Visit to Poole S Maternity Services

BOROUGH OF POOLE

VISIT TO POOLE’S MATERNITY SERVICES

20 SEPTEMBER 2012

The Visit commenced at10am and concluded at 11.40am

Present:

Borough of Poole Councillors Mrs Evans, Mrs Hodges, Mrs Moore, Potter and Meachin

Kate Rixom, Democratic Support Officer, Legal and Democratic Services, Borough of Poole

Sandra Chitty, Head of Midwifery, St Mary’sHospital, Poole

Helen Williams, Deputy Head of Midwifery, St Mary’s Hospital, Poole

Adrian Dawson,Director of Public Health, NHS Bournemouth and Poole

The Councillors and Officers were shown around St Mary's Maternity Unit by the Head and Deputy Head of Midwifery. The Unit’s Services and facilities were explained throughout the tour and questions raised were answered during and following the tour. The key points were noted as follows:

Background:

St Mary’s Maternity Unit, Poole Hospital was originally built in 1962. It was the centre for all high risk pregnancy care in East Dorset.Care was shared between midwifery and medical staff and undertaken within the Maternity Unit or community settings, according to clinical needs.
The Unit annuallyhad around 5,000 deliveries per year; 62% were normal births the rest were a mixture of elective and emergency caesarean (this figure did not include those that had been induced). The national average was 65% normal births, however, as the high risk unit a slightly higher percentage was expected. 20% of births were induced.
An average of 15 elective caesarean births were carried out per week and 1.3% of babies were born at home.
The Maternity/Post-Natal Wardhad 3 rooms, each with 4 beds per room. If there were no complications the normal length of stay in the Maternity Unit was 6 hours, these mothers and babies would go home directly from the delivery room. Partners and mothers’ own children could visit between 9am and 9pm; all other visitors were restricted to the hours of 2-4pm and 7-8pm. Only the mothers’ own children were allowed to visit for infection control purposes.
The average stay for those women whose babies were in the Transitional Care Ward was 5/7days, on the Neo-Natal Unit (if a baby was very premature) the length of staysvaried between a few days and several weeks.
Care on the Transitional Care Wardwas managed by the Neo-Natal Unit.
The Central Delivery Suite Area consisted of 2 Theatres and eight delivery rooms.
The Haven Birthing Suite was for those women deemed to be a low risk and consisted of four rooms, of which 2 had birthing pools.
The Ante-Natal Clinic was an outpatient clinic that provided a facility for consultant clinics, a midwifery day assessment unitand 3 ultrasound screening rooms.
The Neo-Natal Intensive Care Unit, whilst within the Maternity Unit was managed by Poole Hospital’s Paediatric Department. This Unit was a level 2 unit, which cared for babies requiring special care, whether it was due to pre-maturity (27 weeks +), illness at delivery or health problems during the baby’s stay at hospital. The Unit had 20 cots in total; 4 were intensive care cots and 6 were high dependency cots. Its Special Baby Unit had two overnight rooms with en-suite shower, a playroom and a family room.
Southampton General Hospital was the surgical unit for babies and provided neo-natal intensive care for those babies born at 23 weeks +.

Current circumstances:

The Hospital had taken on board complaints and the Poole LINk’s Recommendations, mainly regarding clinical care and caesarean births during November 2010-January 2011.

All areas of concern, including the staffing issues at Poole’s Maternity Services had now been resolved.
8 additional staff members were to commence employment at the Unit in November 2012 and apprenticeships for support workers post 18 years were available within the Unit; of which 2 were currently on the Scheme.
Capacity was an issue; the Unit had a 3% year on year increase in the number of births. Whilst the Unit now had the appropriate levels of staff there remained a lack of space.
There were known peaks and increases in multiple births had beenlinked to IVF Treatment, an officer monitored such peaks to ensure sufficient staff resources. There was a peak end of August and September 2012, the next known peak was expected in December 2012 and January 2013.
The need for an additional 12 beds had been identified during peak periods. Beds in the Ante-Natal/Elective Caesarean Area had beentemporallyutilised during periods of high demand and work was being undertaken to enable 8 permanent beds to be created within this Area.
The Delivery Rooms and Maternity/Post-Natal Ward were very small and would not meet the standards required for a new build.
There was a huge demand for birthing pools, as they aided natural pain relief and positive child birth experiences for mothers, the Unit currently had just 2 birthing pools.
There was a need for a new Maternity Unit, however due to the financial climate this was not expected in the next 5 years. As an interim measure to aid the Units restructure, help effectively utilise space and provide more equipment, such as additional birthing pools etc. a funding bid of £4m had been put forward to the Trust Board, a decision was expected in the week commencing 25September 2012.
It was clear that following previous unsuccessful attempts to fund a new maternity unit The Trust may have to think outside of the box and possiblyconsider alternative partnerships in order to achieve sufficient funding.