Helen McCarthy - Matron Lead MidwifeOwen Cooper - Consultant Obstetrician

Sue Lloyd - Consultant ObstetricianLinda Matthews - Supervisor of Midwives

NGHT 2009 ‘Pre Safer Births’Birthrate: 4700 births per yearLSCS 27.6%Triage access for all women admitted to Labour WardLow midwifery staffing numbersPoor skill mixHigh turnover of Senior MidwivesInsufficient Consultant Obs presence on Labour WardInconsistent verbal and written communication

Why Safer BirthsNetworkingEngage maternity stakeholdersEngage staff in the process of changeUse The King’s Fund expertise in process mapping,

recommendations, support and adviceUnique opportunity to share practice

ObjectivesKey aspects to implement:Increase recruitmentSupport for newly qualified midwivesDevelopment programmes Roles and responsibilities for all staff Consultant rounds Triage Working Party

RecruitmentStrict shortlisting criteria and scoring assessmentRobust interview questionsSmall recruitment senior midwifery team

Measures of success:Recruitment and quality of applicants – assurance

and increased staff moraleVacancies reduced Put in eg, of questions used and CTG

Interview questionSCENARIO: You are the midwife working

on Labour Ward, and are asked by another midwife to do a ‘fresh eyes’. The client is a primigravida and undergoing an induction of labour for postmaturity.

What is your interpretation of this CTG?

In the event of an abnormal CTG, what would you do?

Staff developmentPractice Development teamPreceptorship packageDevelopment programmeMSW NVQ level 3 programme Labour ward consultants appointed

Measures of success:Preceptorship Programme Funding was secured for NVQ programme Dedicated time for professional development

Roles and ResponsibilitiesMaPSaf visit February 2010Representation from Consultants, Clinical Director, Directorate

Manager, Senior Midwives, Midwives, SoM, Risk ManagerDo staff know their roles?Actions – devise ‘Roles and Responsibilites’ for all staff on Labour

WardForms part of induction programme for all new starters

Measures of Success:To repeat the MaPSaf in 12 monthsIncreased staff awareness through the roles and responsibilities

Labour Ward Rounds

Driven by need to improve communicationDeveloped formal Labour Ward round led by Consultant

ObstetricianStill work to be done

Triage – Drivers for changeNot TriagePoor communicationMany drivers for change

SAFETYComplaints

Triage Working Party

Consultation exercise

Triage Consultation Exercise

Triage – where we are nowOngoing piece of workSome changes have been madeMoved beyond The King’s Fund team and now a priority for

the DirectorateCurrently in the process of an Options Appraisal

Measures of success:Decrease in patient’s complaintsAudit – before and after number of callsImproved staff morale and working conditionsIncreased Home Assessments

How did The King’s Fund help?

Time away from NGH to discuss problems and planRegular meetings kept momentum goingInvaluable advice from guest speakersGave work validityConsultation exercise