Market Drayton Community Base 0 0 Market Drayton Antenatal, homebirth and postnatal care provided. The needs of women accessing maternity services are assessed and classified against 3 different pathways, which are defined at a national level (standard, intermediate and intense). The proportion of women within each of the different pathways in 2016/17 in Shropshire, Telford and Wrekin is provided in the table below and includes a comparison to other areas. Number (%) Women Shropshire Telford & Wrekin West Midlands CCGs 2015/16 Stage of Pregnancy Level of Need Antenatal Standard 1450 (51%) 892 (39%) 49.2% Intermediate 1134 (40%) 1147 (51%) 41.8% Intense 264 (9%) 220 (10%) 9% Delivery Without 2133 (80%) 1720 (78%) - With 528 (20%) 473 (22%) - Postnatal Standard 1643 (63.4%) 1097 (55.8%) 70.6% Intermediate 940 (36.3%) 860 (43.7%) 28% Intense 7 (0.3%) 9 (0.5%) 1.4% Performance against quality indicators for maternity in 2016/17 was within the expected range and in line with national performance. However, there are a number of indicators for which performance is worse than the expected range. Indicators that were not within the expected range are given in the table below: Descriptor Lower Limit Expected Figure: N = National Target, S = Birth Rate Plus Target, A = LSA Target, L = Locally agreed expected figure, B = Nationally Benchmarked Upper Limit 2016/17 2015/16 % of births in Consultant Unit 70% 75-85% (L) 90% 85.1% 82.3% % of births in any MLU 10% 15-25% (L) 30% 14.4% 17.4%
Consideration: How can the future model of services help in delivering the recommendations of wider local reviews? The maternity workforce is fragile. A recent Birthrate Plus report indicates that an overall increase in the number of maternity staff, including midwives is required, but that the smaller MLUs are for the level of activity. Sickness and absence rates within maternity services have increased in recent months; So much so, that the combined factors of fewer staff and increased demand for the consultant unit has led to the provider taking action to re-distribute staff across the service. This has meant that a reduced service is currently being delivered within the smaller midwife led units, with the units being closed for inpatient births and postnatal stays. Community visits and home births are still available. Consideration: How can the skill mix of staff be improved to ensure that the midwives are supported by others to enable midwives to focus their time on activity that they are especially trained to do? Consideration: What can be done to ensure that staff with the right skills are in the right place at the right time? Information systems and record keeping processes are time consuming and there is duplication. The provider is introducing more electronic ways of working, including electronic patient records, but these aren’t yet in place. Consideration: How can the future model of service include effective electronic information, both for women, their families and professionals working in or with maternity services? The provider is reporting that the current model of provision is not financially sustainable. Consideration: The review acknowledges the £1m cost pressure referenced by the trust. However, due to the way the service receives income as well as other influences across/from other services, this shouldn’t be a driver for this review as no reconfiguration of midwifery led care can fully address the wider financial picture. How can the future model of services be as efficient as possible, work to get best use of funds, staff and assets? and their families value the services provided by the midwife led units. They report positively about having services close to home with midwives that they know. Women feel that the units are welcoming and calming. Postnatal care provided by the midwife led units is regarded highly, particularly in relation to breastfeeding, emotional support and confidence building. Consideration: What can be done to retain/build on the elements of service delivery that women and their families most value? Next Steps