KEEPING CHILDBIRTH NATURAL AND DYNAMIC
NATIONAL STEERING GROUP
Draft notes of the meeting held on Friday May 15, 2009
Present:
Yvonne Bronsky, Local Supervisory Midwifery Officers
Cynthia Clarkson, National Childbirth Trust
Noreen Kent, Lead Midwives Scotland Group
Ian Laing, Royal College of Paediatrics and Child Health
Geraldine Butcher, KCND Consultant Midwives
Morag Martindale, Royal College of General Practitioners
Helene Marshall, SMMDP
Belinda Morgan, NHS Health Scotland
Fiona Dagge-Bell, NHS Quality Improvement Scotland
Gillian Smith, Royal College of Midwives
Monica Thomson, NHS Education Scotland
Fiona Greig, Consultant Midwife
Ann Holmes, Programme Lead KCND (In the Chair)
In attendance: Helen Cheyne, CSO NMAHPRU
Natalie Smart, NHS Health Scotland
1. Welcome and Apologies
Ann welcomed everyone to the meeting in lieu of an appointment to the Chief Nurse position and round table introductions were made. Helene Marshall was welcomed as the new SMMDP Director.
Apologies were noted from: Margaret McGuire, Acting Chief Nurse; Rosslyn Crocket, Directors of Nursing Group; and Sandra Smith, Consultant Midwife.
2. Minutes of previous meeting
Minutes of the Midwifery 2020 Programme Board and web link to the Cochrane review of midwife led care had been circulated as agreed at the previous meeting. Monica indicated that her surname should be spelled Thompson and that NHS Education Scotland should read NHS Education for Scotland, otherwise the previous minutes were accepted as an accurate record.
3. Overall and regional progress reports
Overall programme report
It was noted that work is progressing well in the main. NHSGG&C is implementing remaining objectives alongside a major service redesign and would therefore be unlikely to achieve the specified timescales, so is reported as such. NHS Borders and Fife have local obstetric opposition to implementing the midwife as caseload holder, so while local strategies are in place, they are reported as possibly unlikely to meet the timescales.
Morag asked whether GPs would notice any difference at practice level in relation to the midwife as caseload holder. Following discussion, it was agreed that as many Boards are already working this way, some may redesign local community midwifery services, otherwise documentation of a midwife as lead care provider in SWHMR may be the only notable difference.
Regional reports
North, SEAT and West region reports were reviewed. As NHS Borders have not appointed a replacement Consultant Midwife (currently seconded to CSO), Gillian requested that the Board be asked to clarify how KCND central funding is being used. Ann will follow this up on behalf of the Group. Action: AH
NHS Boards are progressing all objectives, though implementing the midwife as first professional contact appears slow in some areas. Ann indicated that whilst significant work is ongoing locally, she anticipates some Boards may have difficulty meeting the December timeline and may show amber or red in the next report. Monica asked for clarity around what should be reported amber/red and Ann advised on the guidance within the report template (included below). As current reports are for March, Boards, with the exception of NHSGG&C, were reported green due to significant ongoing work and 9 months remaining on the timeline. This was agreed as appropriate by the Group, with no alterations required to current reports. It was agreed that an additional 3 month progress report should be requested from Boards. Action: AH
Column 6 Status - green indicates that key tasks outlined in column 2 are either completed or on track to meet the timescales specified in column 3; amber indicates that there may be a problem either completing key tasks or meeting timescales, in which case column 7 should be completed and the action plan to redress this outlined; red indicates that key tasks or timescales have not been met, again column 7 should be completed as above.
The amended programme timeline for activity in 2009 was tabled and agreed.
4. Special Health Board updates
· NHSQIS
Fiona overviewed the previously circulated report from NHSQIS. On behalf of the Group, Ann thanked NHSQIS for this excellent work culminating in the care pathways. The pathways have been disseminated across NHS Scotland and were launched by the Minister for Public Health and Sport on 12th May. Fiona tabled thanks to Lucy Powls who had led the work.
The report included recommendations on the "six week postnatal check" and Ann queried how these could be shared across NHS Scotland. Following discussion, it was agreed that NHSQIS would package this aspect of the work and disseminate via their usual channels. Morag indicated the importance of facilitating family planning advice by three weeks postnatal; and Iain highlighted the importance of avoiding duplication, through facilitating combining this with the eight week neonatal examination. It was agreed that NHSQIS recommendations should take account of these points. Action: FDB
Helen highlighted that it was difficult to find and attribute relevant references in relation to the pathways and queried whether a link to the CSO NMAHPRU literature review could be made clearer in the report. Fiona advised the report was intended for this group only, however NHSQIS would share a short summary with relevant networks. This was agreed as appropriate and NHSQIS would add a link to the CSO literature review to the pathways webpage which would be available to all.
Action: FDB
· Health Scotland
Belinda overviewed the previously circulated report from Health Scotland. She described the development process for a poster and leaflet, including feedback from pre-testing with women and tabled final drafts (pending updated photography). Round table discussion ensued. Belinda and Natalie advised that these represented an initial social marketing approach requested by some NHS Boards. A wider social marketing campaign is planned towards the end of 2009, if possible aiming to combine messages around 1st point of contact, enhanced antenatal screening, inequalities and early years agendas. A Ministerial launch of this campaign would be requested towards December to fit with the programme timeline. The Group agreed this as a good way forward.
Ann indicated that whilst the timeline for 1st point of contact is December, most Board leads are keen to have the poster/leaflet as soon as possible to help progress this objective locally. However, it would be important to avoid antagonising GP colleagues where Boards are not ready to implement this objective. It was agreed that the final poster/leaflet should be distributed to KCND Board leads for them to use where appropriate and that this should be clearly articulated in the circulation. In the interim, Belinda will request final comments from the Group on the leaflet content. Action: BM
Geraldine asked if these would be distributed to pharmacies and Natalie advised this would be done via following the wider campaign launch. Action: BM
5. Evaluation programme update
Interim data collection results had previously been circulated and Helen re-iterated that these were incomplete and therefore not ready for wider dissemination. All data had now been returned and a full report would be generated on completion of the analysis. Helen proposed that the full report be circulated to this group and KCND Consultant Midwives/leads, which was agreed.
It was of note that approximately 50% of women were recorded high risk at the start of labour, although acknowledged that this data represented the status pre introduction of NHSQIS pathways. All agreed that the data generated would be of significance, as it provided information from all units across NHS Scotland at a specified time period. Helen indicated an intention to repeat the exercise in early 2010, following sufficient time to embed the NHSQIS pathways and this was agreed. Action: HC
6. e-health proposals
Two proposals had previously been circulated to the group for comment, on the need for a minimum maternity dataset and information sharing between GPs and midwives. As these issues were longstanding and wider than KCND, Ann proposed the group table these with SGHD Maternal and Child Heath Information Group, requesting them to consider a way forward. This was agreed. Action: AH
In the interim, Morag suggested potential to share examples of good practice in relation to GP and midwife communication and that NHS Tayside were already working on this. Belinda highlighted the possibility of including such messages in the social marketing campaign, which could use a women centred/patient journey approach. This was agreed as a good way forward and a subgroup would be established to develop these. Action: AH/BM
7. Feedback from stakeholders
Iain advised on related work for the group to note, namely a report from MSAG on the future of neonatal services and leaflets around newborn screening.
Noreen queried whether the group wished to continue receiving information on Midwifery 2020 and it was agreed that a link to the website would be circulated with the minutes. Action: AH
8. AOCB
No other business was tabled.
9. Date of the next meeting
Friday November 06, 2009, 1.30pm-3.30pm Conference Room 2 Victoria Quay (sandwich lunch available from 1pm)