The best start: five-year plan for maternity and neonatal care was published in 2017. The strategy outlines a vision for future planning, design and safe delivery of maternity and neonatal services in Scotland. It puts the family at the centre of decisions, and promotes every woman, baby and family receiving care which matches their needs.
Since 2017, the Scottish Government tasked NHSGGC with implementing 23 out of the 76 Best Start recommendations. Developing these necessary changes was predicted to take 5 years.
The following overview outlines the user involvement work that we hosted prior to the COVID-19. It shows how we worked with patients and staff to evaluate how well we implemented Best Start recommendations.
Clyde Early Adopter work – continuity of carer evaluation
NHSGGC’s Clyde region is one of five Early Adopter sites selected to implement a number of Best Start recommendations. Midwifery teams across Clyde are testing new models of care to promote patients seeing the same staff throughout their maternity journey (continuity of carer).
During local evaluation of this model, we recognised many aspects of continuity of carer can only be assessed by listening to women’s experiences. The Patient Experience Public Involvement (PEPI) Manager has provided advice, guidance, tools and support to the Clyde Early Adopter group over the last 12 months. This allows us to evaluate the new model of care from a patient perspective.
Purpose of Evaluation
- Explore whether women felt they received continuity of carer throughout their pregnancy, labour and birth, and postnatal care
- Understand how this new model has made a positive difference to patients’ overall care and relationship with midwives
- Find out what is important to women as they go through their maternity journey
- Identify and reflect on what we’ve done well and where where we can improve.
Local implementation of Care Opinion
Care Opinion is used to capture patients’ experiences of continuity of carer models in Clyde. The PEPI Team provide support to the Chief Midwife and Lead Midwives to help them respond and act on all maternity feedback received on Care Opinion.
The Lead Midwives respond to feedback, share positive experiences with teams and identify areas for improvement. They’re also required to demonstrate how feedback has made a difference and what changes have been made as a result.
Midwifery staff can encourage patients to share their experiences on Care Opinion through word of mouth. There are also pop up banners on display across maternity sites and regular promotion of Care Opinion on NHSGGC social media. The PEPI Manager is exploring how we can promote Care Opinion on Badgernet – the electronic maternity record that patients can now access.
Care Opinion feedback should influence and inform the development of maternity services, alongside other feedback sources. Positive labour stories at the Inverclyde Royal Hospital and Vale of Leven’s Community Maternity Units could be used as part of ongoing promotion of these Birthing units.
Review of NHSGGC’s Maternity Services Liaison Committee
The PEPI Manager and Chief Midwife explored innovative approaches to engaging with patients to shape maternity services. This included connecting with Seona Talbot (Sure Start Manager in Northern Ireland and President of the National Childbirth Trust) who successfully changed their approach to user involvement. After facing similar challenges to NHSGGC with traditional Maternity Services Liaison Committees (MSLC), they adopted a co-producing model which includes using social media to engage.
The majority of their user involvement happens on Facebook, where they capture real time feedback and engage on specific transformation projects. The maternity staff also feedback to patients how their views have influenced the services. It was agreed our Chief Midwife would discuss this model with the Directorate Management Team, and agree the future of the MSLC with the Director.
As part of this work, the service should find out how patients want to help shape maternity services and use this as an opportunity to co-design the user involvement activity.
At the same time as our local review, the Scottish Health Council carried out a national scoping exercise on behalf of the Scottish Government. The purpose of this was to examine how NHS Boards across Scotland involve patients to develop maternity services; which included MSLC and other activities.
Moving Forward Together third sector event
We hosted A Moving Forward Together event with Third Sector organisations on Wednesday 19 June 2019. The Moving Forward Together programme sets out our vision to transform health and social care services to meet the needs of the local population. We shared information on how our services are changing and engaged with third sector organisations to shape what the services will look like. The event was also an opportunity to raise awareness of Best Start and the future vision for maternity and neonatal care in NHSGGC.
Poster presentations were on display throughout the event. They included key information on the national Best Start framework and what the continuity of care model will mean for patients locally. The PEPI Manager provided support by developing content and attending the event to display the poster and engage with attendees about Best Start.
No maternity related third sector organisations were able to attend the event. However, we’ll continue to explore opportunities to engage with these organisations, as this is part of us building and maintaining relationships with our key stakeholders. It also supports a partnership approach to service development and redesign. The approach will allow us to reach out more patients and their families, and gather more views and experiences for service redesign.
Engagement with women and partners around maternity visiting
We’re also required to involve partners and allow them to provide support to patients during the antenatal and postnatal period. As part of this, each health board has to review accommodation provision and ensure they have a local policy for partners having a presence overnight.
Within NHSGGC, the PEPI Team gathered views and experiences of patients and their partners. They asked people to comment on visiting times and their preferences around partners having a presence overnight. This involved visiting our postnatal and antenatal wards and carrying out 1:1 conversations using a semi-structured approach.
In total, the PEPI Manager spoke to 29 people during 19 conversations with patients and their partners. The views and experiences informed the revision of the Board’s maternity visiting policy and accommodation provision for partners. The findings also helped plan the Maternity person centred visiting workshops led by our Person Centred Visiting team. These workshops were due to take place in March and April 2020, but were subsequently postponed due to the COVID-19 Pandemic.