Guisborough Maternity Unit

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• Guisborough Maternity Unit
• Redcar and Cleveland Borough Council
• Health Improvement Overview
• Scrutiny Select Committee
• 12 December 2002

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Scrutiny Panel 12th December 2002 John Foster
Chairman Bill Murray Chief Executive Fran
Toller Maternity Services Manager Dr Helen
Simpson Consultant Obstetrician Alison
Hughes Divisional Manager
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NORTH TEES
Whitby
Northallerton
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Strategic Planning

• Maternity Services
• To provide safe high quality services to the
  population of South Tees.
• The Service is to be delivered through a whole
  range of interrelated services, leading to births
  at three possible locations -
• Home deliveries
• The Guisborough Unit
• The James Cook University Hospital

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Numbers of deliveriesSouth Tees

• Home Deliveries 8
• Guisborough Unit 150
• James Cook 3400
• Note
• For the population of Redcar Cleveland
  there are approx 1300 births per year, of these
  60 are classed as low risk. Women are given the
  choice of delivering at home at Guisborough or at
  James Cook.
• Therefore out of approx 780 women who could
  choose to go to Guisborough only 150 gave birth
  there last year.
• As part of its strategy the Trust will continue
  to encourage more women to choose Guisborough
  when it reopens.

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Consultation Communications strategies

• The Trust will review all its policies and
  strategies for issues such as closures.
• Operational closures
• Temporary closures (Like Guisborough)
• Permanent closures
• The Aim will be to ensure that all parties
  who need to be informed and involved are, and
  that there is a clear understanding between them
  of how this is communicated to the wider
  population

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Responding to public concern

• The Trust has consistently stated that this is
  not a permanent closure.
• Its closure is temporary and on safety grounds
  only and we will reopen the unit as soon as we
  can.
• We will be happy to co-operate with the Council
  in any way possible, in order to communicate this
  message.

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Overview of Services - South Tees
Maternity Day Unit Antenatal clinics including
specialist areas Antenatal and postnatal
wards Central Delivery Suite Guisborough (11
Beds) Community - 6 teams Specialist Infant
nutrition team Specialist midwifery
practitioners Risk Management
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Process to date

• April 2001
• April 2001 to date
• 15th October 2002
• 23rd October
• 30th October
• 14th November
• 30th Oct - 4th November
• 4th November
• 15th November

• Problems identified
• Wide range of actions taken
• Situation deteriorated rapidly on
• Met with PCT CEO and Chair
• Met with GPs and presented issues
• Maternity Service Liaison Committee
• Patients contacted
• Press releases
• Closed Unit

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Strategy for Women and Childrens
Developing safe, robust and cost effective
health services for patients and their relatives
and carers HOWEVER GMU very much part of the
future as we see it today and always has been. We
as a Trust have never questioned its
future. Sustainability means we must increase the
deliveries there. Womens choice Staffing
11
Transportation

Emergency provision Access No complaints
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Patient care aftercare

• Philosophy of care
• low dependency
• high dependency
• critical care

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Midwifery training and professional development

• 18 month pre registration (4)
• 3 year direct entry (5-6)
• 6 month preceptorship (supernumerary)
• PREP requirements
• Mandatory training CTG/PPH/Shoulder
  dystocia/neonatal resuscitation/obstetric
  crisis/B/F
• Extended skills perineal suturing/epidurals/
  induction of labour/IV cannulation

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What have we done to reduce the impact?

• Developed the role of the Health Care Assistant
• Reviewed staff/patient ratios
• Staff worked extra
• Implemented minimum F grade
• Reduced management time
• Reduced non clinical posts
• Reviewed and redesigned key processes
• Dedicated theatre team

20 of our population 100 of our future
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What have we done to attract staff

• Training and development opportunities
• Funded training
• Developed appraisal
• All staff have Personal Development plans
• Supervision
• Preceptorship for newly qualified staff
• Full and detailed induction programmes
• Rotated staff
• Leadership development programmes