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Showing results for tags 'Maternity'.
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News Article
Welsh Covid rules on hospital visits and maternity appointments relaxed
Patient Safety Learning posted a news article in News
New Covid guidance for hospitals could see more patients receiving face-to-face visits from loved ones. NHS Wales has given health boards and hospices flexibility to allow visits based on local levels of COVID-19. Until now accompanying people to medical appointments and hospital visits have not been allowed, with a few exceptions. It also allows for pregnant women in low Covid rate areas to take their partners to maternity appointments. The Welsh Government said the new flexibility was "due to the changing picture of coronavirus transmission across Wales, with significant variations in community transmission across different parts of the country and differences in the rate of nosocomial transmission". Read full story Source: BBC News, 30 November 2020 -
News Article
NHS to get millions of pounds to help save babies’ lives
Patient Safety Learning posted a news article in News
Ministers are to invest millions in making Britain's maternity wards safer, it was announced on Wednesday after The Independent exposed a series of cases in which mothers and babies had suffered avoidable harm during childbirth. The new money, almost £10m, was announced as part of the spending review unveiled by Rishi Sunak, the chancellor, in the Commons and will deliver new pilots of what the Treasury called “cutting-edge training” to improve practice during childbirth. Significant failings in maternity safety units across the NHS have devastated families and left some babies needing tens of millions of pounds to look after them in later life. In November last year, The Independent joined with the charity Baby Lifeline to call for a new fund to be set up after exposing the single largest maternity scandal in NHS history at Shrewsbury and Telford Hospitals Trust, where dozens of babies have died or been left with brain damage. The new funding will also cover the final year of the independent investigation into the Shrewsbury trust. Read full story Source: The Independent, 26 November 2020 -
News ArticleAn Essex maternity department has been served with further warnings by the Care Quality Commission (CQC) and again rated “inadequate”. Serious concerns were raised about the services at Basildon University Hospital in the summer, after several babies were found to have been starved of oxygen and put at risk of permanent brain damage. Despite the CQC issuing warning notices to Mid and South Essex Foundation Trust in June 2020, a subsequent visit on 18 September found multiple problems had persisted. The CQC’s findings at Basildon included: the service was short-staffed and concerns were not escalated appropriately multidisciplinary team working was “dysfunctional”, which sometimes led to safety incidents doctors, midwives and other professionals did not support each other to provide good care. Read full story (paywalled) Source: HSJ, 19 November 2020
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Content Article
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Pain is spoken about often within health and social care. Patients might be asked to locate our pain during examinations, to rate our level of pain or to describe the type of pain we are feeling. They may be forewarned of the possibilities of pain occurring during or after procedures or operations. Medical consent forms often include reference to the risk of pain and require a signature to confirm they have been appropriately ‘informed’. Pain can be acute (lasting less than 12 weeks) or chronic (lasting more than 12 weeks), and the way we experience it, our thresholds, can also vary. It can be our body’s way of warning us of potential damage, yet it can also occur when no actual harm is happening to the body.[1] It can cause trauma, physiological reactions, mental health difficulties and chronic fatigue, and can have a huge impact on someone’s quality of life and ability to perform daily tasks.[2] Pain is undoubtedly complex, but is it a patient safety issue?[3] -
News Article
More than 75% of NHS midwives think staffing levels unsafe, says RCM
Patient Safety Learning posted a news article in News
More than three-quarters of midwives think staffing levels in their NHS trust or board are unsafe, according to a survey by the Royal College of Midwives (RCM). The RCM said services were at breaking point, with 42% of midwives reporting that shifts were understaffed and a third saying there were “very significant gaps” in most shifts. Midwives were under enormous pressure and had been “pushed to the edge” by the failure of successive governments to invest in maternity services, said Gill Walton, the chief executive of the RCM. “Maternity staff are exhausted, they’re demoralised and some of them are looking for the door. For the safety of every pregnant woman and every baby, this cannot be allowed to continue,” she said. “Midwives and maternity support workers come into the profession to provide safe, high-quality care. The legacy of underfunding and underinvestment is robbing them of that – and worse still, it’s putting those women and families at risk.” RCM press release Read full story Source: The Guardian, 16 November 2020 -
Content ArticleIdentifying improvements in maternity care to help reduce the risk of delays in crucial interventions during labour when a baby is suspected to be unwell is the focus of this latest Healthcare Safety Investigation Branch (HSIB) report. The report was compiled after a review of 289 of our maternity investigations into intrapartum stillbirths, neonatal deaths and potential severe brain injuries. In 14.9% of the cases the delay was a contributory factor. The review identified issues such as inadequate staffing, poor infrastructure and high workload as contributory factors to the delays. Evidence from national reports confirms that such delays are a recognised patient safety risk.
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Content ArticleObstetric quality of care measures have largely focused on severe maternal morbidity (SMM), with little consensus about measures of less severe but more prevalent delivery and neonatal complications. This study, published in The Joint Commission Journal of Quality and Safety, analyses risk-adjusted maternal and neonatal outcomes using both ICD-10 coding and electronic health record (EHR) data.
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Content ArticleAs set out in Implementing Better Births: Continuity of Carer, continuity of carer means each woman: • Has consistency in the midwife or clinical team that provides hands on care for a woman and her baby throughout the three phases of her maternity journey: pregnancy, labour, and the postnatal period. • Has a named midwife who takes on responsibility for coordinating her care, and for ensuring all her needs and those of her baby are met, at the right time and in the right place, throughout the antenatal, intrapartum and postnatal periods. • Has “a midwife she knows at the birth”. • Is enabled to develop an ongoing relationship of trust with her midwife who cares for her over time.
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Content ArticleHaving consistent healthcare support during pregnancy, labour and after your baby’s born can make the world of difference. In this webpage, the National Childcare Trust (NCT) focuses on the following questions: What does Continuity of Care in maternity mean? What are the benefits? How can I make continuity of care more likely?
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Content ArticleThis review suggests that women who received midwife-led continuity models of care were less likely to experience intervention and more likely to be satisfied with their care with at least comparable adverse outcomes for women or their infants than women who received other models of care. Further research is needed to explore findings of fewer preterm births and fewer foetal deaths less than 24 weeks, and all foetal loss/neonatal death associated with midwife-led continuity models of care.
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Content ArticleThe purpose of this study, published in Acta Bio-Medica, was to explore the skills of the continuity care of patient operated by the midwife and to research the evidences that support such model. In particular, the aim was to verify whether there are efficacy trials that support the caseload midwifery care model. The questions that have guided this work are the following: Is the midwifery-led care model a safe caring model based on the evidences? Is the continuity of care provided by the midwife during pregnancy and childbirth as safe as the one provided by physicians or multi-professional teams? Is it therefore possible to propose its implementation in the obstetric units in Italy? The second aim was to explore evidence of customer satisfaction with the midwifery-led care model, and to verify also the satisfaction from the midwives who are part of a midwifery-led care model, in terms of job satisfaction and of a good balance between private and professional life.
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Content ArticleThis resource from the Royal College of Midwives, contains practical information and contains interactive exercises for midwives to use on their own or as part of a group, to support implementation conversations relating to continuity of carer.
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Content ArticleThis report, from the Royal College of Midwives, found that continuity of midwifery care contributes to improving quality and safety of maternity care. High quality evidence indicates that women who receive care in these models are more likely to have effective care, a better experience and improved clinical outcomes. There is some evidence of improved access to care by women who find services hard to reach and better co-ordination of care with specialist and obstetric services. Continuity of midwifery care can provide services for all women across all settings, whether women are classified as high or low risk and current evidence shows improved outcomes with no adverse effects in populations of mixed risk. In addition improved birth outcomes also result when women receiving continuity of midwifery care give birth in obstetric units.
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News Article
Basildon maternity unit handed 'urgent' safety deadline
Patient Safety Learning posted a news article in News
An NHS hospital where a woman bled to death in childbirth has been given an "urgent" deadline to keep patients at its maternity unit safe. A letter seen by the BBC reveals the Care Quality Commission (CQC) found unsafe staffing levels at the unit at Basildon Hospital throughout August. The CQC said the trust that runs it had until next Monday to implement appropriate measures. The trust said it had a "robust improvement plan in place". The seven-page document, sent by the CQC on 7 October, puts the Mid and South Essex NHS Foundation Trust on notice that it has to "implement an effective governance system", among other measures. Consequences for missing the deadline were not stated, but the CQC said it was using its powers under the Health and Social Care Act to impose conditions on the trust's registration. The Act does allow the CQC to temporarily close health services. Read full story Source: BBC News, 3 November 2020 -
Content ArticleLearning about healthcare safety often focuses on understanding what has gone wrong, but it is just as important to examine what good looks for safety in maternity units. In this blog, Elisa Liberati describes how she worked with a team and several collaborators to develop a framework describing 7 key features of safety in maternity units. To ensure the study was as rigorous as possible, they combined several different methods and worked in a highly collaborative way across the system. Follow the link below to read the full blog, published by THIS.Institute.
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News Article"Women may be suicidal or want to die. They may have thoughts about harming their baby. It's our job to keep them safe until they can keep themselves safe," says Debbie Sells. She manages a mother-and-baby unit in Nottingham which supports a small group of new mothers and pregnant women with serious psychological problems. It's one of 19 units across England which each year treat about 800 women with perinatal mental health problems like psychosis and severe depression. Clinicians say it is important to keep mothers and babies together to protect their relationship and the infant's development. Some clinicians fear there may soon be an increased demand for their services due to extra pressures pregnant women are facing during the pandemic. "We are hearing stories of women delivering on their own and not having the support of their partner, says Debbie. "A traumatic birth can lead on to other things. Now not only are women becoming seriously unwell with a baby, but it's happening within a pandemic" NHS England says while it is understandable some women and their families may have felt uneasy about seeking help in the early stages of the outbreak, it is vital they ask for support if it is needed. Read full story Source: BBC News, 26 October 2020
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News ArticleA hospital that was at the centre of a major inquiry into unsafe maternity care five years ago is facing new questions over its safety after bosses admitted a baby boy would have survived if not for mistakes by hospital staff. Jenny Feasey, from Heysham in Lancashire, is still coming to terms with the loss of her son Toby who was stillborn at the Royal Lancaster Infirmary, part of the University Hospitals of Morecambe Bay Foundation Trust in January 2017 after a series of mistakes by staff who did not act on signs she had pre-eclampsia. Jenny, 33, has backed The Independent’s campaign for improved maternity safety and called on midwives to learn lessons after what happened to her family. She added: “This was an easily avoidable situation. They just didn’t piece it together, all they had to do was carry out a test and I lost my son because of it." Read full story Source: The Independent, 25 October 2020
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News ArticleWhen Jess and Patrick discovered they were expecting their first baby in the new year, they looked forward to an early glimpse of their unborn child via an ultrasound scan. But the couple, who live in the north-west of England, were soon told that Patrick would not be able to attend any antenatal appointments, including routine scans at 12 and 20 weeks. When their baby begins its journey into the world, Patrick will be permitted to join Jess only when labour is fully established, and he must leave an hour after delivery. He will not be able to visit his new family in hospital again. “It’s taken the shine off the pregnancy,” said Jess, a junior doctor. “Patrick hasn’t been able to come to a single appointment. It’s making me very anxious and stressed – I’ve had actual nightmares about things going wrong and Patrick not being with me. He’s had to wait at home when I’ve gone for appointments, worrying and waiting for me to call to say everything’s OK.” The hospital where Jess will give birth is among 43% of NHS trusts that – despite official guidance – have not eased restrictions imposed during lockdown on partners attending antenatal appointments, being present throughout labour, and staying with new mothers and babies after the birth. And as Covid transmissions rise across the UK, almost a quarter of NHS trusts have said they expect to reimpose such restrictions. Read full story Source: The Guardian, 24 October 2020
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News ArticleParents and professionals have been devastated by the impact of the pandemic on some of the UK’s most vulnerable patients Kelly Stoor gave birth to her daughter, Kaia, 14 weeks early. On 12 March, the midwife held her up for Kelly to see before whisking Kaia off to the neonatal unit for critical care. Kaia became seriously ill and was transferred to a hospital in Southampton, 50 miles away from home, for specialist treatment just before lockdown was imposed on 23 March. While there, she teetered on the edge of life and death for weeks and underwent life-saving surgery twice. The impact on Kelly, her husband, Max, and their other three children has been enormous. Hospital restrictions in April dictated that only one parent was allowed to visit. Both parents were not able not hold their daughter for the first time until 88 days after she was born. “It was extremely difficult,” says Kelly. “I wasn’t allowed to hold her because of Covid. I had to wear gloves if I was going to touch her. We didn’t know if she was going to make it, and Max and I weren’t allowed in together to be with her. There was one time I was with her for three hours and I couldn’t cope any more. I wanted to break.” Kelly is not alone. In the UK, at least 25,000 children are living with conditions that require palliative care support and their lives, along with those of their families, have been upended by the coronavirus pandemic and accompanying restrictions. A report by Rainbow Trust found that lockdown was a distressing experience for many; 80% of those surveyed by the charity in April said their situation was worse or much worse than before lockdown. Nearly 60% of parents, meanwhile, say that their mental health is worse than before the pandemic. Families have had to take on the strain of caring full-time for a child with a life-limiting illness, such as cancer or neurological conditions, with little to no support. There has been no respite, explains Dr Jon Rabbs, a consultant paediatrician and trustee for Rainbow Trust. When lockdown was announced, many community healthcare services had to stop face to face contact and special schools which supported children were also closed. “One of my families is at breaking point, they are so exhausted and worried,” he says. In child healthcare there have been delays, he says. Urgent treatment is always available but follow-up care has been cancelled or delayed in some places. “In my practice we have not missed any significant relapses,” he adds. “But imagine the worry not knowing whether things were going to be OK or not.” Read full story Source: The Guardian, 22 October 2020
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Content ArticleHarry Richford was born at the Queen Elizabeth the Queen Mother Hospital (QEQM), Margate, Kent on 2/11/17. He died on 9/11/17 at the William Harvey Hospital, Ashford to where he had been transferred. The cause of death was 1a Hypoxic Ischaemic Brain Encephalopathy. There was a narrative conclusion setting out some seven failures in the care of Harry Richford together with a conclusion that his death was contributed to by neglect.
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Content ArticleThe State of Care is the Care Quality Commission (CQC) annual assessment of health care and social care in England. The report looks at the trends, shares examples of good and outstanding care, and highlights where care needs to improve. The care that people received in 2019/20 was mostly of good quality. But while the quality of care was largely maintained compared with the previous year, there was generally no improvement overall. And in the space of a few short months since then, the pandemic has placed the severest of challenges on the whole health and care system in England.
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News Article
England's 'fragile' care sector needs immediate reform, says regulator
Patient Safety Learning posted a news article in News
The government must immediately deliver a new deal for social care with major investment and better terms for workers, the Care Quality Commission (CQC) has said, as it warned that the sector is “fragile” heading into a second wave of coronavirus infections. In a challenge to ministers, the regulator’s chief executive, Ian Trenholm, said overdue reform of the care sector “needs to happen now – not at some point in the future”. Boris Johnson said in his first speech as prime minister, in July 2019: “We will fix the crisis in social care once and for all.” But no reform has yet been proposed, and more than 15,000 people have died from COVID-19 in England’s care homes. Trenholm said Covid risked turning inequalities in England’s health services from “faultlines into chasms” as the CQC published its annual State of Care report on hospitals, GPs and care services. The report reveals serious problems with mental health, maternity services and emergency care before the pandemic, and says these areas must not be allowed to fall further behind. The regulator argued that the health system’s response to the pandemic needs to change. After focusing on protecting NHS services from being overwhelmed, health leaders must now adapt to prevent people who need help for non-Covid reasons from being left behind, it said. These include people whose operations were cancelled and people from black and minority ethnic backgrounds, people with disabilities, and people living in deprived areas who have suffered more severely from the impact of Covid. “Covid is magnifying inequalities across the health and care system – a seismic upheaval which has disproportionately affected some more than others,” said Trenholm. Read full story Source: The Guardian, 16 October 2020 -
Content ArticleEnsuring quality of care during pregnancy and childbirth is crucial to improving health outcomes and reducing preventable mortality and morbidity among women and their newborns. In recent years, Perinatal Quality Collaboratives (PQCs) have been driving improvements in perinatal care across the United States. PQCs are state or multistate networks of teams working to improve the quality of care for mothers and babies. PQCs do that by advancing evidence-informed clinical practices and processes using quality improvement principles to address gaps in care. PQCs work with clinical teams, experts and stakeholders, including patients and families, to spread best practices, reduce variation and optimise resources to improve perinatal care and outcomes. The goal of PQCs is to achieve improvements in population-level outcomes in maternal and infant health. In this article, LifeQI outlines the PQC approach, tools LifeQI can offer and some examples of PQCs being run. Life QI is the global web platform where tools, people and data come together to make improvement happen.
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News Article
‘Babies are still being damaged’ Tory peer warns ‘evasive’ ministers
Patient Safety Learning posted a news article in News
The government has been told it is ‘not sustainable’ to continue to delay its response to a major review on patient safety as ‘babies are still being damaged’. The Independent Medicines and Medical Devices Safety Review spoke to more than 700 people, mostly women who suffered avoidable harm from surgical mesh implants, pregnancy tests and an anti-epileptic drug, and criticised “a culture of dismissive and arrogant attitudes” including the “unacceptable labelling of many symptoms as “attributable to ‘women’s problems’”. The review’s author Baroness Julia Cumberlege told HSJ that “time is marching on” for the Department of Health and Social Care to implement the recommendations of her July report, which include setting up a new independent patient safety commissioner. The Conservative peer said pressure was building on government to adopt the findings of the review, since it had been endorsed by Royal Colleges and has already been adopted by the Scottish government. She said the government had given “evasive” answers in parliament on the issue. In an exclusive interview with HSJ, Baroness Cumberlege said: There is a crowded field of regulators but “there’s a void” for a service that listens and responds to patients’ safety concerns. She feels “diminished” that women’s concerns are still being dismissed by clinicians, but said young doctors are a cause for hope. She is “very optimistic” report will be implemented – but the NHS has to have the will to make changes. Read full story (paywalled) Source: HSJ, 13 October 2020 -
News ArticleOne of the largest studies of its kind suggests that most pregnant women who become infected with the coronavirus will have mild cases but suffer prolonged symptoms that may linger for two months or longer in some cases. The study, published in the journal Obstetrics and Gynecology, found that most women who participated had mild cases of COVID-19 — a finding consistent with previous studies. Among the nearly 600 women followed, only 5% were hospitalised and 2% were admitted to intensive care units. Despite the mildness of their cases, 25% of the participants continued to experience symptoms eight weeks after becoming sick. The median length of symptoms was 37 days. Although pregnancy is known to cause major changes to the immune system, the length of time for continuing symptoms was surprising, said co-principal investigator Vanessa Jacoby, vice chair of research in the obstetrics, gynecology and reproductive sciences department at the University of California at San Francisco. Read full story Source: The Washington Post, 10 October 2020
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