Following a visit by the Care Quality Commission (CQC) to review maternity services at Milton Keynes Hospital NHS Foundation Trust in September 2009, which found that significant progress has been made, a report outlining their findings is released today (19 January 2010). Since the review took place, additional improvements have been made to services.

Dr Sandro Lanzon-Miller, Medical Director at Milton Keynes Hospital, said: “We took action immediately following the visit made by the Healthcare Commission, the previous healthcare regulator, in 2008, and instigated a series of actions in response to their feedback. We are pleased that the CQC acknowledge the improvements that we have made in the provision of maternity services, which include implementing the systems required to consistently deliver safe, high quality care.”

“We put temporary measures in place to ensure that we always have enough midwives to deliver safe and effective care to local mothers while we work to recruit more permanent midwives and open more beds permanently. To increase staffing levels we are encouraging midwives to return to practice, recruiting more students and linking with other hospitals to share their staff. We are steadily appointing additional midwives to our team and our recruitment drive continues.”

“We are fully committed to consistently delivering the highest standard of care, and we are working hard to drive forward further improvements. The Trust continues to work with NHS Milton Keynes to implement plans to meet the needs of local women by increasing capacity in the hospital.”

“Strenuous efforts continue to be made by the Trust to recruit additional midwives. To ensure the delivery of high quality care we have increased staffing levels on wards with bank and agency midwives.”

To ensure that all mothers can receive one-to-one care in established labour the Trust has revised the maternity escalation policy, so that extra staff can be called in earlier when the maternity unit is very busy. An on-call system for lead midwives is now also in place, to ensure swift back up for midwives, when necessary.

The birth rate in Milton Keynes continues to increase and during 2008/09 the number of births rose by 3%, with a record number of 3,939 babies being delivered.

Milton Keynes Hospital is working in partnership with NHS Milton Keynes to agree capacity plans to keep pace with the projected increase in demand.

As part of the national Maternity Matters strategy, which states that mothers should have a choice of access to maternity care, type of post-natal care and place of birth, women are being reminded that they are able to choose from a variety of providers, including hospitals in neighbouring areas, for care and delivery.

During the follow up visit, the Care Quality Commission observed that staff morale within maternity services had improved.

Significant progress has been made against the recommendations made. Actions undertaken include:

A strong leadership team is well established, and is developing and motivating staff to deliver high quality maternity services. A Risk Midwife, Trust Risk Manager, Head of Midwifery and permanent Director of Nursing, are now in post, and a new management team was appointed in 2008. In addition, funding has been agreed to recruit a Consultant Midwife.

· A dedicated Obstetric Theatre is available 24 hours a day, 7 days per week.

· Protected learning time is in place for all doctors, midwives and maternity care assistants, so that they can undertake professional training.

· Maternity guidelines are reviewed regularly by multidisciplinary teams, which include consultants, registrars, midwives and maternity care assistants, to gain ownership of them.

· The amount of time that consultant Obstetricians spend on the Labour Ward has been increased, which has improved the support given to midwives and junior doctors.

· The processes and procedures for the reporting, investigation and auditing of incidents, including Serious Untoward Incidents (SUIs), have been fully revised. The new reporting system ensures that learning is cascaded to all staff and that the Trust’s Healthcare Governance Committee and the Board of Directors are provided with comprehensive and timely information about SUIs, and are assured that appropriate action is taken.

· The number of Supervisors of Midwives has increased, which has improved the professional support given to midwives, and has further enhanced team working.

Elizabeth Hunter, Head of Midwifery at Milton Keynes Hospital, added: “The delivery of safe, high quality care is our top priority and our aim is to deliver one-to-one care to all women in established labour as we continue our efforts to meet the required number of midwives for the increasing birth rate in the city. We are developing services and moving towards more flexible, midwife-led maternity services, based around the needs of women.”

The two recommendations that the Trust is still working to implement fully relate to midwife numbers and the need for more staff in order to increase capacity. At present, an additional 12 beds continue to be opened flexibly, as required, in order to meet peaks in demand.