Caithness Maternity and Gynaecology Group

Action Note

25thJuly2017, 7pm, Caithness General Hospital

Present:

Name / Representing (*)
Alison Brooks / GP, Thurso and Halkirk Medical Practice (Princes Street, Thurso),Chair
Cara Birnie / Midwife, NHS Highland
Janette MacDonald / NHS Highland
(Maternity Care Assistant)
Jim McPherson / Bower Community Council
John Calder / Castletown Community Council
Linda Bremner / Tannach and District Community Council
Mary Burnside / NHS Highland
(Lead Midwife, North & West)
Maimie Thompson / NHS Highland
(Head of PR and Engagement)
Marie Aitken / Sinclair Bay Community Council
Maureen Forbes / Member of public
Sandra Owsnett / Thurso Community Council

(*) –Members are responsible for cascading information to the people they are representing

Apologies

Debbie Pottinger / Member of public
Eric Green / NHS Highland
(Head of Estates)
Graham Cormack / Scottish Ambulance Service
Kerri-Ann Roberts / NHS Highland
(Infant Feeding Support Worker)
Nicola Sinclair / Wick and East Caithness, Highland Councillor
Rona Morrison / NHS Highland(Midwife)
  1. Notes of meeting held on 25th April 2017

Revised notes (of 24th July) approved and will be available on NHS Highland website Here in due course

1.1Protocol for sign off, dissemination and publishing

It was agreed that once draft notes issued members would be asked to comment within one week. Any changes would be made and published on website and circulated to various distribution lists. The notes would be formally approved at next meeting

  1. Membership Update

Confirmed Nicola Sinclair is attending as local councillor and would feed-back to other local councillors.

CHAT has not met since last meeting but are due to meet on Thursday 27th July and will consider request to have members return to the Group.

Action – Nicola or Maria to update at next meeting

  1. Feed-Back The Best Start: Maternity & Neonatal Care in Scotland

Best Start is a five year plan for maternity and neonatal care and servicesin Scotland. Link to the Report HERE

Mary and Maria had attended Regional event in Aberdeen on 3rd July as part of a series of events to engage with service users and staff to discuss implementation of the plan. The event included workshops on challenges and opportunities.

Maria fed some back on some of the themes including her views on key themes:

  • Community Outreach- Seven day community outreach for neonatal care’-Maria voiced that our Paediatrician is over a hundred miles away and we have no paediatric nurse which leads to specific staffing and training needs for our area
  • Link GP for women- Who will provide a liaison point for the midwifery and obstetric team? Who will provide support and advice for midwifery and health visiting teams? Will this prove difficult due to the lack of permanent GPS’ in Caithness?
  • Workforce Planning including need for some higher banded posts in Remote and Rural- Band 7 recommended-Island status for pay increase is being investigated for Caithness. By WHO? Extra support for newly qualified staff due to increased responsibilities in remote areas. Continuity of care including midwives and obstetricians, realigning into teams and staff being co-located in provision of care
  • Training Gap Analysis Maria felt that as different areas require different models of maternity and neonatal care and Caithness must have its own model of care for maternity and neonates as we have our own unique needs and priorities.
  • Choice–A move to more personalised care planning and women having more choice-and a move away from red amber and green pathways.
  • Opportunities for greater family involvement-families should be kept together and partners more involved in supporting the mother which would impact on the need for more suitable family accommodation near the place of birth with clear information provided for families.

The new plan will be implemented over the next five years and has three core themes: ‘Safety,choice and quality’. The Best Start Mantra is;

Services should be designed around the people rather than around the service’

In general both Maria and Maryfelt not enough was covered about remote and rural and recognition that different areas would require different models. Further detail on the event available from Mary and Maria

Next Steps re implementation

  • Feed-back to boards on the Regional events
  • Boards to set up Implementation Group
  • Service users to be invited to take part in NHS Highland Implementation Group

Action – Mary to keep group appraised of local implementation

  1. Recruitment Update

Mary updated that midwife from New Zealand has accepted post and will take up position in September. A second post had also been offered but midwife withdrew.

Currently vacancies for Band 6 and Band 7. There is interest in the Band 6 Post. Job Description for Band 7 just being completed. Any gaps are being covered by Bank and Agency

Maimie had approached North Coast 500 around some free marketing opportunities through their website and this has been secured. Now looking for staff to Volunteer to promote their roles and the benefits if living in the North Coast.

A meeting is being scheduled to meet with Anne Bremner, Director of Learning and Teaching for North Highland College. The college is very keen to collaborate. They offer an extensive provision in health and social care and can play a role in supporting the development of the workforce you require.

Action – Mary to keep group updated on Recruitment

Action – All to identify Volunteers for North Coast 500 Blog

Action – Maimie to update on links with North Highland College

4.1Highland Midwife

Discussionon the three part series on Channel 5 – the Highland Midwife. Programme had been watched by some members and was well received. It was noted that there are some different models for providing ante-natal care (At Home vs at Clinic), which is dependent on size of case load, geography and individual clinical assessment.

It was felt it showed the wider role of a community midwife and how most of their work is in the community.

Maimie updated that the producers have approached NHS Highland to consider doing a follow-up series. If it did go ahead there would be opportunities to include Caithness but would require mothers, families and service users to consent to take part. Generally it was felt that it could be very positive for the area highlighting work in a remote area (not rural) plus show-case of the work of the community midwives in Caithness.

Alison Brooks commented on how struck she was with the ‘can-do’ attitudes of the families and staff filmed and how they looked for solutions and not problems.

Action – Mary and Maimie to keep Group appraised

  1. Work stream updates

5.1.Service User Experience

Wording of Questionnaire now finalised and will be tested. Following this it will be issued to all mothers around six weeks after birth. Confirmed it would be anonymous and additional support needs addressed (eg language, literacy) to ensure everyone has an opportunity to participate.

Alison Brooks said as a GP she got a good overview of experience mothers attended to for eight week baby check

Action – Keri Anne to feed-back on testing

Action – Mary to oversee their being a process in place to issue Questionnaires, collate findings, reporting of results

5.2.Liaison Officer

Rachel Macdonald has been to Caithness to meet staff which went well. System is working well, Rachel responds quickly and no issues identified.

She phones the wards each morning and if there are Caithness Mums she meets them and leaves her card. Mainly advising on claiming back their transport costs and if they have any issue with accommodation to get in touch.

Maria asked is the role is full-time and would it be made permanent. It was explained that Rachel was available to respond to anything full-time but the activity did not require a full-time role. It is combined with a number of other duties but Liaison Officer duties get prioritised as required.

Decision on whether role will be permanent and what all it might cover will determined in due course. It seems likely that the functions will be covered but there are some other new roles in Raigmore being established and will be keen to avoid any duplication.

5.3.Accommodation

Apartment for family accommodation and flat with disability access now in place and bookings being taken. Overall process generally working well but still occasionally having to use Hotel accommodation due to pressures at some times on Kyle Court.

Cara updated that inductions/sections now getting another night’s accommodation as their two free nights often used before birth. This is currently a local arrangement but will be highlighted in leaflet which is being updated.

Discussion on whether staffing challenges in Dr Gray’s will put more pressure on Raigmore including accommodation. While discussions are ongoing, Raigmore will not be the default for transfers and any additional activity would only be agreed to if sufficient capacity was available.

5.4Transport

No issues reported and is working as planned. Confirmed Ambulance would be available if clinically necessary. Key remains appropriate clinical assessment to ensure time for travel. If issue on route, for any reason, 999 should be called. Careful planning is required for families who don’t have access to transport. On occasions taxi will be used.

Maria updated on discussions with Home Start who can provide ‘be-friending’ support both locally and Inverness. Agreed should look at other Third Sector input

Wider discussion on number of patients having appointments in Raigmore including transport implications and how this might be addressed going forward. Maimie confirmed there are a number of strands to this issue and it is being picked up as part of Transforming Outpatients

5.5Patient Information and Facebook

Two draft leaflets have been circulated for comment:

“Maternity Care in Caithness and Raigmore Hospital”, and

“Highland Maternity Services”

MD asked if the new information on three free nights accommodation can be included on the local leaflet.

It was agreed it would be important when handing out leaflets to explain the content and highlight relevant key sections depending on circumstances.

It was clarified that Homebirths are a local option.

Cara confirmed Facebook up and running and working well. 37 ‘friends’, it’s updated every couple of days and people can post private messages.

Action – Allto feed-back to Mary on content and format of leaflets by 18th august to allow these to be signed off and issued

  1. Risk Register

Risk Register will be discussed at next NHS Highland ‘Hub and Spoke’ oversight Group meeting on 26th July. Maria has received some information from Jane Plumb CEO of Group B Strep Support and will pass this to Mary

Action – Maria to pass info on Group B strep to MB

  1. AOCB

Baby Boxes almost finished. May need some storage space in Caithness General and Raigmore. It was agreed that this would be arranged.

  1. Date of Next Meeting

Tuesday 29th August, 7 pm in Caithness General Hospital

Maimie Thompson

1st draft issued 26th July 2017

2nd draft issued 2nd August and updated on website

Approved 29th August 2017

Approved notes from meeting held on 25th July2017