Letter - Minister for Health and Social Services - Response to Information Request - 2 March 2021

Health and Community Services

Women, Children and Family Care Group

Health and Social Security Scrutiny Panel Review Response to request for information

 26 February 2021

In response to Deputy Le Hegarat 's letter on behalf of the Health and Social Security Scrutiny Panel to the Minister for Health and Social Services dated 15 February 2021, the responses to the questions posed are as follows:

1. How many births have taken place each year since 2015?

Indicator  Definition  2015  2016  2017  2018  2019  2020

Deliveries with an

1054  1024  958  928  878  863 Births  outcome of 'Live'

2. How many miscarriages (that you are aware of) and stillbirths have occurred each year since 2015 ?

The data below in reference to miscarriage' refers to those women who were known to Maternity services at the time of their miscarriage. The information is only available from 2016 onwards.

3. How many formal complaints have been raised each year since 2015 by parents in respect of the care provided whilst receiving maternity services?

Indicator  2015  2016  2017  2018  2019  2020  2021 No of Complaints  5  5  5  7  2  20  3

a)  What were the nature of these complaints?

The nature of the complaints are categorised as follows:

4. How many staff work within the Maternity Unit and Antenatal Clinic within the General Hospital (and what are their positions)?

• 2 midwives have been trained and can do a limited range of scans

• 1 midwife just commenced in role can do the full range of scans

This is part of their midwifery role

5. How many Midwives in total are currently employed in Jersey (community midwives and hospital midwives)?

There are currently 52 midwives employed in Jersey, including the Head of Midwifery and Lead Midwife. This is equal to 47. 21 full time equivalents (FTE)

6. How long has the current Head of Midwifery been in her position?

The current Head of Midwifery/Associate Chief Nurse started on 2nd September 2020

7. How many Head Midwife's have been in place since 2015?

There have been three Heads of Midwifery since 2015. The current Head of Midwifery has been in post since 2nd September 2020.

In addition, there was a senior midwife who undertook an act-up position between postholders.

8. How many women were offered a debrief of their birth in 2019 and 2020 and how many women took this up?

In 2019, a total of eighty (80) women (plus some partners/family) accessed support through our Listening Clinic. Fifty-five (55) were seen at the hospital and twenty-five (25) in their home.

In 2020, a total of sixty-four (64) women accessed support through our Maternity Listening Clinic.

9. When was the last time a review (internal or external) was undertaken by HCS regarding maternity services?

The last review of Maternity Services was undertaken by an independent clinician between 1 – 4 September 2020.

Documents to be provided:

1. A governance diagram of maternity services in Jersey

Please see Appendix 1. This is currently under review.

2. Any documentation from any previous internal or external review of maternity services (including results from any previous surveys)

These documents will require consideration for sensitive personal data and third party redaction where there may be third party/patient identifiable information. The response will be provided at the earliest opportunity.  

3. Any detailed plans of future renovation/upgrade work to the maternity unit

Phase 1:

· 1A Create a new Bereavement Room and

· 1B New HDU Isolation Room with lobbies, Clean Utility and new Learning and Development Room.

Phase 2:

· Decant Bereavement room to new completed Phase 1A area.

· Completed Phase 1B HDU room to be designated as Hot Birthing Room & Old Obs Theatre to be designated as Hot SCBU area. Hand over SCBU 2 and Edward Rooms to main contractor.

· Create a new SCBU area including new courtyard extension.

Phase 3:

· Decant old SCBU into completed Phase 2 area

· Main Contractor to take possession of old SCBU

· Create 2 new MLU Delivery Rooms with en-suite as well as temporary Nurse Station

· Undertake Service renewal within existing Staff WC & Kitchen in accordance with MEP specification

Phase 4:

· Create new CLU 03 Birthing room with pool within old Obstetrics theatre, new on call doctor's room, Dirty Utility and Blood Gas room.

Phase 5:

· Phase 5 A - Create 2. New CLU Delivery Rooms 01 & 02 with en-suite and new nurse station

· Phase 5B - Turn redundant Delivery Room 02 into New Store 02.

Phase 6:

· Create new Female and Male Staff changing room areas and refurbish existing offices.

· Sub-phases required to ensure staff retain changing areas throughout phase.

· Decant ex Lockers temporarily into completed Store 02 & Staff to use existing Wet Room & 2no Staff WCs on the unit whilst new locker rooms are created.

· Existing Offices are to be decanted temporarily into the Learning & Development Room.

· Undertake service installation works within existing lift lobby and replace existing ceiling.

· On completion of new Lockers - Temp locker room/ Store 02 to be changed permanently into a Store.

Phase 7:

· Refurbish existing Collas 3 ward including new en-suite

Phase 8:

· Refurbish existing Staff Room to create new Collas 7 (private room) with en-suite.

Phase 9:

· Phase 9A Create a new Private Room 04 and refurbish existing Collas Room 3.

· Phase 9B - Refurbish existing Private Rooms Collas 4 & 5.

Phase 10:

· Refurbish existing Collas 2 ward

· Refurbishment of the Breakout space for New Baby Exam Room

· Refurbish Clean Utility Room 03

Phase 11:

· Refurbish existing Collas 1 ward

· Refurbish Medical records store for new Doctor's On Call Room 02

The refurbishment will provide

• The 6 new birthing rooms, 4 new Private rooms and SCBU areas will feature WCs/ ensuites.

• Collas ward 1 & 2 will have 2 new bathroom/ wet room facilities,

• Collas 3 will only have provision for 1 new Wet room.

This was deemed a betterment of the existing condition as fathers had been expected to leave

the unit to access the ground floor facilities.

4. Details of any policies/legislation currently in place that relate to maternity services

There are a range of HCS policies which relate to all services, including maternity. These include, for example, Duty of Candour, the Serious Incident Framework, Patient Safety Learning Event policy, Resuscitation Policy. There are also Government policies that apply throughout all departments, for example HR policies, finance and risk management.

Our clinical guidelines are based on the Royal College of Obstetricians and Gynaecologists and the National Institute of Care Excellence (NICE). These can be provided if requested.

A list of policies will be provided as soon as possible and any policy document can be provided on request.

We are not aware of any Jersey legislation that specifically prescribes or directs the operation of the maternity unit at the hospital over and above that which would affect the Hospital generally, for example, the Data Protection (Jersey) Law 2018 and GDPR; the Health and Safety at Work (Jersey) Law 1989; the Discrimination (Jersey) Law 2016; the Human Rights (Jersey) Law 2000 and so on.

5. Minutes and any associated documents from the current Maternity Voices Partnership meetings and any previous incarnation of this group/similar advisory or consulting group from the last 10 years.

In 2015, we operated a scheme called Quality & Women & Children's Services' (QWAC).

In 2016, this was termed Maternity Liaison' and more recently it has been re-branded as Maternity Voices Partnership'.

This is a women and families participation forum which seeks to gather constructive patient feedback  and  valuable information from their  experiences.  The  service  will  remunerate patients for their time taken in participating in this group.

Minutes and associated documents will require consideration for sensitive personal data and third party redaction where there is patient identifiable information. The response will be provided at the earliest opportunity.  

Appendix 1 Governance Diagram. Currently under review