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Scrutiny Panel review of Review of Maternity Services
Bronwen Whittaker CEO
February 2021
1. Background
Family Nursing & Home Care (FNHC) is a Jersey charity committed to providing high quality, integrated nursing and home care in the community from pre-birth to end of life. Our services touch the lives of more islanders than any other charitable organisation, helping children, their families, the sick, the elderly and the dying. We have teams of experienced and highly qualified nurses operating a range of services including, Health Visitors, School and Children's Nursing, District and Specialist Nursing as well as Home Care
2 Family Nursing & Home Cares Response to the panel questions :
- Are the current maternity facilities in the General hospital and the planned upgrade of works appropriate and adequate?
FNHC have not had any involvement in the plans to upgrade the area, therefore cannot comment on this question.
- Is there suitable antenatal and perinatal mental health care and services available to new parents?
Development of the Perinatal Mental Health Pathway has been underway for around 2 years which includes Health Visiting, Midwifery, Parent Infant Psychotherapist (CAMHS), Adult Mental Health, MIND Jersey, JTT, NSPCC and their Pregnancy in Mind (PIM) Programme.
This pathway is looking to integrate services that already exist, which will be informed by client experience. In addition, the pathway is looking to develop new ways of working for referrals, triage and service response. Where gaps in provision are being identified, it is proposed that a business case will be developed to enable the service to meet client needs and become more robust. This development will include protected time for a dedicated midwife and aligning the service to meet Safeguarding requirements. The highest priority within the pathway is an emphasis on the identification of needs at the earliest point and early intervention.
- Is the care that is provided during the antenatal, intrapartum, and postnatal stage of pregnancy delivered safely and effectively?
As a response to a recent Serious Case Review the multiagency approach is embedding the Pre-birth Protocol into practice (https://www.fnhc.org.je/media/43318/multi-agency-pre-birth-protocol-for- unborn-babies-ratified-july-2020.pdf).
Multi agencies attend and engage in an antenatal Multidisciplinary Team meetings where parents and unborn babies with additional needs are the focus. Plans, actions are outcomes of the meeting are developed on a case by case basis. Meetings occur monthly and monitor progress of actions and the pregnancy throughout the antenatal period.
Discharge summaries for mother and baby are shared with health visitors by midwives following birth and discharge from hospital.
FNHC Paediatric Liaison health Visitor (PLHV) provides information flow across maternity, Health safeguarding and Health Visiting. This provides a flow of information which cuts across IT systems and ensures practitioners are aware of issues required for their safe practice. This includes progress and care of neonates, cared for on SCBU, antenatal and post-natal parents.
Health and Community Services (HCS) second 1 Whole Time Equivalent midwife to the delivery of the Baby Steps perinatal parent education programme https://www.fnhc.org.je/Search?q=baby steps.
This ensures that as a universal offer, new parents are able to engage with a programme designed to increase their confidence and preparedness of becoming new parents.
- Are women able to make safe and appropriate choices of maternity care for themselves and their babies?
FNHC is not aware of the criteria and basis for choices given to new parents nor do we ask our clients for feedback therefore are unable to make any comments.
- Are the relevant policies appropriate and are they utilised in a suitable manner?
Current implementation of the Multiagency Pre-birth Protocol is being embedded in practice
FNHC is commissioned to deliver the Baby Friendly Initiative (BFI) which is based upon the UNICEF Programme and is aimed at increasing breastfeeding rates https://www.unicef.org.uk/babyfriendly/.
Maternity Services have achieved Stage one of a three stage UNICEF accreditation having achieved the 8 standards of BFI.
- Are sufficient manpower/resources/skills available to deliver the best care?
FNHC cannot comment on this however during the initial COVID lockdown, the 1 WTE midwife seconded to Baby Steps was drawn back to maternity services to enhance the hospital establishment.
- How can maternity services be improved to meet the needs of families?
FNHC are invited; and contributing to; a new multiagency meeting with a Public Health focus where the aim is to establish evidence-based information that can be given to parents consistently. This is an area that requires a plan for joint working so as to improve the client experience. It is chaired by the Head of Midwifery and attended by all agencies who meet parents in the prenatal, antenatal and postnatal period. The attendance is to be broadened to include the Community and Voluntary Sector. The subjects that are currently prioritised are; smoking, alcohol, mental health, nutrition and C- sections. To date there has been one meeting.
- What impact has Covid-19 had on the provision of maternity services?
FNHC do not have any involvement with the provision of maternity services nor have we been asked by the service for client feedback during Covid -19, therefore are unable to comment.