Agenda item

Report of the Staffordshire and Stoke-on-Trent ICB.

Helen Slater, Associate Director for Transformation at Staffordshire and Stoke-on-Trent ICB and Karen McGowan, Associate Director Nursing, Quality & Maternity at Staffordshire and Stoke-on-Trent ICB presented the Maternity and Neonatal Services Update to the Committee.

The Committee noted the following comments and responses to questions:

·         Assurance was given that there was a Patient Safety Specialist officer in place as per the Ockenden report.

·         Freedom to speak up policies across the ICS were being refreshed. Assurance was given that the providers within Staffordshire were ensuring that there were robust speak up processes in place.

·         The Freestanding Midwife-led Birthing Units (FMBU) at County Hospital and Samuel Johnson Community Hospital were suspended at the beginning of the pandemic in line with national guidance. It was reported that significant staffing challenges had prevented these units to reopen safely. The ICB had worked with UHNM and UHDB to outline the current position of FMBUs and had presented a case for change to NHSE and they supported the proposal to continue with an options appraisal process and public engagement regarding the birthing services at County Hospital and Samuel Johnson.

·         Prior to the temporary closure of the FSBUs, the number of women choosing to give birth there remained low. In 2019/20, 94 women gave birth at County Hospital and 220 women gave birth at Samuel Johnson Community Hospital. It was reported that these numbers were significantly below the 350 births per unit per year recommended in 2018 for the FMBUs to be clinically and financially viable.

·         A draft Communications and Engagement plan setting out the Public Engagement activities over the next few months had been shared with the Staffordshire and Stoke-on-Trent People and Communities Assembly and ICB Quality & Safety Committee and feedback would be incorporated into the business case.

·         Home birthing services were also suspended during the pandemic and had subsequently been restored and were currently paused due to workforce challenges. It was reported that the ICB received regular updates in relation to the anticipated reintroduction of these birthing services within Q4 2023/24.

·         Staffordshire and Stoke-on-Trent had the second highest neonatal mortality rate in the UK. The UHNM Neonatal Improvement Group had been re-established to better understand the data and identify areas for learning. It was also reported that the Children and Young People Programme Board had commissioned an Infant Mortality review and a steering group had been established to look into the wider social factors which may impact on neonatal mortality rates.

·         A full route cause analysis is completed for every neonatal death.

·         Following a CQC visit to UHNM Maternity Services in March 2023, a S29a notice was issued with further actions included in the final report. The Trust’s response to these actions was overseen by the ICB and NHSE.

·         The Committee discussed that SSOT ICB should investigate the feasibility of an external audit of maternity services in Staffordshire.

·         There had recently been successful recruitment campaigns in both UHNM and UHDB to reduce the vacancy rate. The Committee were informed that initially the influx of new recruits would require support and present additional pressure however, the Committee were assured that there was still a skill mix of midwives and some of the posts had specific skill requirements.

·         Inductions of Labour at UHNM remained a challenge as a result of ongoing workforce challenges; spontaneous labour would take priority over an Induction.

·         Healthwatch Stoke and Healthwatch Staffordshire had completed a joint review of maternity services at UHNM which was due to be published in the coming weeks.

·         A Dashboard of data had been developed by the SSOT ICB and UHDB and UHNM.

·         Staffordshire and Stoke-on-Trent were included in a pilot to appoint a Maternity and Neonatal Independent Senior Advocate to support women and families who had experienced a traumatic episode. This was a temporary post and work was ongoing to extend the funding for a further 12 months. There was also the Maternity & Neonatal Voice Partnership (MNVP) which had processes to work Mothers and identify champions who worked with these women and families who had experienced a traumatic episode.

·         NSCHT and MPFT provided a birthing trauma service. There was also a bereavement service available.

·         Assurance was given that there were translation services available to families and there had been investments in translation technology.

Resolved – That (a) the report be received, and the Committee comments be noted.

(b) Staffordshire and Stoke-on-Trent ICB investigate the feasibility of an external audit of maternity services in Staffordshire.

(c) the Committee receive an update on maternity services and on the Freestanding Midwife-led birthing Units.