February Newsletter

Bedfordsite Women’sServices

February2023–Issue22 BedfordsiteNewsletter

Welcome to our newsletter from our Bedford leadership team, Tara Pauley (Head of Midwifery), Montasser Mahran (Gynaecology Clinical Lead), Liliana Grosu (Obstetric Clinical Lead), Rebecca Lees (Senior Service Manager)

Emma Hardwick (Director of Midwifery) and Pushpa Maharajan (Clinical Director) form the Trust wide leadership team across both sites of Bedford and Luton and Dunstable with Heather Spackman.

We have made this newsletter available in digital format too for easy access – this will be published on the Marvellous Maternity Facebook group

MessagefromTaraPauley HeadofMidwifery

During the month of February…..

Welcome to February’s newsletter.

In this month we highlight:

• Our monthly birth statistics

• The incredible increase in FFT responses

• Our upcoming Who's Shoes event 28th April (Bedford)

• Learning and Governance summary

• Compliments and positive feedback

• Job opportunities

• Triage building works progress

• Local area updates

• Feature on Alex our Research Midwife for the GBS3 trial

• Infant Feeding updates and learning

• Fetal monitoring key learning points

• No smoking day and our Keeping Well in Pregnancy (KWiP launch)

• Digital midwife update and data information learning

• Staff wellbeing offer reminders

• PMA updates

• THRIVE behavioural framework

• How to raise a concern

Thank you everyone for your continued hard work in serving our families as well as we can here at Bedford hospital.

Tara Pauley Head of Midwifery

Infographics

184 Births were recorded

186 Babies were born

4 home births occurred

164 births occurred within Delivery Suite

14 babies born in Acorn Unit

2 BBAs occurred

100% of women received 1:1 care

2 set of twins were born

Term babies were admitted to Meadow bank (NNU)

1 stillbirth was sadly recorded

0 Neonatal deaths were recorded

There were no occasions of diverts occurred

(details available on the shared drive here: P:\Maternity\Maternity dashboard)

Updatesfromtheareas: Safety&GovernanceTeam

Overview of Lessons Learnt from recent investigations

Please see the risk report for further detail

There were 85 incidents relating to maternity and obstetrics and 11 incidents relating to Gynaecology on the Bedford site. Themes included maternity care, PPH, 3rd degree tears.

HSIB, Serious Incident Cases

There were 0 serious incidents declared in February 2023

Trust SIs

Complaints: 5 complaints received in February 2023

1 complaint for Gynaecology, 4 complaints for Maternity

Updatesfromtheareas: Safety&GovernanceTeam

PALS

There were several PALS concerns relating to Obstetrics and Gynaecology. The main themes are delays in receiving appointments, pregnancy booking appointments, cancellation of appointments, clinic changes and waiting list times.

Top Risks – Scoring 15 or above on the Risk Register

• Community Midwifery Lone Working (20)

• Resuscitaires (20)

• Medical and surgical outliers on Orchard Gynaecology Ward (20)

• Development of robust triage assessment (16)

• Non-compliance with Saving Babies Lives Version 2 (16)

• Gestational diabetes pathway for screening and acting on results (16)

• Temporary adjustment to continuity of care model (16)

• CTG issues cross-site (16)

• Safeguarding standards in community midwifery not being met (15)

• Patient Call Buzzer System (15)

Michelle Vaughan Risk Management Lead Matron

Patient Experience

Big well done to everyone, especially ANC for their massive engagement. Please continue to engage women/birthing people and their families to provide feedback via our friends and family test

What is going on in Patient Experience?

WHO’S SHOES Community Engagement Event, Friday 28 April 2023.

Supporting women and families with personalised tours

Following up feedback from surveys and speaking directly with women and families about their feedback

Collection of patient stories

Pelvic health workshop to improve outcomes for women

Links made with Imams within the Muslim community, particularly in relation to Ramadan

Supporting PMA service

Patient Experience at Bedfordshire Hospitals was nominated for the category of Excellence in Experience at the Regional East of England Awards Day in Cambridge!

If you require support or training, please feel free to contact me on 07771 835 135. I am more than happy to support you. Kelly – Patient Experience Midwife

We haven’t met yet but I am the new emotional wellbeing midwife for Bedford, working with Ocean. I just wanted to drop you a line to say a big thank you for your amazing care you gave Sarah Boenke, she can’t speak highly enough of you and you helped her achieve the birth that she wanted which has been wonderful for her to help heal from her previous traumatic delivery. Your kindness works magic!

Thank you again and hopefully we’ll bump into each other soon.

Compliments

On behalf of the 3rd year cohort, we would like to extend our appreciation for the amazing work done by Zara Bishop as our Clinical Tutor. The endless hours that she has worked on our demanding tasks (E roster accommodation, personal support, clinical and academic) made a better experience within our placement time. The professionalism, as well as the moral support for individuals is outstanding. Zara has also helped us whilst being under pressure herself and working independently. We feel that her job fulfils our needs and provides us with proper guidance due to her passion and understanding of the role. Without her diligence and determination, hard work and extra hours given for the students we would not have been able to make it this far.

Please accept our sincerest appreciation for the brilliant job she is doing in our maternity department.

• This is just to say how impressed I have been with the care at the Orchard Ward at Bedford Hospital This is now my second stay at the ward within the last six months The nurses and doctors have been outstanding, attentive, friendly, and professional both times Thank you and keep up the excellent work!

• I would like to pass on my praise and thanks to the Gynaecology team I saw today, I was very nervous about the procedure and needed further explanation of what would happen All of the staff involved were very welcoming, helpful and gave clear explanations of what was happening What was a bit of an uncomfortable, and possibly embarrassing procedure, was completed in a way, and in an atmosphere in which I was made to feel comfortable and that I could ask questions etc if I needed to Please can my thanks and appreciation for their work, time on a Sunday clinic, and clear explanations be given to Mr Mahran and his team, Bobby Moore, Jane and Pauline.

‘Just wanted to say a huge thank you to Chelsea and Rachel who looked after me. They made me feel calm and relaxed. X’

• I would like to express my thanks and gratitude to the lovely nurse Michele in the Obstetric & Gynaecology Dept. A few weeks ago (12/01) I had to go and have a hysteroscopy and polyp removal I was extremely anxious about the procedure However, the little team of nurses were all very supportive and friendly, particularly Michele She was absolutely lovely, patient and kind Distracted me throughout by chatting away and calming by nerves; even holding my hand I felt very emotional during the process which wasn’t particularly pleasant but I made it through with her help I then had to have a coil fitted last Friday (03/02) and fortunately I was lucky enough to have Michele in assistance again Not that she remembered me initially but I remembered her! Again she was exactly the same as my previous appointment So I just wanted to take the time to let you know what a little star I think she is!

If anyone receive messages like this , and would like it featured in the newsletter please send to : Louisa.smith@bedfordhospital.nhs.uk

ProfessionalDevelopment

Opportunities/Recruitment

Job Opportunities in out for advert or coming soon:

Consultant Midwife Band 8B (Cross Site )

Midwifery Operational Manager Band 7 (Luton)

Maternity Training Officer (administration) Band 4 (Luton)

Triage work so far

Triage continues to progress more and more each day… walls are up, flooring underway, we meet with our MVP and service users on 28th March to gain their input on designs.

Community

Community & Homebirth updates

 Lone worker app – We will shortly be launching a new application ‘StaySafe’ for all community midwives. This app is loaded directly onto work phones and will provide added security to all our lone workers. This app is for your safety when working in the community setting, so when the training information is sent to you, please ensure you watch the demonstration and make yourself aware of this app and all its functions.

 Kings House Hub – We are now in the new area 1 HUB at Kings House. Currently we have the office space up and running with numerous ‘hot desk spaces’ for all to use, and we also have a small private room for bookings that can be utilised. Please speak to one of the band 7’s if you wish to use this room. Caseloads have been identified and the midwives for the 1st phase of moving in have been contacted. The GP surgeries will be contacted officially to inform them of the plans moving forwards.

 New Starter – We have Phoebe who has joined us from NWAFT and will be joining the homebirth team as a full time member of staff. I am sure you will meet with her during her orientation through community over the next few weeks! Welcome Phoebe!

 We also have Victoria Miller (MSW) who is with the community team proving support to us all. Welcome Victoria!

 Solus – Thank you to everyone for the support you have shown with using the new Solus application. New bookings are starting to come through and whilst we always pick up a few teething issues with any new process, we appreciate your support and feedback to improve the service. If anyone has any issues regarding using the new booking app, please contact Sarah Lumley, who will be happy to support.

 Safeguarding – Just a reminder for you all to ensure your safeguarding caseloads are kept up to date. The SG team are not able to attend meetings for the lower level cases due to their own work commitments, but they are always there to support if needed. If you have a meeting to attend, please make sure you speak to the B7’s who can arrange for cover for your clinical work in order for you to attend.

 Referrals for Homebirths – Again just a reminder to have ‘the discussion’ at booking with all women about their choice of place of birth at their booking appointments. Referrals to the homebirth team need to be made as soon as possible to ensure women have the best chance of being taken on their caseloads. There are a limited number of women the team can take.

 Please ensure the team are emailed on homebirthmidwives@bedfordhospital.nhs.uk

 Sarah Perry has now completed her band 7 secondment and I just wanted to say, what an amazing job she has done during her time with us. She has shown exceptional leadership skills and enthusiasm within the teams. Sarah has taken on every challenge head on and learnt so much over the past few months. Her development will continue and I am sure there will be many projects she will continue to take on to keep supporting and improving things for you all.

Delivery Suite Update

- Well-done to the team especially to our MCS’s, domestics and ward clerks for all of their hard work in making sure the checks and flushing of our low use outlet are continuing to take place. We have scored another whopping 100% for the second month running in both areas.

- New positivity board being created In the staff room with a areas for staff to share their success stories. If you have a positive work related story or journey to share, put it in writing to me for us to add it to our story board on delivery suite for everyone to read.

- Well done to everyone for the 2nd month running in an improvement to our defib check on delivery suite (97%) and orchard ward (100%)- lets keep this going!

- I feel very proud to share there has been evidence of excellent MDT team work, support and care for each other in the inpatient areas with an emphasis on wanting to learn, share and celebrate the good- there is always good! Well done to everyone for creating and supporting psychological safety.

Inpatient Update

It has been a busy time for the inpatient areas with lots of exciting changes and new staff joining us: A very big and warm welcome to:

Georgia Curtis our housekeeper on delivery suite. Georgia is responsible for monitoring and reporting our equipment on delivery suite, stocking and supporting patient meals. Georgia is working Monday-Friday from 8-4pm on delivery suite.

Sharran White Orchard ward manager who is job sharing with Gemma Cook. Sharran has a wealth of experience as a ward, ANC and birthing centre Manager.

Changes to our areas:

Triage:

Change to triage area from delivery suite or orchard ward on 20/2/23 went very well. Thank you to everyone involved in making it a success. We have had positive feedback from staff who have worked in the triage area. Thank you to the staff who have taken the time to make suggestions to make further improvements to the area to support you working safely and effectively. The renovations to triage on delivery suite are progressing positively. The next area for renovation after the triage area will include the midwives station.

A gentle reminder to support you working in triage:

- Complete the daily checklist for triage to support safe practice, found In a clear folder in triage.

- Wheel chair should be made available at all times in triage for safe transfer. This is currently the main method for transferring women in a urgent situation to delivery suite.

- Daily chase up and action of the blood and microbiology tests in ICE folder

- Any patient who attends triage and is found to be in advance labour or not coping should be transferred for assessment on delivery suite. This will minimise the risk of a delivery in a nonappropriate area.

GBS3 trial at Bedford went live on 2/3/23 this will change care for our women from a GBS perspective. Please make sure all midwives and Obstetricians look at the video that Alex has sent and sign the declaration form to say verify that you have had training. This is a very important piece of research which will hopefully define the way we screen for GBS in the future for every pregnant women.

Gentle Reminder:

- Mattress checks to be carried out monthly on every bed on Delivery suite and Orchard ward

- Monthly drug and fluid checks to check for expiry dates, send any expired drugs back to pharmacy and carry out stock rotation for patient safety

- To complete the weekend cleaning book found on delivery suite and Orchard ward

- RESUSITIARES are checked twice per day at the start of the LD or LN shift on orchard ward and on delivery suite

I’m Alex, the research midwife for Bedford Hospital. I coordinate all maternity research studies conducted on the Bedford site. My job role includes, working out the feasibility of new studies for Bedford hospital, liaising with various maternity departments about current and upcoming studies, conducting staff education, formal patient consenting and follow ups for each study.

I qualified as a Midwife in 2021 from the University of Bedfordshire, I then worked clinically in Cambridge and then moved over to Research at the beginning of this year. I am currently working on the GBS3 study which opened on the 2nd of March - This study is looking at the Group B Streptococcus bacteria and if testing all women will reduce the rates of GBS caused Neonatal sepsis.

Kind regards,

Alex Gurton

Welcome to the international Midwives that joined us this Month Cohort 12:

Onyinye Assumpta Ndunwa-Chidi (BH)

Ayodeji Olayinka Adeyoriju (L+D)

Karimot Titilope Oladosu (L+D)

Riskatu Mohammed Amin (L+D)

Juliet Yamoah (L+D)

Judith richerson (L+D)

Midwives that passed there OSCE this month:

Sara Doustitalkohi

Chiliebele Becky Okobi

Mahnaz Rahmanpour

InfantReadmissions

Infant Feeding

The run chart below shows the data in over the past 2 months. It was pleasing to see the upward trend this month of all areas.

The final figures for January are as follows ;

Skin to Skin =86.5%

Number of babies who received breastmilk = 82.1%

The data shows our monthly figures for skin to skin can vary quite considerably. Please can we ensure all mothers are offered the opportunity to have skin to skin with their baby at delivery (as long as mother and/or baby are clinically well) and this is correctly updated on CMiS

Fetalmonitoring

Fetal Monitoring

Fetal monitoring practice: Escalate – get support

KWiP Launched

Our maternity departments at Bedfordshire Hospitals launched the Keeping Well in Pregnancy (KWiP) Service on March 8th to coincide with No Smoking Day.

The service has been designed to offer specialised support to pregnant women/pregnant people with quitting smoking during pregnancy to ensure a healthy outcome for Mother & baby.

We welcome our New Maternity Stop SmokingAdvisers, Desta WrightBrown covering Bedford site and KD Singh & Karina Jeffryes who will be covering Luton into their new roles. They will provide 1 to 1 care and personalised, confidential support to our pregnant people/partners and families.

Informative stalls were held on both sites by our Maternity Stop Smoking Advisers to raise awareness and promote the service!

#NoSmokingDay

We would like to thank all staff for their support in helping us get the new service off the ground.

Digital Maternity Update February

Digital Maternity Update February

Welcome to the Digital Maternity update for February 2023.

This month’s update is all about DATA. Love it or hate it, we cannot get away from it, so here is the lowdown.

 What is data?

Data is different types of information usually formatted in a particular manner. Data (digital.nhs.uk)

 Why does data matter?

Data inspires progress and galvanises change. We need to know where we are, so that we know where we need to go. We need to identify our challenges and how to find a solution.

12 Reasons Why Data Is Important - The Council on Quality and Leadership (c-q-l.org)

 What is data accuracy?

Data accuracy is the most critical aspect of data quality. It means that we can trust that the data collected gives us a reliable and appropriate view of the situation. This enables us to review our performance and make better decisions for planning, forecasting and budgeting. Inaccurate data leads to faulty predictions which can then lead to wasted time, money and resources. If we are confident in our data, decision making is enhanced, along with productivity and efficiency whilst reducing costs.

 Why do you need to know?

When data is entered into CMiS, it doesn’t just stay there. We use all of that information you type into it for lots of different reasons. We report on a number of indicators to identify our performance as a trust. We report nationally into the Maternity Services Data Set (MSDS) which is a nationwide data collection tool that provides an overall view of the state of maternity services. It helps to highlight if there is an issue at a particular trust, for example a high stillbirth or maternal death rate may means that there are failings at a particular trust. Which could mean using incorrect guidelines, incorrect CTG interpretation etc. The data will show us what we are doing and how we are doing it.

At any given moment, I can provide our performance data to the senior team who can advise the board. This is particularly useful if we need more resources.

 Data issues at Bedford

There are two main issues at Bedford currently:

1. Low risk births on delivery suite being recorded as an Acorn Suite (MLBU) birth. This is incorrect. Only births that have taken place in Acorn Suite (rooms 7, 8 and 9) can be recorded as an MLBU birth on CMiS. It is essential, that you do not record a low risk birth on delivery suite as an MLBU as this is incorrect data.

2. CMiS not reflecting the handwritten notes as shown below: -

When the “onset of labour”, “second stage” or ”pushing commenced” fields are not completed in CMiS, the recorded is rejected by MSDS, as you cannot have a vaginal birth without this information. This means I have to access the handwritten notes to establish the timings and add them to CMiS. I may also send you a friendly reminder.

Whenever you enter any data into CMiS, you must ensure it is accurate. I have amended a number of records that have a “delivery decision date” of a whole year before. So if the data was to be believed, this poor person waited a year for their instrumental/operative birth following the decision being made by a doctor!! We all make typos, but it is important to review the data you are adding. Also, if you have students recording information in CMiS, please check the record.

Please be kind to your Digital Midwife!

If you need any support from me with anything, please do get in touch.

Sarah.Lumley@bedfordhospital.nhs.uk

Wellbeing:

The Wellbeing Room for Women’s Health is available to all our staff members and is located by reception G of the Cygnet Wing

Our aim is to provide a quiet space for reflection and rest, away from the demands of the workplace. Access code is C3468Y.

Please leave the space As you would wish to find it.

PMA Update

•We are currently looking at allocation of sessional hours for our sessional PMAs.

•Sessional PMAs are currently linking themselves to a community, ward, student year group etc. Even though you will have a Link PMAfor your area, you are most welcome to be supported by any PMA.

•The PMAbooklet is in draft form and will be ready soon to disseminate to all of Marvellous Maternity

•Late evening drop in sessions have been planned for maternity colleagues to come and have a listening session with a PMA. The next session is on the 22nd March from 6pm to 8pm

THRIVE Behavioural Framework

Teamwork

We work mindfully and collaboratively to create a well-organised, professional and supportive atmosphere that achieves the best possible outcomes for all. We do this by:

* Communicating effectively and respectfully with our colleagues.

* Valuing all contributions and taking the time to listen to each other

* Making decisions together to provide the best possible service for all

Honesty & Openness

We are open, authentic and have integrity in all we do by:

* Openly sharing constructive feedback with others in a kind and empathetic way

* Understanding the impact and value of our role on patients, colleagues and carers

* Supporting colleagues to learn and reflect when things don’t go as expected

Respect

We respect colleagues, patients and carers by actively listening, responding, and providing everyone with a voice to create a positive work atmosphere. We do this by:

* Showing empathy and understanding when communicating with others

* Valuing the importance of everyone’s role within the team

* Taking the time to actively listen and respond to patients, colleagues and carers

* Respecting each other as equally capable, independent people

Inclusivity

We are fair and inclusive and appreciate the diversity within our community:

* Supporting the diverse communities we serve in our working life

* Confidently challenging discriminative behaviour

* Considering different needs in order to provide fair access to our services

* Ensure that our workforce has equal access to opportunities.

Valuing People

We value patients, colleagues and carers by showing care and empathy. We do this by:

* Acknowledging everyone’s efforts and successes.

* Taking the time to care for our own wellbeing and check in on others.

* Encouraging a supportive community that enables everyone to make a difference.

Excellence

We share knowledge, information and support each other to develop, innovate and learn. We do this by:

* Being open to challenges and improvement

* Acting on and embracing constructive feedback

* Collaborating with others to share innovative ideas.

Freedom To Speak Up (FTSU)

Patients are at the heart of everything we do here at Bedfordshire Hospitals and staff should feel proud to work in such a caring and safe environment. However, just sometimes we see things which raise a concern in our minds.

Don’t keep those concerns to yourself. Speak up and we will listen and act, where appropriate. Staff are often the first to identify a serious problem and the hospital wants to know about any concerns you may have to ensure every ward and department is running as safely as possible

In addition to the existing processes for raising concerns (such as raising with your line manager if comfortable or appropriate to do so) The Trust has a Freedom to Speak up Policy available on the Intranet and provides advice to staff on the best way to escalate any concerns they have. It outlines who is the most relevant personto contact depending onthe type of concern.

There are two appointed FTSU Guardians – one on each hospital site that staff can approach to raise any concerns confidentially. The FTSU Guardian for BedfordHospital is:

Lana Haslam

Email: lana.haslam@bedfordhospital.nhs.uk

Telephone: extn. 2065 / mobile: 07585402774

Safety Champions

Please also be aware of our varioussafety champion rolesas below: