Agenda item

Senior representatives of North Tees and Hartlepool NHS Foundation Trust (NTHFT) were present to update the Committee on developments involving its maternity services following issues identified by the Care Quality Commission (CQC) in 2022.  As well as updating Members on the actions taken in response to these CQC outcomes, NTHFT had also been asked to provide details of its review of the community midwifery offer after concerns were raised by the Committee in early-2023.

Led by the NTHFT Associate Director of Midwifery and supported by the NTHFT Chief Nurse / Director of Patient Safety and Quality, a presentation was given which covered:

•           Perinatal Organisational Structure: Significant changes made in relation to these services with a shift in terminology to ‘perinatal’ and alignment with the neonatal offer (reflecting a national drive for restructuring existing maternity provision).  The Trust’s introduction of a ‘quadumvirate’ (four key posts within the perinatal structure) was nationally recognised as best practice in terms of organisational composition, of which the Associate Director of Midwifery post was one of three additional professional leadership roles which had been implemented as part of a transformational plan.

•           Perinatal Services Governance: NTHFT had commenced an NHS programme which focused on strengthening culture within its maternity offer – this was expected to take over six months and would enable learning which could be applied to other Trust areas / networks.  A key consideration around governance was also to ensure the voice of service-users was appropriately sought, considered and, where necessary, acted upon – this was an important aspect of the ‘Ward to Board’ / ‘Board to Ward Governance’ ethos.

•           CQC Improvements (5 Must Dos; 1 Should Do): Focused inspection undertaken by the CQC in 2022 which identified areas for improvement – all ‘must do’ actions had since been signed-off as complete.  Example included of detail, evidence and ongoing monitoring arrangements for one of the ‘must do’ elements – this information was accessible to staff and this assurance mechanism would be adopted throughout the Trust’s perinatal structure.

•           National Safer Care Recommendations: Increased national focus on maternity services following high-profile failings elsewhere in the country.  NTHFT was on-track for compliance with both the Maternity Incentive Scheme and the Ockenden Report: Immediate and Essential Actions which fed into the maternity and neonatal three-year delivery plan.  The Trust had received positive feedback following visits led by the North East and North Cumbria Integrated Care Board (NENC ICB) and a peer review, with notable changes recognised – this was empowering for the whole service and its staff.

•           Community Midwifery Services: Led by the regional midwife team, an external review of this provision started in July 2023 which included the hosting of several workshops, sessions with staff, and the triangulation of local intelligence (complaints / compliments).  Engagement with the Maternity and Neonatal Voice Partnership (MNVP) was also initiated, and an interim report had since been produced which would be considered by the senior team.  The Trust had secured investment from the regional midwife team to strengthen the existing community offer.

•           Areas of Good Practice: Several positive aspects in relation to NTHFT maternity provision were highlighted, including the development of a bereavement pathway, a Professional Nursing Advocate (PNA) and Professional Midwifery Advocate (PMA), and ‘Badgernet’ – electronic patient records which had interface with neighbouring South Tees Hospitals NHS Foundation Trust (STHFT).  There had been visits from the Deputy Chief Midwifery Officer for England and the Regional Chief Midwife, post-discharge neonatal feeding support (in conjunction with a baby-friendly initiative), and 0% staff turnover this month, with a forecast of positive recruitment to the service by 2024 despite the well-known challenges around recruitment and retention within health and care.

The Committee thanked officers for their presentation and welcomed the positive steps that had been taken / achieved to improve the maternity offer which reflected wider input from professionals outside the locality.  Members were pleased to hear of the national / regional recognition of the Trust’s work to strengthen provision and spoke of their knowledge of an increasing number of expectant / new mothers being aware of the services which were available to them.  Links to STHFT regarding patient records was also praised given some of the Borough’s residents accessed the James Cook University Hospital, Middlesbrough, and the Committee was keen to receive Maternity and Neonatal Voice Partnership (MNVP) input as part of any future update on the Trust’s maternity services.

AGREED that the North Tees and Hartlepool NHS Foundation Trust (NTHFT) maternity services update be noted.