped formal Labour Ward round led by Consultant
ObstetricianStill work to be done
Triage – Drivers for changeNot TriagePoor communicationMany drivers for change
SAFETYComplaints
Triage Working Party
Consultation exercise
Triage Consultation Exercise
Triage – where we are nowOngoing piece of workSome changes have been madeMoved beyond The King’s Fund team and now a priority for
the DirectorateCurrently in the process of an Options Appraisal
Measures of success:Decrease in patient’s complaintsAudit – before and after number of callsImproved staff morale and working conditionsIncreased Home Assessments
How did The King’s Fund help?
Time away from NGH to discuss problems and planRegular meetings kept momentum goingInvaluable advice from guest speakersGave work validityConsultation exercise
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