Trust Board papers November 2012 - Barking Havering and ...

CQC Update Report
2012
improvements have been made
and are so far being sustained
MATERNITY 9. Further improve the
maternity triage process with
the introduction of regular
monitoring and learning to
ensure that services improve for
all mothers.
MATERNITY
10. Take appropriate action to
ensure that babies are not
transferred to the neonatal care
unit unnecessarily.
New pathway implemented with
monitoring in place; performance
reported weekly to NHS London;
triage working group in place.
Performance levels need to
improve.
Policy and guidelines in place but
being reviewed; Trust audit has
recently taken place. Performance
outputs not meeting required
levels.
New pathway implemented 30th July 2012. However still issues
with middle grade doctor cover, this will be resolved when KGH
closes. Performance continues to be monitored on a monthly
basis
OAU now has appointment system and achieves the standard.
See performance report above
Target moving towards women seen by a doctor within 30
minutes.
Work has been undertaken in HDU to minimalize hypothermic
babies, e.g. skin to skin, bear‐hugger equipment, thermometers
in each bay in HDU however there are some safeguard reports of
environmental issues (cold rooms / non‐functioning thermostats)
which are impacting the temperatures of babies on postnatal
wards. Discussions underway with estates department The latest
audit of all neonatal admissions was undertaken on the 8 th
September and revealed no admission due to environmental
conditions or hypothermic neonates.
Averil Archibald
Wendy
Matthews
MET
BUSINESS
AS USUAL
MET
BUSINESS
AS USUAL
MATERNITY 13. Continue with its
recruitment plans in maternity
services to ensure that it has
suitable numbers of qualified
staff across all service delivery
departments.
Recruitment is on target to deliver
a 1:29 ratio, with higher numbers
of substantive staff in post. CQC
inspections have identified some
concerns around midwifery care
assistant staffing levels. Trust has
faced challenges in recruitment
and retention, although these are
not particular to this Trust alone.
Midwife to birth ratio 1:29 achieve with bank usage, however 26
student midwives qualifying in September to November at which
time bank will only be used for maternity leave and sickness
HDU nurses available at all times in HDU. Midwives now
undergoing training for management of critical obstetrically ill
women
all vacant MCA posts recruited. Study days for MCA's
implemented as annual mandatory training. Competency training
being rolled out.
Proposed boundary changes will ensure that this ratio is
maintained, and there are clear plans for the recruitment of
midwives on an on going basis to ensure standards are
maintained.
Richard Howard
Dele
Olorunshola
MET
BUSINESS
AS USUAL
MATERNITY
Increase the level of training on
the interpretation of CTGs, so
that all staff have undertaken
All midwives were due to have
completed training by end of
March 2012, although the
JP comments ‐ M12.1 number of SIs coming through with CTG
interpretation issues still. Discussion re management framework
for response discussed with SOM and DOM with Risk Manager ‐
Jude Piper
MET
BUSINESS
AS USUAL
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