TO FOLLOW

The Sub-Committee continued the discussion from the meeting on 20 February, which began with residents describing their experiences of maternity services provided in the borough. Tom Logan, Divisional Director of Operations, Women’s Health, began the presentation explaining that BARTS Health, in conjunction with Whipps Cross and Newham, provides maternity care for around 5000 women and babies annually. This takes place primarily in the  labour ward, although the Lotus Birth Centre which is midwife Led care and home births are also available.

The Royal London also provides care for women with chronic diseases through the Maternal Medicine Network, for support during and after their pregnancies as well as  specialist foetal medicine care and a diabetes clinic.

Sabrina Mubiru, Patient Experience Midwife, then provided information on the methods Royal London uses to improve the patient experience and reduce inequalities in healthcare. This includes enhancing the online booking system to now translate in 100 different languages, for ease of access to maternity care. Further work with improving referrals is ongoing to ensure the recommended timeline of nine weeks and six days is adhered to. Ms Mubiru stated that community partnership work with ‘Sister Circle’, ‘Maternity Mates’ and the Maternity Neonatal Voice Partnerships helps in enhancing service users' experience. Additional phones are now accessible in the labour  ward, and translators to ensure communication with patients is as easy as possible.

Monthly community engagement sessions are also available to hold antenatal education and peer to peer group sessions and alleviate any concerns and forward any referrals that are required. A Birth Reflection Clinic, run by Midwives is also available for women to explore difficult experiences post birth. MS Mubiru informed sub-committee members of the high-risk antenatal classes conducted by midwives for women of black and Asian and mixed ethnic origin, and the Health Inequalities task force, held monthly to discuss health inequalities within the sector.

Shereen Nimmo, Group Director of Midwifery, BARTS Health NHS Trust, then detailed the funding received to support two projects for the Somali community,  an engagement officer who works specifically for Somali residents and the women's inclusive team, who hold drop in services and visit residents at home to better understand their needs and assist in all aspects of women's care. Bengali health advocates are also on hand to assist mothers

Tristan Kerr, Director of Nursing and Governance, then informed sub-committee members of the 38 new midwives who have started since 2024, with a further six in training. One midwife, Stella Simon-Brown was awarded a National Silver Award for her 20 year contribution to midwifery by the Chief Midwifery Officer for England.

Dawn Cooper-Newman, Head of NEL LMNS Programmes, NHS, provided details on the 3 year delivery plan and the survey conducted by Healthwatch to build upon the equality and equities framework.

Sub-committee members were updated on the ongoing methods to improve patient outcomes and effectively manage patient flow at triage. The BSOTS, or Birmingham Symptom Specific Obstetric Triage System, has now being implemented, to enable rapid assessment for pregnant women, and aims to triage patients within approximately 15 minutes from their arrival to the unit. Recruitment on BSOTS specific midwives is currently on going. Mental health care is also a priority and work with the ‘My Body Back’ clinic assists in safeguarding, with the collaboration of an obstetrician and midwife.

Sub-Committee members then heard from Momina Begum, who attended the previous meeting to discuss her lived experience. Although pleased with the improvements noted, particularly regarding the equality with language issues mentioned, and urged health professionals to continue the positive work. Ms Begum  has worked with the Lime House Project for over 20 years and explained that many women have faced poor health care service. Ms Begum acknowledged the changes will take time to be fully embedded and thanked  the team for the presentation.

Further to  questions from the sub-committee,

·       Clarified that around 1% of women in the borough opt for home births, which is in line with national outcomes. The Home Birth team deals specifically with this type of birth and mothers are given details of the procedure and proximity to the nearest hospital. If any issues occur, the midwife works alongside the London Ambulance Service and an alert card script is read to enable either a category one or two transfer call, depending on issue.

·       Explained that following the CQC maternity services inspection in 2022, fortnightly meetings are now undertaken, assurance process has been implemented with a  maternity safety support program. The Neo Committee has been established to examine any escalations, and more equipment, increased staffing numbers, and robust policies are now ongoing. Another priority is ensuring patient voices are heard throughout the department, including in the governance process. Barts NHS Trust is now working alongside University of East London in recruiting nurses and midwives.

·       Clarified that all births have been suspected at the Barkentine Practice in the Isle of Dogs, due to safety concerns. The situation was exacerbated by a national shortage of midwives at that time. Currently the centre deals with antenatal care, appointments, breastfeeding support and post Natal checkups by midwives and support workers.

·       Acknowledged that as newly qualified midwives require more experience, internationally educated midwives have been recruited. The NHS Cadets programme is available for  local young residents, not in education to discuss a career in the sector. The T Level students of 16 to 18 year olds can also gain experience in the postnatal ward. A report on the future population growth, health and statistics regarding anticipated maternal health in conjunction with acute provider collaboration and North East London colleagues will be published in May.

·       Confirmed that there is one Somali Engagement Officer delivers antenatal care and education to the community, to improving patient experience and has received positive feedback. Consideration has been given to offering further support to residents of an Eastern European background.

·       Explained that during routine antenatal consultations midwives discuss FGM with patients in a sensitive manner and make it clear that details will not be escalated to social services. Sister Circle advocates are also on hand to give support. Midwives receive mandatory training annually to understand FGM and cultural aspects around it.

·       Clarified that complaints are dealt with at local resolution meetings in the first instance, where patients can discuss concerns with clinicians. The complaint is closely monitored until it is resolved. There is an open governance process, so junior staff can receive feedback Production boards are held monthly to analyse trends in complaints and key performance indicators.

·       Noted that a 3 year consolidated improvement plan has been set up with various work streams following a community engagement event to fully understand patient’s needs. Maternity assessments are made via the Care Quality Commission (CQC) and collaboration with the Maternity Safety Support Programme (MSSP). Details on statistics for each borough are available on the Integrated Care Board (ICB) website.

·       Explained that professional midwifery Advocates (PMA) who complete additional training can provide support to other midwives who have endured challenging circumstances as a professional midwifery advocate.

·       Confirmed that a dedicated perinatal mental health midwife is available in Barts Health for women who are experiencing mental health issues. A perinatal health team collaborate with clinics and multidisciplinary teams including psychiatrists across the borough. Funding has been confirmed to keep the specialist midwife post one more year.

RESOLVED that;

1.    A written response to the work experience waiting times for Central Foundation Girls School to be returned to the sub-committee for review.

2.    The presentation be noted.