KEEPING CHILDBIRTH NATURAL AND DYNAMIC
NATIONAL STEERING GROUP
Draft notes of the meeting held on Friday 6 November 2009
Present:
Yvonne Bronsky Local Supervisory Authorities Midwifery Officers
Sheona Brown KCND Consultant Midwives
Cynthia Clarkson National Childbirth Trust
Fiona Greig Consultant Midwife
Ann Holmes Programme Lead KCND
Mairead Hughes NHS Quality Improvement Scotland
Noreen Kent Lead Midwives Scotland Group
Morag Martindale Royal College of General Practitioners
Helene Marshall SMMDP
Margaret McGuire Acting Chief Nurse (In the Chair)
Belinda Morgan NHS Health Scotland
Natalie Smart NHS Health Scotland
Gillian Smith Royal College of Midwives
Monica Thompson NHS Education for Scotland
In attendance: Helen Cheyne, CSO NMAHPRU
Purva Abhyankar, CSO NMAHPRU
1. Welcome and Apologies
Mags welcomed everyone to the meeting and round table introductions were made.
Apologies were noted from: Fiona Dagge-Bell, NHS Quality Improvement Scotland; Rosslyn Crocket, Directors of Nursing Group; Ian Laing, Royal College of Paediatrics and Child Health; Liz McGrady, Royal College of Anaesthetists; Phil Owen, Royal College of Obstetrics and Gynaecology; and Sandra Smith, Consultant Midwife.
2. Minutes of previous meeting
It was noted that Monica's name was misspelled and Yvonne wished Local Supervising Midwifery Officers amended to Local Supervising Authority Midwifery Officers. Otherwise the previous minutes were accepted as an accurate record.
Ann updated on the e-health papers previously submitted to the Maternal and Child Health Information Strategy Group (MCHIS). MCHIS was currently under review and had not met, however the chair would update on progress with the papers in due course. In the interim, the need to develop an identified dataset was being fed into the workplan of the Maternity Services Action Group (MSAG).
Gillian tabled RCM's concern around the impending loss of several non substantive Consultant Midwife posts and questioned the use of central funding within some Boards, particularly Borders, Highland and Tayside. Gillian requested SGHD action and indicated that she would be discussing this issue during a scheduled meeting with the Cabinet Secretary. Mags would take advice from SGHD Workforce Directorate and table this with the Scottish Executive Nurse Directors (SEND). She noted the possibility of KCND funding being withdrawn from any NHS Board not continuing the KCND Consultant Midwife post. Action: MMcG
3. Overall and regional progress reports
Overall programme report
It was noted that most NHS Boards had implemented NHSQIS pathways for maternity care and the midwife as lead professional for healthy women in practice. NHS Borders and GG&C anticipated completion by December 2009. Most Boards reported anticipating implementing a midwife as first professional contact for the majority of women by December. However, where Board reports indicated static or minimal progress from the June interim feedback, these were reported amber (may not be completed within timescale). This was agreed as appropriate by the Group. Board leads had been offered additional support in relation to this objective, however significant work was ongoing alongside local stakeholders and leads were keen to continue to progress locally.
Regional reports
Regional reports had been circulated previously and were noted.
4. Special Health Board updates
· NHS Health Scotland
Belinda and Natalie overviewed the previously circulated report from Health Scotland and outlined the professional and public aspects of the social marketing strategy. A professional pack, primarily aimed at GPs, health visitors and midwives was nearing completion and included: letter from Chief Nursing and Medical Officers; content of 1st professional contact; extract from NHSQIS antenatal pathway; screening programme timeline; and examples of good practice communication. The pack would be endorsed by both RCM and RCGP, and would be disseminated in early January. A public awareness campaign would follow late January/early February, around enhanced antenatal services and changes to the screening programme. Marketing would include strategies such as advert shelves in pharmacies and posters on buses and bus shelters. Draft posters for testing with women were circulated for information. To support the strategy at practice level, KCND Consultant Midwives, Morag and other key stakeholders were being offered media training.
Ann advised that relevant Ministers and SGHD colleagues had been briefed around this strategy and tabled thanks to colleagues from RCM and RCGP for their support with this important work.
Morag indicated that a briefing for RCGP Office may be beneficial and other group members felt this would be useful for all stakeholders. Natalie and Ann agreed to produce a Question and Answer type briefing and disseminate to the Group for use by any stakeholders involved in the programme. Action: NS/BM/AH
The group agreed to submit possible questions for Health Scotland to consider as soon as possible. Action: All
Monica commended the strategy and its links to early years and screening work. Gillian queried the position of NHS GG&C and Highland in relation to providing fetal anomaly scanning. Sheona advised that this was now in place across GG&C and Mags indicated that the National Services Division were responsible for working with NHS Boards around this.
- NHSQIS vulnerable families pathways
Mairead tabled a recent project newsletter (enclosed) and overviewed aims and objectives of this multiagency workstream. It aims to agree a national framework for co-ordinating and planning support for vulnerable pregnant women and children (0-3). It would consider a common assessment framework and practice model, which would require to be embedded in maternity services and highlighted that this would compliment KCND. There were three working groups considering pregnancy, early years, and common language. Output from them had contributed to drafting an outline framework, which would be the subject of a steering group workshop the following week. It was anticipated that draft output from the project would be available for consultation from March 2010.
5. Evaluation programme update
Helen and Purva presented results from the first round of NHS Board data collection, pre introduction of NHSQIS pathways for maternity care. Round table discussion ensued and Helen highlighted that this indicated a snapshot of one period in time. She indicated that while this information concentrated on outcomes for low risk women, in the next round it would be useful to consider outcomes for all women. This was supported by the Group.
Cynthia asked whether the presentation could be shared wider than the Group, however it was felt that results could be taken out of context without an accompanying presentation. Mags suggested that Helen and Purva present the results to the RCM Lead Midwives Scotland Group, SEND and NCT. Action: HC/PA
Gillian raised concern around NHS Board staffing projections for the coming years and, in particular, the ratio of registered to unregistered staff. This could have a negative impact on KCND implementation, for example where midwives were indicating it was preferable to practice continuous electronic fetal monitoring due to pressures around the ability to provide 1 to 1 care in established labour.
6. Feedback from stakeholders
Monica advised that NHS Education for Scotland were keen to continue the partnership working around leadership support commenced during KCND. A three year programme of events is in planning, commencing March 2010. This will offer all key midwifery stakeholders the opportunity to discuss future challenges in relation to, for example, maintaining KCND and taking forward the output from Midwifery 2020.
Helen advised that she would be developing a questionnaire around attitudes to the NHSQIS pathways and the group agreed to pilot these personally and feedback to Helen and Purva. Action: HC/PA/All
Morag advised that she would shortly be presenting to the East Faculty meeting of RCGP and would repeat this in the other faculties if beneficial.
7. AOCB
Ann tabled an individual communication which had been mailed to the Group and a number of other colleagues. It was agreed that it would be unhelpful to respond to this, as the issue was currently being dealt with by the relevant NHS Board.
8. Future meeting plans
It was agreed to have further meetings in June and December 2010, to monitor progress with remaining objectives and receive an update on the evaluation programme. Meeting for 2010 will be as follows:
June Date, time, venue
December Date time venue