Agenda item

To consider a report of the Senior Commissioner for Children & Maternity (GM ICS – Stockport Locality).

The report provides an update on Stockport Maternity Services.

The Scrutiny Committee is recommended to comment on and note the report.

Officer contact: Jennifer Connolly on 0161 474 2442 or email: jennifer.connolly@stockport.gov.uk

The Senior Commissioner for Children & Maternity, Greater Manchester ICS – Stockport Locality submitted a report (copies of which had been circulated) which provided an update on Stockport Maternity Services.

The Cabinet Member for Health and Adult Social Care (Councillor Keith Holloway) attended the meeting to respond to questions from the Scrutiny Committee.

The following comments were made/issues raised:-

·         In relation to poorer outcomes for black and minority ethnic communities, it was queried what steps were being taken to improve the data quality around these outcomes and whether the work to improve outcomes for black and minority ethnic communities included greater continuity of carer.

·         In response, it was stated that relating to the data a business analyst had been supporting maternity services and grow the digital team within midwifery in order to produce more, detailed data to provide assurance. With regard to continuity of carer, following the Ockenden report, there were some concerns around midwifery staffing and the safety of other services and a letter from Government suspended the full roll-out of continuity of carer across the whole population to focus predominantly on vulnerable families and minority ethnic groups. 

·         Welcomed the work to support asylum seeking women and families and women that do not speak English as a first language in Stockport.

·         Requested that a future report on maternity services in Stockport include information comparing the outcomes women who are not asylum seekers but are from a minority ethnic background to understand the differences of outcomes.

·         In relation to the increase in caesarean sections, it was queried how planned caesareans were managed in line with emergency caesareans.

·         In response, Members were informed that there were two theatres within the maternity unit and one theatre within the main hospital. The planned elective caesarean section list was staffed by a team specifically and on delivery there was a team waiting for any emergency caesarean sections.

·         It was queried at what point had there been no maternal deaths.

·         In response, it was confirmed that tableaux reporting began in 2020.

·         It was queried why there had been an increase in induced method of onset.

·         In response, it was stated that there was a national driver within the maternity improvement programme which was focussed on reducing deaths and where a risk had been detected women would be induced at different stages dependent on their pathway. As a result, the induction rate had risen nationally, however the safety of babies had improved.

·         Requested clarification in relation to the CQC January 202 inspection action ‘the trust should work to reduce the increasing number of instances where the service is closed to admissions.’

·         In response, it was reported that at that time the maternity unit was declaring a divert in maternity services where the service was closed to individuals who were booked at Stockport to have a baby due to issues around staffing. However, this had been improved and additional staff had been recruited.

·         It was noted that historically residents within other authority boundaries had elected to use maternity services within Stockport and queried whether this was still the case.

·         In response, it was confirmed that women had a choice where they preferred to birth and for the last three years, Stockport had provided care for women who had booked at Macclesfield due to them suspending their intrapartum care at the start of the pandemic.

·         Recognised that policies and improvements since 2016 and queried whether adequate funding was in place.

·         In response, it was stated that maternity services were commission paid for through a national tariff arrangement and as part of the transformation programme there was a commitment to review the funding arrangements. However, staffing levels were comparatively strong and permission had been granted to recruit to any turnover.

·         Requested assurance in relation to the recommendation of the Ockendon report that the staffing establishment at night on the ante/postnatal ward was now in line with safe staffing.

·         In response, it was confirmed that staffing at night was altered immediately to ensure that there were three midwifes and two support workers in place.

·         Expressed disappointment that the full roll-out of continuity of carer across the whole population had been suspended and queried whether the full roll-out would be delivered in due course.

·         In response, it was stated that the long-term position was unknown as the service was awaiting the single plan from maternity services which was due to be released at the end of March, however the Trust valued continuity of carer and the benefits that it delivered. The current statistics showed that approximately 40% of women were on the continuity of carer pathway.   

·         In relation to the recruitment and retention of midwives, additional information was requested around the appointment of a retention midwife.

·         In response, it was confirmed that the appointment was for a current practicing midwife who had stepped out of the practicing element as a supernumerary person to work with the newly qualified midwives which was funded through one-off funding for one year. The position was a restorative, supportive role to support newly qualified midwives and also included involvement with the international recruitment of midwives.

·         It was queried whether the vacancy as a result of the retention midwife was recruited to.

·         In response, it was confirmed that as the service was able to recruit to turnover, her post had been filled. 

·         Clarification was requested in relation to the safety action ‘avoiding term admissions to a neonatal unit.’

·         In response, it was stated that avoiding term admissions to the neonatal unit was a national programme to reduce harm leading to avoidable admissions to neonatal units for babies born at or after 37 weeks through good working relationships with the neonatal units and sought to avoid separation of mothers and babies.

·         Welcomed the progress that had been made and queried whether there was opportunity to make further improvements.

·         In response, it was stated that the Trust was awaiting the national plan from NHS England and there as a robust, continuous improvement programme in place to ensure that the Trust was well positioned within the local maternity neonatal system. In the immediate future the key focus was the sustainability plan, continuous improvement and a five-year plan around equity and equality to understand the offer to all women within the community.

RESOLVED – That the report be noted.