Briefing for Joint Health Overview and Scrutiny Committee (JHOSC) on STAND-ALONE MIDWIFE LED UNITS (smwlu)

Transcription

1 Briefing fr Jint Health Overview and Scrutiny Cmmittee (JHOSC) n STAND-ALONE MIDWIFE LED UNITS (smwlu) Backgrund As part f the decisin n Fit fr the Future the PCT Bard agreed that there shuld be:- C-lcated Midwife led unit at Wrthing Hspital alngside the Cnsultant led unit Stand-alne midwife led unit at St Richards A stand-alne unit in the nrth f the cunty This reflected the advice received by the Bard frm the Maternity CRAG and fllwed n frm the decisin n 7 th May t chse Mdel 3 fr services in West Sussex. The PCT prpsed that there shuld be discussin with JHOSC t determine the best way f ensuring public engagement in selecting the lcatin f the smwlu in the nrth f the cunty. PCT Prpsal Rather than immediately launch public engagement in the nrth f the cunty the PCT prpses a staged apprach:- 1. Draw up an utline service specificatin fr a smwlu 2. Establish a Maternity Reference Panel including patients and clinical staff t wrk with the PCT during the Optin develpment prcess 3. Invite ptential NHS prviders t cnsider their ability and willingness t prvide such a unit in the gegraphical area cncerned (see attached draft invitatin) 4. Use the respnses t develp a shrt list f ptins fr a smwlu 5. Launch public engagement n the ptins identified The aim wuld be t ensure that public engagement was fcused n realistic ptins which were clinically sustainable, financially sustainable and deliverable. Timetable & Prcess The utline specificatin and invitatin fr expressins f interest wuld be issued by end June with timetable fr reply by end July. The PCT wuld assess the prpsals frm the Trusts and develp a prpsal fr public engagement based upn the available ptin. Public engagement wuld be initiated by September 1 st with a prpsed clsing date f 13 th Octber (6 week perid). The utcme f public engagement wuld be brught t bth the relevant Health Overview and Scrutiny Cmmittee and the PCT Bard with the aim f achieving a decisin by end Nvember 2008.

2 The PCT s engagement prcess will invlve three target grups:- Clinical staff in midwifery/bstetrics detailed arrangements fr this will depend n which Trusts ffer t prvide the smlu Mthers and wmen f childbearing age and their partners this will fllw the pattern develped during FFF cnsultatin but with an increased number f engagement events The general public a public meeting will be held in the main twns f the nrth east i.e. Crawley, East Grinstead, Haywards Heath, and Hrsham. Questins t JHOSC Given the cnsiderable cnsultatin n the mdel f services and the prgramme f engagement with mthers already carried ut by the PCT, is it acceptable t have a shrtened perid f further public engagement as utlined? Des JHOSC wish t cmment n the utline timetable and prcess? Brian Hughes DIRECTOR June 2008

3 Appendix A Fit fr the Future Stand alne Midwife-led Unit (in the nrth f the cunty) Request fr Expressins f Interest Backgrund Currently, there are n stand alne midwife-led units (smwlu) in West Sussex. The PCT is cmmitted t develping smwlu, s that wmen can be ffered a psitive and cmprehensive chice f birth place. At the recent PCT Bard meetings n 7 th May and 4 th June the mdel f care and lcatin f maternity services were decided. On the suth cast, the Cnsultant-led Obstetric Unit will be lcated at Wrthing Hspital with utpatient and ante/pst natal services prvided at ther sites acrss the cunty, including cmmunity hspitals r ther sites, such as GP surgeries. The MGH Cnsultant-led Obstetric Unit at Wrthing will have a c-lcated Midwife-led Unit and will be expected t prvide a linked smwlu at St Richard s Hspital. The Cnsultant-led Obstetric Unit based at PRH will be re-lcated t the Ryal Sussex Cunty Hspital in the lnger term. It was als agreed by the PCT Bard that West Sussex culd supprt a maximum f tw stand alne midwife-led units (smwlu) and that the nrth f the cunty culd supprt ne f these units. In rder t take this prcess frward there will be a perid f public engagement t determine the lcatin f the smwlu in the nrth f the cunty. We wish t prvide stakehlders with a chice f ptins, acrss a number f suitable lcatins that can be delivered and are therefre lking fr initial expressins f interest frm lcal Trusts wh may be willing t develp and manage this smwlu. Expressin f Interest West Sussex PCT is keen t hear frm enthusiastic partners wh wuld be willing and able t develp and manage the smwlu in the nrth f the cunty. Outlined belw is a minimum specificatin fr the service t be prvided, respnses shuld be included in the attached table.

4 Organisatin and services Outline Specificatin The smwlu needs t be lcated in the nrth f the cunty (i.e. n, r t the nrth f the A272) in an apprpriate centre f ppulatin t prvide gd access fr the greatest number f West Sussex residents. Lcatins already cnsidered include: Crawley Haywards Heath Hrsham Hwever, this list is nt prescriptive and ther sites with gd access wuld be cnsidered. In rder t ensure financial and clinical sustainability, the smwlu shuld have in excess f 300 births per annum. The smwlu shuld be netwrked with a Cnsultant-led Obstetric Unit that delivers apprximately 4,000 births per annum. Facilities available at the smwlu shuld supprt birth chices, including fr example, birthing pls. The mst effective use shuld be made f the facilities available at the smwlu i.e. ther apprpriate services such as ante natal care shuld be prvided there. Wmen and family centred care shuld be prvided and wmen and their families shuld be invlved in designing the smwlu. Links with the lcal cmmunity shuld be established Strng links with the lcal ambulance service shuld be established. Standardised, apprpriate equipment shuld be used. Ideally, there shuld be managers with experience f wrking in r managing smwlu available t take the develpment f the service frward. Implementatin shuld take int accunt existing service develpment plans and timscales. Clinical Issues 1:1 midwifery care shuld be prvided in labur.

5 Apprpriate clinical gvernance structures and prcesses shuld be in place, examples include prcesses fr: Implementatin f NICE guidance (NICE Intrapartum Care Guideline) Mnitring and implementing evidence based practice (including the Birth Places study due t reprt in 2009). Cllect utine data and undertake regular audits in areas such as: clinical utcmes, transfer rates and satisfactin levels. Cmprehensive care pathways and prtcls shuld be in place which shuld fr example : Identify lw risk mthers wh are able t make use f smwlu Identify changes in risk during pregnancy Facilitate the safe transfer f mthers wh need t be transferred t the Cnsultant-led Unit during labur Staffing All staff shuld have apprpriate training and skills; midwives n the unit shuld have: Advanced Life Supprt Obstetrics (ALSO) curse r similar Nenatal Life Supprt (NLS) curse Examinatin f the Newbrn curse Apprpriate training in the care f wmen laburing and delivering in water Staff wrking at the smwlu shuld be n an apprpriate rta that als allws them t wrk at the Cnsultant-led Unit, in rder t maintain and develp their clinical skills. Prvide regular updating and maintenance f skills and drills mandatry fr all staff under CNST. Other Services The smwlu culd als ffer the fllwing: A link Obstetrician, Paediatrician and Practice Develpment Midwife/Midwife Educatr Outreach services such as ultrasund scanning Pstnatal stay facilities Drp in sessins fr breast feeding and infant care

6 Respnses Trusts are therefre requested t supply (n the Trust Respnse t Expressins f Interest Frm) a list f the sites that culd meet the fllwing brad criteria and therefre prvide a viable smwlu fr the nrth f West Sussex: Access (maximises access fr the childbearing ppulatin and their families) Clinically sustainable, including safety aspects f smwlu (links t a Cnsultant led Obstetric unit and exceeds 300 births per annum) Financially sustainable (prvides ther maternity services n site and exceeds 300 births per annum) Deliverable (fits int existing service develpment plans and timescales) Acceptability (takes accunt f the views f the general public and ther stakehlders) These criteria will then be used t select the lcatin f the smwlu, after the public engagement prcess has been cmpleted. If yu are interested in discussing in greater detail the issues arund prviding this smwlu in please cntact: Liz Cstigan FFF Prgramme Manager Clinical Wrkstream elizabeth.cstigan@westsussexpct.nhs.uk