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Maternity Services Review:
Other Review Activities

Public Survey Results


In May 2010, we asked women and families who were using, or had recently used, maternity services about their experiences. We asked people what was good about their care, what they would improve and how. Over 200 people took part - the results included a lot of praise for the care and treatment women had received but also suggestions for improvement across a range of areas.
 
Although aspects of clinical care, processes and systems were highlighted; much of the feedback related to how staff communicate with women and their partners throughout pregnancy, labour, birth and postnatal care.
 
Most women had good things to say about their care, but others had poor experiences to share. Importantly, women had very strong feelings across a range of experiences.
 
Several examples illustrated that a good experience, where women received support and reassurance from staff, built a sense of confidence and trust which carried through into the whole journey of care. However, a negative experience, no matter how small, often led to a loss of confidence and heightened anxiety. To reduce the negative experiences, there is a need for the supportive, reassuring and sensitive approach used by many staff to be more consistently adopted. The full report of the survey can be found under 'Further Information'.
 

Staff Survey Results


We also asked staff for their views about what was good and what and how they would improve the care they provide. Staff said they feel they generally work well as teams that co-ordinate care. For example, they strive to offer choice and continuity of care to women through community based teams, with easy access to highly specialist care when needed.
 
Community staff felt that it is possible to provide care close to home throughout pregnancy for many families; staff at Dr Gray's Hospital, Elgin, were proud of their high normal birth rate; Aberdeen Maternity Hospital (AMH) staff felt they were open to adopting new practices: a recent example was helping women affected by domestic abuse to say so confidentially.
 
Staff everywhere felt they would have more time to care for women and families if there was less duplication, better matching of tasks to skill levels of staff and more co-ordination of processes. Other improvements suggested included:  giving more one to one care during labour in Aberdeen's Midwife Unit; fairer rotas for community staff and making sure services are in the right place.
 

Improvement Event Success


Over 50 people attended the improvement event in August, including staff and public representatives from across Grampian. The report is now available to Link opens in new windowdownload as a pdf.
 
During the week we looked at problems in the service before agreeing what an ideal service would look like. We looked at what parts of the ideal service were possible to achieve, despite the constraints facing the service such as funding.  The main achievements were:
  • a vision for future maternity services which has formed the outline of NHS Grampian's next maternity strategy

  • a range of changes to improve safety, efficiency and the experiences of women such as:

    • involving communities in parent support programmes

    • improving the quality of information we provide and making it available electronically

    • moving to a single telephone service for women needing urgent advice

    • consistent clinical management and clinical procedures across Grampian

    • matching antenatal clinics to areas of Grampian to reduce waiting times

    • reducing unnecessary interventions and improving the normal birth rate, for example, by increasing one to one care in labour at AMH and improving the information and support given to women after a caesarean section

    • better management of operating theatres so that emergency operations don't delay planned ones
  • agreement for the need to assess how maternity services are set up - looking at what they provide, who provides it, and where they are located. This is to ensure services can cope with challenges such as rising birth numbers.

Feedback from people who attended the event was very encouraging with three quarters rating all aspects of the event as positive.