Agenda item

Helen Buckingham (Deputy Chief Executive and Director of Whole Systems Commissioning, NHS Kent and Medway), Peter Gilmour (Director of Communications, East Kent Hospitals NHS University Foundation Trust), Dr Neil Martin (Medical Director, East Kent Hospitals NHS University Foundation Trust), Dr Sarah Montgomery (Senior Clinical Advisor, NHS Kent and Medway), Dr Brighton Chireka (GP Clinical Lead for Children Services, South Kent Coast CCG), Laura Counter (Commissioning Project Manager - Maternity Services, NHS Kent and Medway), and Abina Browne (Head of Midwifery, East Kent Hospitals NHS University Foundation Trust) were in attendance for this item.

(a)       The item was introduced with NHS representatives explaining that the report covered the implementation of the changes to maternity services introduced the previous year which the Committee had looked at in detail. One Member of the Committee commented it had been the best example of a review since the creation of HOSC.

(b)       One main area of discussion was how the changes were being publicised. NHS representatives explained that the information booklet ‘Your Birth, Your Choice’ had been produced and was available in key languages. Midwives were provided with copies to hand out and it was advertised in the GP Bulletin which went to all practices. This provided a link so that it could be downloaded and/or printed on demand. Members expressed the hope that this information would be actively promoted so that people were actively aware of the current arrangements for maternity services. A copy of the booklet was requested by Members and a hard copy left by NHS representatives for later circulation (see Appendix).

(c)        There would also be publicity around the formal opening of the new Margate Alongside Midwife-led Unit. This had been pushed back to 8 February from its original date as it had been possible to arrange for Pam Ferris, star of television programme Call the Midwife, to attend and formally open the unit.

(d)       A Member of the Committee referred to the meetings of early 2012 when the Committee had been informed of issues around midwife numbers in East Kent and asked for an update on recruitment and retention. It was reported that the recruitment campaign had achieved what it had set out to do and that retention was very high compared to other areas. There was an in-house training programme to allow midwives to develop their skills; this was enhanced by the presence of two Alongside Midwife-led Units in East Kent which helped develop skills and experience.

(e)       The question of monitoring and assessing performance of maternity services regarding the experience of patients was also raised. It was reported this was something the NHS was working on. Patient experience was important to assess but was difficult to get from purely quantitative information.

(f)         There was extensive discussion around births before the arrival of the midwife (BBA). There was clarification provided that although in the last three months there had been 17 BBA across East Kent, as stated in the report, there had been 52 across the whole of last year. Of the two in the Dover area in the last quarter, one birth had been en route to the hospital and the other was a scheduled home birth when the midwife had not been called in time. There was a discussion around the possible causes of BBA occurrence, including problems with service organisation, social circumstances and education of the mother, and transportation. The clinicians attending among the NHS representatives emphasised that BBA was a physiological event that would happen however the services were arranged. It was also added that BBA can be less traumatic for the mother than a prolonged labour in hospital precisely because labour is over quickly in a BBA. It was reported that Kent was not an outlier nationally on the number of BBA. Members requested additional information on this subject covering – comparative statistics of numbers over the last four years, including whether these were home births, comparisons with other regions, and information of outcomes of BBA. NHS representatives undertook to provide this information to the Committee.

(g)       There was also a discussion clarifying the opening times at the Buckland Hospital in Dover. Members were reminded that Buckland provided ante-natal and post-natal services but did not carry out deliveries. The hospitals carrying out deliveries were open 24/7. The opening hours 8am – 8pm Monday to Friday, including Bank Holidays, shortened to 9am – 5pm on weekends, and it was reported that shorter opening hours on Saturdays and Sundays were consistent with how mothers wish to use services. In addition, there was a 24/7 on-call midwife service.

(h)        The Chairman proposed the following recommendation:

·        The Committee thanks its guests for their contribution, asks them to take on board the points raised in the meeting and looks forward to updates in the future.

(i)         AGREED that the Committee thanks its guests for their contribution, asks them to take on board the points raised in the meeting and looks forward to updates in the future.