Warrington and Halton Hospitals

RCOG maternity report 2014

Warrington and Halton Hospitals NHS Foundation Trust has published and welcomed a report it commissioned from the Royal College of Obstetricians and Gynaecologists last year and has already adopted many of the recommendations that were put forward.

The report, commissioned by the trust last summer to help them look at a cluster of stillbirths that occurred in 2013-2014, said that there was no evidence that the unit was unsafe, or that the findings from the thorough investigations could not be resolved. However, there were a number of clear findings and recommendations made.

The report was presented to the trust board in November 2014 and then with the families directly involved who had requested sight of the report before being made publicly available in February 2015.

Karen Dawber, director of nursing at the hospitals, said:

“We commissioned this report to give an outside expert perspective on our services after we had identified this cluster of stillbirths. It has told us that our service is safe and that our stillbirth rate locally remains lower than the national average for the UK, but it also took an in depth look at everything we do and made recommendations to strengthen key elements of our service further.

“We are now six months on from the snapshot of our service and a great deal of progress has been made. Training has been strengthened as the report highlighted areas that it could be made better, staffing has increased and the concept of a midwifery led unit for women and families in Warrington and Halton is moving closer. New systems to increase safety are in place and new staff have been appointed. Leadership in the unit has also developed with a new strategy for the future development of the service in place.

“Any time a baby is lost it is a tragedy and we look closely at every case. We know that for anyone who has lost a baby, it is something that will never be forgotten. Our aim is to take our service forward and ensure that we continue to provide the safest care for the 3,100 women and babies we care for in Warrington each year."

The trust has been working to use the recommendations of the report as a driver to strengthen its service. Some of the actions that have been put in place already (as at February 2015) include:

  • The trust has adopted a system called GROW (Gestational Related Optimal Weight) charts as a standard. GROW is a system that improves the detection of fetal growth problems during pregnancy and can help reduce stillbirth rates. The system has been accompanied with revised guidelines and training for identifying, managing and escalating cases where risk has been identified. Training has also included revised learning for all staff around interpretation of readings from CTG (cardiotocography) which is used to monitor unborn babies during labour.
  • Work has also begun to explore options around creating a midwifery led unit for the local community. Midwifery led units (also known as MLUs) are separate units designed specifically for low risk births where the care is led by midwives. New guidelines from the National Institute for Health and Care Excellence (NICE), released in December 2014, say that all women with straightforward pregnancies should plan to give birth in a midwife-led unit or at home rather than in a traditional hospital labour ward. The trust is working with commissioners to look at how this service might be provided locally.
  • The unit is also currently advertising for a new consultant midwife post to help drive further changes and lead work around creating the MLU.
  • Staffing levels have also been increased with five extra midwifery staff recruited over the last year.
  • Birthrate Plus – a midwifery workforce planning tool recommended by RCOG – is going to commence in March 2015 that will look at any other staffing needs in more detail.

Please note that names of staff interviewed have been redacted from the report but all other information from the report is presented in full.
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