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NHS Update – Maternity Services

NHS North East Essex - Clinical Commissioning Group - Advice on antibiotics crisisExternal Review of Maternity Services provided by Colchester Hospital University NHS Foundation Trust

An external review of maternity services across North East Essex has been published by North East Essex Clinical Commissioning Group (CCG) and Colchester Hospital University NHS Foundation Trust (the Trust).  The review by the NHS England Strategic Clinical Network, which was jointly commissioned by the Trust and the CCG, noted much good practice and commended the enthusiasm and commitment to women and their families. Out of a total of 19 recommendations in the report, there was just one major concern requiring immediate action.

The report recommended that the Trust should ensure the delivery suite at Colchester General Hospital should have an extra (supernumerary) senior midwife on duty in line with a previous recommendation by the Royal College of Obstetricians and Gynaecologists (RCOG). Work is already underway to ensure the Trust meets this recommendation.  The report also comments on the small number of women giving birth at the midwife-led units at the community hospitals in Clacton and Harwich, stating there are insufficient births to warrant a 24 hours a day 7 days a week service. It adds that the need to cover three sites is part of the difficulty in meeting the midwife to birth ratio recommendation from the RCOG.

Lisa Llewelyn, Director of Nursing and Clinical Quality at the CCG, said:

The report gives the CCG external assurance about the service and supports us in preparing for consultation with the public on a sustainable and safe service. We note the comments around the number of births at the midwife-led units at Clacton and Harwich but are also conscious of the need to provide choice of birth location as recently proposed in draft guidelines by the National Institute for Health and Care Excellence.

Amanda Hallums, Divisional Director of Women’s and Children’s Services at the Trust, said:

We are grateful to the Peer Review Team for carrying out a very thorough review. We welcome the findings of the report as it identifies many strengths and areas of good practice. We will be working jointly with the maternity multidisciplinary team and CCG colleagues to address the recommendations.”

Commissioned to assess opportunities for improvement in and to assess the viability of births from three sites across North East Essex (Colchester, Clacton and Harwich), the report’s 19 recommendations were grouped under the following headings:

  • Clinical governance
  • Operational efficacy
  • Clinical  leadership

Included in the recommendations were:

  • An urgent review of midwifery staffing together with clinical pathways, patient information, communication, quality and governance
  • Annual review of staffing to ensure resources match demand
  • A wider Essex review of maternity services
  • Build on good practice to ensure continuous improvement including reviewing risk management structures and clinical governance
  • Boards of both organisations need to ensure they have sight of outcomes as well as performance
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Personal Health Budgets

NE Essex CCG issue news of personal health budgetsNHS North East EssexCCG introduces personal health budgets for local people

People in Colchester and Tendring who get funding from the NHS for their continuing healthcare will now have a greater say in how that money is spent.

From 1 April 2014 everyone eligible for on-going treatment and support for a complex medical condition has the right to ask for a personal health budget. That includes the option of asking for direct payments to be made to them, or to someone who looks after them.  Then, with the help of local NHS professionals in putting together an individual care plan, each person can choose how to use their allocated budget for a tailored package of health services.

Each patient will be able to get a range of help that is appropriate to them and their condition – such as clinical treatments, therapies, personal care and equipment – from NHS, private and voluntary sector providers.  Or the personal healthcare budget can carry on funding the healthcare and support that is already working well for them, if they don’t want to make changes.

Personal budgets are not entirely new. Some people already have the benefit of direct payments for social care, and continuing healthcare is the right place to start with personal health budgets. It is one of the few areas where the NHS commissions healthcare person-by-person,” said Lisa Llewellyn, Director of Nursing and Clinical Quality at NE Essex CCG. “We have learned from pilots across theUK that personal health budgets give patients greater involvement in planning their care, and greater choice, flexibility and control. So they can then buy services they know will best improve their health and wellbeing, and that are right for them and their families.

NHS organisations in Essex are working in partnership with ecdp, an organisation run by and for disabled people, to help introduce the new approach. edcp has a pioneering track record in supporting disabled people at local, regional and national levels and has worked with a number of local authorities to help people to manage direct payments.

Mike Adams, chief executive of ecdp, said:

Along with the NHS, we recognise that the individual is the expert in how a health condition affects his or her life. Personal health budgets offer the opportunity for people to work in partnership with the NHS on how their health needs can best be met. Many people have said that being fully involved in discussions and decisions with their healthcare professionals is the right thing and will make them more positive about the care and support they receive, and better in control of their quality of life. The benefits seemed to be felt more strongly by people with the highest health needs.

Mike added:

You can manage the care and support you choose in different ways, ranging from doing this yourself through to getting help from another person, or from an organisation like ecdp to implement what’s in your care plan on your behalf.  You can review and update your choices with your local NHS team when you need to, for example if your health changes or something in your plan isn’t working for you. You can also continue to receive the support in the same way as now if that is your preference.

People who want to consider whether a personal health budget might be right for them should speak to their healthcare professionals – GP or practice nurse, district nurse or a member of their Continuing Care Team. There is also more information about personal health budgets on the NHS Choices website at www.nhs.uk/personalhealthbudgets.

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