The Maternity Services Liaison Committee (MSLC) serves the mid and south Buckinghamshire district as a statutory body. The MSLC has been very active during the year from 1st April 2007 to 31st March 2008. Wycombe Hospital Maternity Unit, Stoke Mandeville Hospital Claydon Wing and Buckinghamshire PCT have worked together and supported the Maternity Services Liaison Committee. There has been regular user involvement and representation, however the MSLC is mindful that we are constantly trying to engage with new user members, particularly of vulnerable and ethnic minorities, to seek their views.

Buckinghamshire Hospitals NHS Trust’s (BHT) two maternity units delivered a total of 2,778 babies at Stoke Mandeville Hospital and 2,736 at Wycombe Hospital with a 28.4% Caesarean section rate at the Stoke Mandeville unit and a 23.6% rate at the Wycombe unit. This is against a perinatal mortality rate for the district of around 4% per 1000 births.

The midwifery led pathway at Stoke Mandeville saw 16% of deliveries as midwifery led care with a home birth rate of 5%. At WycombeHospital the trial period for the Wycombe Birth Centre has now completed its third year and it is envisaged that once the unit becomes standalone, it will appeal to local women with uncomplicated pregnancies who wish to birth in the low risk home-from-home environment. The number of women in the trial has risen and 126 women were delivered. The home birth rate was 3%.

The MSLC aims and objectives have been to advise the PCT’s commissioners on all aspects of maternity services provided for its residents in Buckinghamshire. Listed below are some of the MSLC’s achievements for 2007-8:

  • Regular meetings to enable users to have a voice and to influence commissioners and providers.
  • MSLC user representatives have been involved in the redesign of the Claydon Wing at StokeMandevilleHospital.
  • MSLC user representatives have been involved in the design of the postnatal booklet and a variety of information leaflets utilised within the services.

Appointments

Ailsa Harrison stepped down as Joint Chair of the MSLC in April 2007 and Dr Graham Robinson took over as sole Chair. This has been supported by the Head of Midwifery Celina Eves with administrative support from Julie Everett.

Work of the MSLC over the past year

The MSLC have met on four occasions (quarterly) receiving presentations from the maternity services and the County Council. One of the key points discussed throughout the year was the service transformation. Previously the MSLC had been involved and influenced the option appraisal for the maternity services in Buckinghamshire and with the long awaited reconfiguration of maternity services to StokeMandevilleHospital the date for this reconfiguration has been postponed for the last three years.

The second key point discussed was the Healthcare Commission report where the maternity services achieved a ‘Better Performing’ rating for maternity and neonatal services, at both Wycombe and StokeMandevilleHospitals.

Recurring themes throughout the year were the Labour Ward Forum, the reconfiguration, and agreement of and input into information leaflets and guidelines.

Meetings

At the April meeting a presentation of UNICEF Baby Friendly Status was given by Chris Sparks, Breastfeeding Midwife, with a commitment from the maternity services to work toward this status and an action planning visit planned for July 2008.

At the July meeting a presentation was given on teenage pregnancies within Buckinghamshire by Catherine Lawson, the Teenage Pregnancy Midwife.

In the October meeting the Terms of Reference were re-visited and also the Strategic Health Authority initiative as a result of Maternity Matters, to review and improve the MSLCs within the South Central Strategic Health Authority. The Postnatal Information Pack was tabled for review at this meeting too.

At the January 2008 meeting, the Healthcare Commission Report national review had been released and there was discussion around the action plan. Also discussed was the 3Is project focused on normal birth and reducing the Caesarean section rate. This had been a huge initiative utilised in 2007 where MSLC members had been fully involved in action planning workshops. There was a presentation from the Bucks Real Nappy Initiative at the County Council.

Progress on local strategies and targets

1.The UNICEF Baby Friendly Strategy

  • To move towards and support the maternity services with the achievement of UNICEF Baby Friendly status with an action planning visit from UNICEF in July 2008.

2.Three I’s initiative in January 2008

  • A Lead Midwife for Normality came into post within Buckinghamshire Hospitals NHS Trust across the two sites to put in place the work from the action planning workshops to reduce the Caesarean section rates, but primarily to increase the normal birth rate.

3.Maternity Matters action plan

  • To ensure that this continued to be monitored and updated.

4.Healthcare Commission report

  • Action plan to be monitored and updated.

Workplan for the coming year

  • Education and development for the Maternity Services Liaison Committee members.
  • To continue to comment on leaflets and input into the work of the Labour Ward Forum and guidelines for the maternity services.
  • To look towards completion of the National Service Framework with the introduction into the services of a midwife for vulnerable and disadvantaged groups within the Buckinghamshire area.
  • To review the Healthcare Commission action plan.
  • To look at the Fatherhood Institute’s ‘The Dad Deficit’ 12 point action plan.
  • Widening and increasing the membership of the MSLC to involve vulnerable and disadvantaged groups and particularly ethnic minorities.
  • To improve breastfeeding rates.
  • To increase the normal birth rate, therefore reducing the rates of Caesarean section.

Recommendations for the PCT

  • MSLC members to be fully involved in the shaping of maternity services and feeding back to commissioners.
  • MSLC members to lead on the changes that are required in the maternity services.
  • MSLC to make a useful and measurable contribution to the local maternity strategy.
  • To look at the commissioning plan for the maternity services together with the PCT to ensure that we have a maternity service that is provided and individually tailored to the needs of all women in the area.
  • To develop a budget with the PCT to support the MSLC.

CE/jae/Meetings/MSLC/Annual Report MSLC 2007-8 9 Oct 08 1 of 3