Agenda item

11.20

For the Committee to receive a report of the Chief Nursing Officer, Oxford University Hospitals FT, on the current position of maternity services. 

12:40 Lunch

The Committee received a report from Sam Foster, Chief Nursing Officer, Oxford University Hospitals Foundation Trust (OUH) on the current position of maternity services.

Members raised a number of questions:

·       If the Trust has been collecting outcomes data to analyse any impact of the suspension of services.

·       If the CQC’s ‘Musts’ have been implemented.

·       If there was a plan to improve the two areas rated Red under the Incentive Scheme.

·       If further information on the Continuity of Carer (CoC) issue could be provided.

·       If any of the health inequality issues that have been identified were impacted by the issues around CoC;  if the teams were working to the recommendations of the MBRRACE Report.

·       If decisions to induce and other issues were discussed with the mother with an opportunity to ask questions before and after the birth and if shortages of health visitors were impacting significantly on the frequency of visits.

·       If there was data to compare with national figures on stillbirths, complications and trauma.

·       If there had been a response to the CQC report that had highlighted the lack of quiet rooms.

·       If CQC visits were unannounced and if their report contained any surprises.

·       If there was a prospect of the service moving from “requires improvement” grading to “good”.

·       If the communications and engagement around the temporary closures at Wantage and Chipping Norton were satisfactory.  If there was a timeline for reopening and if population growth trends were being taken into account.

·       Where the main shortages were in staffing.

·       If there was a problem with midwives having to endure poor living conditions

Sam Foster responded as follows:

·       The Trust was required to produce a quality impact assessment and review all of the alternatives – their pros and cons – which they were in the process of doing.  They had established that six patients were affected but they had been able to maintain one-to-one maternity care through this period.

·       The audits around the ‘Musts’ have given assurance that those improvements were in place.

·       On the Incentive Scheme issues, electronic notes were ensuring 100% compliance on point 6.  Point 8 related to training which encountered difficulties under Covid when front-line care had to be prioritised nationally.  However, they were on track to ensure compliance.

·       A national report (Ockenden final report ) had recommended pausing the Continuity of Care model due to a recognition that it could compromise safe staffing under the current workforce restraints.

·       The Lotus Team was focussed on health inequality and vulnerability issues and the Trust was continuing to invest in that team.  That team had the expertise to deal with the recommendations of the MBRRACE Report.

·       The decision to induce will always be a clinical decision.  The service could do better on providing information and will work with patients, families and Healthwatch to see how they can improve.

·       The service was working towards providing a dashboard and benchmarks.

·       The fabric of buildings could be an obstacle to providing bereavement areas and capital funding was needed.  However, Government capital spending was currently focussed on urgent care and elective recovery.

·       Most CQC visits were unannounced.  There were no surprises in their report.

·       The CQC currently had no plans to visit to regrade.  The inspection regime had changed a lot since they recommenced after Covid.  They were currently focussed on reactive visits based on concerns.

·       The temporary maternity closures at Wantage and Chipping Norton were related to staff shortages and quality assurance.  Wallingford on the other hand had three times the number of maternities.

·       There was a communications team dealing with media queries ensuring consistent information and midwives were meeting with the ladies affected.The service would be happy to work with the Committee on future planning.

·       Recruitment was improving.  The main shortage was in midwifery and the biggest issue was in retaining newly qualified staff.

·       The service has just carried out a survey on housing and new accommodation was currently being built.

The Chair expressed surprise that the expected maternities and future trends of expected maternities in Wallingford locality would be greater than the Wantage locality and asked for information on what postcodes the community hospitals were serving and whether current population and trends informed the decision making.  It was noted that a meeting of senior OUH officials was to meet to discuss plans for re-opening in the coming weeks.

Actions:

Sam Foster to provide more detail on the CQC Action Plan Update and on the Lotus Team as well as the Maternity Safe Staffing Paper.

Committee to be updated on the OUH executive decision concerning temporarily closed midwifery units.