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North Mid maternity - innovative services, comprehensive training, improved team work, and collaborative partnerships

Families using the maternity service at North Middlesex University Hospital NHS Trust can be confident their care will be provided by staff who have the right mix of qualifications, training and experience, who work well together, and are committed to continually improving services, according to a new report published in November 2021.

The report from the Care Quality Commission (CQC) which regulates all providers of health and care services, summarises findings of a team of CQC inspectors who visited our hospital-based maternity service in September 2021, to undertake a focused inspection on progress against an action plan we developed to support ongoing improvement.

Outstanding practice

The inspection team highlighted North Mid’s ‘Magnolia Midwives’, our award-winning perinatal mental health midwifery service, as an example of outstanding practice for its multi-disciplinary approach to supporting people experiencing mental illness before, during and after pregnancy.

The CQC inspectors, who interview and capture feedback from staff, patients, stakeholders and other data to inform their findings, noted that North Mid is above the national average for detecting babies whose growth was small compared to expected stage of pregnancy. This helps identify at an early stage if there may be possible complications in fetal development, and is known as the Growth Assessment Protocol (GAP). GAP is part of a set of tools developed by NHS England called  the Saving Babies Lives care bundle, which form a ‘best practice’ approach to reducing stillbirths across the UK. North Mid’s stillbirth rate is below the national average.  

Inspectors identified that improvements in training on fetal growth monitoring since 2020, as well as comprehensive mandatory and statutory training, widespread learning and development opportunities, an effective approach risk identification and mitigation, and prioritisation of safety and continuous learning, meant that North Mid’s maternity service “managed safety incidents well”. Their report also noted that the service “controlled infection risk well and kept equipment and premises visibly clean”.

Visible and approachable for patients and staff

Today’s report also describes significant improvements in team working and culture in the North Mid maternity service since challenges with these were first identified by the Trust as a result of feedback from staff through regular staff surveys and increased engagement between frontline teams and senior Trust leaders. The inspection team found that maternity service’s senior leaders were “visible and approachable in the service for patients and staff”, and that staff reported our director of midwifery and associate director of midwifery “were both approachable” and that they “could discuss any issues”.

High demand on maternity and inpatient services

The report identified that further improvements need to be made to induction for junior doctors joining the North Mid maternity service – although some good improvements had already been made – and that high demand on the Trust’s maternity service and other inpatient services were contributing to challenges in smooth discharge of patients out of hospital, as well causing pressures on staff that resulted in them experiencing ‘burn out’.

Additional areas identified for further, faster improvement by the North Mid team included ensuring translation services were available and used effectively to support patients, and capturing evidence of how maternity staff were supporting pregnant women with health information and advice, for example around COVID-19 vaccination, to support informed decision making.

Sarah Hayes, Chief Nurse of North Middlesex University Hospital NHS Trust, said:

“Today’s report shows how much progress the North Mid maternity service has made recently, and I’m really pleased for the teams which form our midwifery, obstetrics and associated services that their hard work, patient-focused compassion, and commitment to evidence-based improvement are making such an impact.

“I’m even more pleased for our local community that these findings show North Mid continues to provide safe, caring, effective care to local babies and families, that we identify, minimise and mitigate risks, and that our genuine commitment to continual improvement permeates every episode of care, every day.

“The past two years have been tough for patients and parents, as well as staff, and we know that the pandemic has had a disproportionate impact on communities like those served by North Mid, so it’s very important that local families know they will continue to get safe, responsive, care from us, at every stage of their pregnancy, through birth, and with their new baby.

Open and transparent about ongoing improvement

“I’m grateful to the inspection team from the CQC for their thorough review of our maternity service, and for acknowledging where we’ve made considerable improvements, and identifying where we need to make more progress to continue towards offering consistently outstanding care to every family. I’m heartened that most of these are aspects we were already aware of and making headway on, and that we are committed to continuing to being open and transparent about our ongoing improvement, which the CQC have commended us on.”

The full report is available on the CQC’s website at www.cqc.org.uk

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