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Content ArticleThis is the first in a series of thematic reports which will be published by the Independent Maternity Services Oversight Panel in the coming year. The purpose of the report is to summarise the learning which is emerging from the ongoing programme of independent clinical reviews of the maternity and neonatal care previously provided by the former Cwm Taf University Health Board. This particular report summarises the key themes and issues which emerged from the clinical review of 28 individual episodes of care1 which were provided by the Health Board between 01 January 2016 and 30 September 20182. It focuses on the care of mothers who needed unplanned emergency treatment during childbirth, including some who required admission to an Intensive Care Unit.
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Content ArticleThis is the second in a series of thematic reports to be published by the Independent Maternity Services Oversight Panel about their ongoing programme of independent clinical reviews of the maternity and neonatal care provided by the former Cwm Taf University Health Board. This report focuses on the care of mothers and their babies who were stillborn. It summarises the key themes and issues which emerged from the clinical review of 63 individual episodes of care which were provided by the Health Board between 01 January 2016 and 30 September 2018.
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Content ArticleThis video presents some highlights of the HSJ Patient Safety Awards on 20 September 2021 at Manchester Central, and includes short interviews with some of the judges and award winners. The HSJ Patient Safety Awards were set up to recognise and celebrate projects that improve patient safety and quality of care. This year, the judges commented that nominees across 23 categories were all of a very high quality and presented innovative projects that made real improvements to patient safety in the NHS. "The quality of this year was quite phenomenal - we were really impressed at how inventive people had been in coming up with solutions to COVID as part of safety strategies," said Lesley Durham, President of the International Society of Rapid Response Systems and member of the awards judging panel. The awards showcase excellent projects and ways of working that have potential to be replicated in other areas. A team from Devon Partnership Trust/Royal Devon and Exeter Foundation Trust won the award for Mental Health Initiative of the Year for their project 'Connecting physical and mental health services in Gastroenterology'. A representative from the team said, "What we want to do now is take this, shout about it and make it happen elsewhere." Many award winners commented on the importance of teamwork across services and trusts and recognised that collaboration was a key part of the success of their projects. View the full list of award winners
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Content ArticleOn Friday 17 September 2021 the World Health Organization (WHO) held their World Patient Safety Day 2021 Virtual Global Conference, focused on the theme of ‘Safe maternal and newborn care’. This page contains links to a number of presentations from the event.
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Content ArticleIn this blog, Mabel Prendergast reflects on key themes discussed at the Institute of Global Health Innovation's (IGHI) third World Patient Safety Day event on the 17 September 2021, with the theme of safer maternal and newborn care. This virtual event was chaired by Dr Mike Durkin, IGHI’s Senior Advisor on Patient Safety Policy and Leadership, and included a range of speakers and panellists.
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Delay in recognising placental abruption (30 June 2021)
Patient-Safety-Learning posted an article in Maternity
This case story about placental abruption, published by NHS Resolution, highlights the importance of regular risk assessments throughout labour to help prevent harm to mother and baby. It provides learning points and considerations that can be applied across all maternity units. -
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House of Commons Debate - Baby Loss Awareness Week (23 September 2021)
Mark Hughes posted an article in Maternity
This is the transcript of a debate in the House of Commons ahead of Baby Loss Awareness Week (9 to 15 October 2021). In this debate, MPs reflected on personal experiences and those of their constituents, the role of Baby Loss Awareness Week as an essential focal point for bereaved families and the potential for the Government to mandate and fund the National Bereavement Care Pathway programme. -
Content ArticleThis is the Government’s formal response to the recommendations made by the Health and Social Care Committee in its report, ‘The Safety of Maternity Services in England’. The Committee’s inquiry examined evidence relating to the safety of maternity services. It builds upon current investigations following incidents at East Kent Hospitals University Trust and Shrewsbury and Telford Hospitals NHS Trust, as well as the inquiry into the University Hospitals of Morecambe Bay NHS Trust. The inquiry also considered whether the clinical negligence and litigation processes need to be changed to improve the safety of maternity services and explored the impact of blame culture on learning from incidents.
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Content ArticlePrisons and Probation Ombudsman Sue McAllister has published the independent investigation into the death of a baby (Baby A) at HMP Bronzefield on 27 September 2019. The investigation identified a considerable number of issues and concerns about the care and management of Ms A, the baby’s mother. Sue makes a significant number of recommendations to improve maternity services in Bronzefield. There is wider learning for the whole of the women’s prison estate from the death of Baby A, and the Prison Service must take this opportunity to improve the outcomes for pregnant prisoners so that this tragic event is not repeated.
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Content ArticleIn most cases pregnancy and birth are a positive and safe experience for women and their families. This is the outcome that everyone working in maternity services wants every time, for every woman. But when things go wrong, we need to understand what happened, and whether the outcome could have been different. The death or injury of a new baby or mother is devastating and something that everyone working in the health and care system has a responsibility to do all they can to prevent. Following the publication of ‘Getting safer faster’ the Care Quality Commission (CQC) launched a programme of risk-based, focused maternity safety inspections involving a more focused in-depth assessment of relational elements such as teamworking and culture, staff and patient experience. Building on our previous calls for action, the CQC also sought to further explore the barriers that prevent some services from providing consistently good, safe care and to better understand the disparities in outcomes that exist for women and babies from Black and minority ethnic groups. This report presents the key themes from nine of those inspections alongside insight gathered from direct engagement with organisations representing women using maternity services and their families, including Five X More and local Maternity Voices Partnerships.
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Leaflet on reduced fetal movement
PatientSafetyLearning Team posted an article in Maternity
This leaflet has been developed by Tommy’s and NHS England to help pregnant people understand more about their baby's movements, why it is important and when to seek advice. The leaflet contains clear messaging on reduced fetal movements consistent with national guidelines.- Posted
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Content ArticleThe '3 P’s in a Pod” poster is a reminder for anyone seeing pregnant women about ‘red flags’ and when to ask for help. Download online version here.
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Content ArticleGood quality midwifery care saves the lives of women and babies. Continuity of midwife carer (CMC), a key component of good quality midwifery care, results in better clinical outcomes, higher care satisfaction and enhanced caregiver experience. However, CMC uptake has tended to be small scale or transient. McInnes et al. used realist evaluation in one Scottish health board to explore implementation of CMC as part of the Scottish Government 2017 maternity plan.
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The Lancet: Miscarriage matters (26 April 2021)
Patient Safety Learning posted an article in Maternity
Miscarriage is common, affecting one in ten women in their lifetime, with an estimated 23 million miscarriages globally. Despite this, the impact and consequences of miscarriage are underestimated, resulting in an attitude of acceptance of miscarriage and system of care which is currently fragmented and can be of poor quality. A new series of three papers published in The Lancet reviews this evidence on miscarriage and challenges many misconceptions. The authors, Siobhan Quenby, Arri Coomarasamy, and colleagues, call for a complete rethink of the narrative around miscarriage and a comprehensive overhaul of medical care and advice offered to women who have miscarriages. -
Content ArticleThis study, published in Midwifery, concludes: "An analysis of retrospective Albany Midwifery Practice statistics over 12.5 years has shown positive outcomes for women and babies in socially disadvantaged and BAME groups, including those with complex pregnancies and perceived risk factors. This study adds weight to a growing body of evidence linking relational midwifery continuity of carer with improved outcomes and policies identifying that all pregnant women should receive midwifery continuity of carer throughout the continuum of pregnancy, birth and new motherhood."
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Content ArticleTokophobia is an extreme fear of pregnancy and childbirth; it causes severe psychological distress and can have far reaching consequences. Despite this, tokophobia is under-researched and many healthcare professionals have never heard of it, explains Sarah-Jane Archibald in this BMJ Opinion article.
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Content ArticleIn this presentation, Trixie McAree, National Midwifery Lead for Continuity of Carer, gives a comprehensive overview of the continuity of carer model and how it impacts on patient safety. Trixie also provides advice and practical tips for teams setting up the continuity of carer model and explains why this transformation is key to improving outcomes. This video provides valuable insight and can be used as a training tool for maternity teams considering this way of working.
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Content ArticleWomen with little-to-no English continue to have poor birth outcomes and low service user satisfaction. When language support services are used it enhances the relationship between the midwife and the woman, improves outcomes and ensures safer practice. However, this study has shown a reluctance to use professional interpreter services by midwives. This study from Bridle et al. aims to understand the experiences of midwives using language support services.
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Content ArticleS. Dorothy Smith instinctively knew that something was wrong with her daughter Katiana, but was dismissed as a hysterical first-time mum who just couldn't cope with normal newborn crying. She wrote a guest post for the Hysterical Women website, which can be accessed via the link below.
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#NotNeurotic: The keeper of the caesareans
PatientSafetyLearning Team posted an article in Maternity
In this guest post for Hysterical Women, Nicola Chegwin writes about the needless stress, humiliation and anxiety of having to fight for a caesarean birth, as a disabled woman with a spinal injury. -
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RCOG/RCM: Undermining toolkit
PatientSafetyLearning Team posted an article in Maternity
The undermining toolkit is an RCOG/Royal College of Midwives (RCM) initiative to address the challenge of undermining and bullying behaviour in maternity and gynaecology services. The toolkit is divided into four sections that can be used independently: Strategic interventions - Recommendations for over-arching institutions such as the wider NHS, GMC, RCOG, RCM and others Unit, trust and local education provider interventions- Recommendations for trusts and hospitals Departmental and team interventions - Recommendations for departments, particularly around team working between obstetricians and midwives Individual interventions - Recommendations for individual victims and perpetrators of undermining. Follow the link below for more information.- Posted
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Content ArticleA new study from Praharaj and Stanciu provides guidance for clinicians discussing the risks of ADHD medications with their pregnant patients.
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Content ArticleThe purpose of this guidance from the Royal College of Obstetricians and Gynaecologists (RCOG) is to urge all maternity units to consider the use of the Maternity Dashboard to plan and improve their maternity services. It serves as a clinical performance and governance score card to monitor the implementation of the principles of clinical governance on the ground. This may help to identify patient safety issues in advance so that timely and appropriate action can be instituted to ensure a woman-centred, high-quality, safe maternity care.
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The RCM standards for midwifery services in the UK
Patient Safety Learning posted an article in Maternity
Crucial reports and strategic reviews about the quality of maternity care in different parts of the UK have consistently identified that improvements should be underpinned by implementation of existing evidence-based clinical standards. The Royal College of Midwives (RCM) identified that to deliver compassionate, well-led, professional evidence-based midwifery care which maximises midwives’ contributions to improving quality also required midwifery service standards within a framework which could be used by service providers, commissioners and RCM members. A small project team was tasked with developing The RCM Standards for midwifery services in the UK. The team developed the standards using a pragmatic review of the evidence available and through consensus informed by views, comments and suggestions on draft outputs from respondents.