Health bosses have highlighted a large drop in the amount of women having major bleeds following childbirth among improvements to maternity services.
A midwives’ director told councillors of North Tees and Hartlepool NHS Foundation Trust’s efforts to improve. This follows the high-profile Ockenden Report into failures in maternity services at the Shrewsbury and Telford trust in March 2022, and findings that the North Tees trust and maternity services at the University Hospital of North Tees and University Hospital of Hartlepool “require improvement” in September of that year.
Stephanie Worn, associate director of midwifery at the North Tees and Hartlepool NHS Foundation Trust, told of the trust’s more recent successes at a meeting of Stockton Council’s children and young people select committee. In particular she pointed to the falling numbers of port-partum haemorrhages: “That’s a really key success for us all.
“It peaked just after January 2023 and came down in January 2024. This is a major bleed following childbirth.
“We were an outlier within the North-east. We recognised that it’s not just about your physical health, it’s about psychological health and support. We knew we had a lot of work to be done.
“We reviewed all the cases we’d had and we realised it’s not just about that moment in time when it happens. This is about making sure women are fit for going into labour and how we optimise their health antenatally.”
She said they were making progress on seven “must dos and should dos” with a safety support programme and improvement plan. Actions included an expanded midwifery workforce with specialist midwives, recruitment of a midwifery associate director and three senior clinical matrons, and revised governance structures, as full-time vacancies fell from 19 in 2023 to three in 2024. She added: “For us what’s key is we actually sustain the improvements and we still monitor.
‘We don’t foresee any concerns’
“We’ll be getting a review hopefully within the next quarter. We’re making good progress and we don’t foresee any concerns with being on track.”
She said they were complying with national recommendations: “Currently we are on track again to be able to say we’re compliant with all 10 safety actions. We’ve done great work with our maternity, obstetric and neo-natal workforce,” she said.
Ms Worn added that they had made improvements with maternity triage, community services, and new ways of inducing labour: “It enables women to have a shorter time in hospital and be able to spend the next 24 hours at home. We know that’s a better environment.
Different ways of working
“If there’s any cause for concern or a woman doesn’t want to be a home, of course we’ve got to respect their wishes, they can still stay in. It’s about quality and experience. We’re trying to promote bonding and establishing those connections early.”
She said they needed to improve people’s experiences, with the new methods meaning women were able to come to hospital for initial assessments “but more importantly they can go home rather than be an inpatient, which is what previously had happened”.
She added: “Our community midwifery services could have been better when we heard from our service user voices and experiences, so there has been lots of work ongoing. Essentially for us here in Stockton what we realised was women were telling us they didn’t have a choice in their locations of appointments.
“We’ve done different ways of working now. The appointment choice is always offered with home as the first port of call.”
Information will be ‘a central focus’
She added they were trying ways of working more flexibly, with family hubs, and “making sure women are heard, is this what they would like for themselves and their families”, and seeing how to support families. They were setting up a project with Teesside University, the student workforce and midwives to develop “bite-sized parent education”, and offering work placements and exploring apprenticeships.
She spoke of more personalised care, more choice and information: “I think we realised sometimes our previous information we provided was quite cold and clinical. We’re looking at different ways of providing that information so that will be a central focus for the next year.”
She said they were also working towards a maternity triage service: “Great work’s going on and we hope we’ll be able to get a date for implementation. It’s not straight-forward, we need to make sure we’ve got the skilled workforce, training elements and digital systems.
“For us coming into the next year, it would be fair to say we would take all the recommendations and reports that are coming through to put it into one sensible improvement plan.” She said they were “probably 75% of our way through” an overall three-year plan.
‘More work to be done’
She also referred to infant feeding in the community: “I think that’s another aspect where we could do better to enhance the service. We’ve now got two infant feeding specialist midwives. We’re possibly looking at running clinics in the community as well.”
She said there were now better links with community services and health visitors: “There’s probably still more work to be done but I would say there’s been an improvement.
“Really post-natal care shouldn’t be any different to ante-natal care or care in labour, because it’s hard. I think post-natal care has to be a key priority, the rest of the journey.”
Councillor Lynn Hall said she was delighted with improvements in oversight and recruitment: “Following our meeting last year I had a lot of discussion. We clearly didn’t have it right at that point.
“There was lots of things going dreadfully wrong and we were hearing about that from our residents. It’s interesting that came out in your survey. With this plan, they’ve made such strides from where we were 12 months ago.”
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