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"Consistently good healthcare which continually improves is our aim."

Scotland's Maternity Services Standard 1- Core Principles

Local Initiatives for Core Principles have been collected from the following local areas:

< Access Local Initiatives for Standards 2 - 5

NHS Argyll & Clyde

  1. The Scottish Ambulance Service has been, and continues to be, closely involved in the planning of procedures for the transfer of women during pregnancy, childbirth and with their newborn within Argyll & Clyde. Specific CMU practice guidelines which take account of the geography of the region had been agreed between the Scottish Ambulance Service and the former NHS Argyll & Clyde for safe transfers. Liaison with the National Neonatal Transport Service was also reported to be working well.

  2. A domestic abuse working group for Renfrewshire, Inverclyde and Lomond commissioned the voluntary organisation Scottish Women’s Aid in partnership with Renfrewshire Women’s Aid to deliver in-house training for domestic abuse trainers. This training equipped the participants with the skills and knowledge to deliver best practice domestic abuse training to healthcare professionals working in maternity services across Argyll & Clyde.

For more information contact:
C.A Harkins, Lead Midwife
Clyde Division, Maternity Unit, Royal Alexandra Hospital Paisley, PA2 9PN
Tel: 0141 314 6682 Email:cathy.harkins@rah.scot.nhs.uk

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NHS Borders

  1. NHS Borders has produced a parents’ support service information leaflet which details: the midwife’s name; health visitor’s name; GPs name; surgery address; telephone numbers and names of other midwives working in the team. The leaflet also contains information on the roles of the community midwife and health visitor during pregnancy and after discharge from hospital following the birth of the baby. There is a baby’s health checklist to help parents recognise symptoms if their baby is becoming unwell and details on how to contact the service should this situation arise. A list of helpline telephone numbers is also included for parents to obtain further information from a range of support organisations.

For more information contact:
Elaine Cockburn, Head of Midwifery Ann Forrest, Midwife
Tel: 01896 826733, Tel: 01896 826898,
Email:elaine.cockburn@borders.scot.nhs.uk or Email: ann.forrest@borders.scot.nhs.uk

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NHS Dumfries and Galloway

  1. A multidisciplinary perinatal review group has been developed within NHS Dumfries & Galloway to analyse all cases of intrauterine death, perinatal death or any other adverse perinatal outcome not resulting in infant death. The group is responsible for identifying areas of concern, and recommends and implements changes to practice and communicates findings to the family involved. The woman and her family including the GP and other staff members are invited to attend and participate in discussions concerning individual perinatal incident case review.

  2. As an effective means of improving inter-professional communication, NHS Dumfries & Galloway uses a co-ordinated system of colour-coded labels and matching alert record sheets to document a woman’s potential pregnancy anaesthetic risk factor/s and any possible neonatal complications. The obstetrician and/or midwife are responsible for implementing a notification of risk following a woman’s antenatal risk assessment using the appropriate coloured system. The system ensures that individual risks are highlighted at an early stage to all healthcare professionals so that appropriate care can be provided to the woman and/or her newborn baby.

For more information contact:
Joyce Linton, Senior Midwifery Manager
Cresswell Maternity Wing, Dumfries & Galloway Royal Infirmary
Tel: 013872 41238 x 3238, Email: joyce.linton@nhs.net

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NHS Fife

  1. At the time of the review process, NHS Fife was one of the few Boards in Scotland teaching newborn life support (NLS) courses. The course is directed by a consultant neonatologist and is scheduled 8–10 times per year. Several hundred attendees throughout NHSScotland have successfully completed the course. NHS Fife staff, including midwives and medical staff have trained as instructors for this course. In addition to this initiative, an arrangement has been agreed between NHS Fife and the University of Dundee School of Nursing and Midwifery to include the NLS course for all final year midwifery trainees.
  2. The Board has provided various domestic abuse training courses for staff including: an introduction to domestic abuse; awareness raising; responding to domestic abuse; impact of domestic abuse during pregnancy; children and young people affected by domestic abuse; domestic abuse in minority ethnic groups; and counselling skills. Courses have been organised in association with the Fife Domestic and Sexual Abuse Partnership.

  3. Women are offered the option to have continuity of midwifery care where possible throughout their pregnancy. The service will endeavour to provide the same midwife to care for a woman throughout her pregnancy and childbirth where shift patterns allow.

  4. The Child Bereavement Trust has awarded a midwife at Forth Park Hospital with a certificate for outstanding bereavement support for services provided to families who have experienced the loss of a child.

  5. Forth Park Hospital midwife-led unit was awarded a runner up position for better birth environment in 2005 by the National Childbirth Trust (NCT) for providing a birth environment that offers a range of facilities, privacy and control for women, increasing their opportunity for a positive birth experience.

For more information contact:
Catherine Cummings, Clinical Midwifery Nurse Manager
Forth Park Hospital, 30 Bennochy Road, Kirkcaldy, KY2 5RA
Tel: 01592 643355, Email:catherine.cummings@faht.scot.nhs.uk

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NHS Forth Valley

  1. Before developing a best practice recommendation on the management of perineal repairs, NHS Forth Valley undertook a training needs analysis of midwives’ skills in relation to this aspect of maternity care. The audit included: information on the labour experience of the individual midwife; their decision for suturing, including skills and technique used; circumstances/ reasons why an individual would not suture a perineal tear; and suggestions and ideas of what training/advice would be helpful to improve an individual’s competence and knowledge in this area.

For more information contact:
Gillian Morton, General Manager, Women and Children
Tel: 01324 624000 x 5004, Email:gillian.morton@fvah.scot.nhs.uk

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NHS Greater Glasgow

  1. On the Yorkhill intranet site, audit is positively promoted on a clinical effectiveness homepage. This page provides links to continuous audit projects, ideas for audit topics and guidelines on questionnaire design and audit software. An annual audit prize night follows poster and oral presentation sessions which are judged by a peer group. Prizes have been won in the past by staff from The QMH and a considerable number of audit projects have been undertaken on important aspects of maternity care.

  2. NHS Greater Glasgow supports three link midwives who have had specialised training in dealing with gender-based violence. There is one link midwife based in each maternity unit and as they do not have their own patient caseload they concentrate on working closely with midwives to provide a city-wide service offering information, support and guidance in detecting and responding to violence against women. They are developing links with women’s organisations and community supports to facilitate referral from midwives and are working towards improving the transfer of care between health services for women who are experiencing abuse. The link midwives are involved in updating the Board domestic abuse policy which will include a routine enquiry of all women at booking.

For more information on:
Alison Miller, Clinical Governance Co-ordinator
Tel:0141 201 0702, Email:Alison.miller@yorkhill.scot.nhs.uk

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NHS Highland

  1. NHS Highland has taken a strategic approach to sharing identified best practice and supporting local developments and is collaborating with Stirling University to organise a conference in recognition of nursing and midwifery achievements.

For more information contact:
Helen Bryers, Head of Midwifery/Area Consultant Midwife/LSAMO
NHS Highland, Assynt House, Beechwood Park, Inverness, IV2 3HG
Tel: 01463 704921, Fax: 01463 717666, Mobile: 07887 813736

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NHS Lanarkshire

  1. The Board has a mechanism in place to report back to staff regarding critical incidents. A newsletter is distributed to staff detailing the nature and outcome of the incidents. The review team considered this good practice as it allows all staff in the unit an opportunity to be informed of all reported incidents and it can also be used as a learning opportunity.

  2. NHS Lanarkshire is participating in a pilot multi-agency risk assessment committee (MARAC) study in conjunction with the Police service. At the time of the review visit, the Board was 6 months into the pilot programme and reported that one midwife in each community area takes responsibility for domestic abuse issues. These midwives are trained to identify risk and provide information on support services to women affected by these issues.

For more information contact:
Evelyn Forrest, Acting Service Manager
Women’s Services, Wishaw General Hospital
50 Netherton Street, Wishaw, ML2 0DP
Tel: 01698 366354(Switchboard 01698 361100), Email: evelyn.forrest@lanarkshire.scot.nhs.uk

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NHS Lothian

  1. The Board has an established day assessment unit which provides fetal and maternal monitoring of high risk pregnancies. Women are seen on an outpatient basis between 8am–4.30pm, Monday–Friday. The unit consists of two rooms each containing two beds with en-suite facilities. The unit operates an appointment system, however, emergency referrals will also be accommodated. The unit is staffed by midwives and clinical support workers who provide a service covering the antenatal high risk clinic and assist with the diagnostic screening service. A senior house officer is also allocated to the unit on a rotational basis. Main sources of referral to this unit can be direct from: the woman in terms of a self-referral; previous attendees for return visits; community midwives or GPs; antenatal clinic; ward areas; the maternity triage service; and other hospitals.

  2. The Board has a domestic abuse counsellor in post as part of a pilot process to provide support to women who wish to seek help with a domestic abuse situation. Women who require this service can contact the counsellor directly to self-refer or alternatively they can be referred by their GP or midwife. The counsellor also provides training for staff to support and advise midwives with the identification of domestic abuse issues.

  3. The Board has created a comprehensive, secure website (www.babylink.info/edinburgh) for parents whose babies are receiving care in the neonatal unit at the SCRH. The website has been designed to help parents gain a better understanding of the treatment their baby is receiving and become more involved in the management of their baby’s care. There are two main components to the website, the general information pages are accessible by anyone who wishes to view the site, and the second part of the site contains secure pages where parents receive a specific password to access information about how their baby is progressing. Parents are required to give their written permission for their babies details to be included on the website.

For more information contact:
Maria Wilson, Chief Midwife, NHS Lothian
Tel: 0131 242 2543, Email: maria.wilson@luht.scot.nhs.uk

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NHS Orkney

  1. NHS Orkney plans to develop additional policies for the management of those who experience domestic abuse. It is envisaged that these will include referral onto and police involvement and be extended to include supporting pregnancy in the under 16 year age group.

  2. NHS Orkney recognises and supports the need to ensure that where a woman wishes her partner/family members to be involved in her pregnancy and childbirth, good provisions are made within the maternity unit to provide overnight accommodation and meals for those supporting the woman during labour.

For more information contact:
Michelle Mackie, Team Lead, Maternity Services
Tel: 01856 888002, Email:michelle.mackie@orkneyhb.scot.nhs.uk

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NHS Shetland

  1. Previously, only women who delivered their babies in the maternity unit at Gilbert Bain Hospital would have an opportunity to complete ‘talk back forms’. Women who delivered at Aberdeen Maternity Hospital could only feedback by means of informal discussions with their community midwife once back in Shetland. However, practice regarding ‘talk back forms’ has changed and these are now completed at discharge by community midwives to allow all women, wherever they deliver, to comment on the care they received. Completing the forms at a later stage also allows women more time to consider the care they received.

For more information contact:
Teresa Chivers, Senior Clinical Midwife
Tel: 01595 743012

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NHS Tayside

  1. Partners are actively encouraged and supported to be involved in pregnancy and childbirth with extensive use across NHS Tayside of written material created in partnership with fathers and the UK’s National Information Centre on Fatherhood charity ‘Fathers Direct’. The information focuses on helping expectant fathers to support their pregnant partners and supports new fathers in the transition to parenthood. The leaflets developed provide useful information on a variety of pregnancy-related issues such as: understanding labour pains and how a partner can be of support; guidance on paternity leave; and breastfeeding issues etc.

  2. In Angus, a website (www.birthinangus.org.uk) has been designed and developed by staff and service users to provide direct access to information and links to other related national supporting organisations. The website contains practical information for women planning a birth in Angus who are in a low risk category. Local information includes: steps to make a straightforward birth easy; who’s who in Angus; testimonials from women who have delivered in Angus; Get involved, which outlines how members of the public can have input into improving local service provision; Contact a midwife, which includes maps of local areas.

For more information contact:
Kay Forsyth, Acting Head of Midwifery
Antenatal Clinic, Level 7
Ninewells Hospital, Dundee DD1 9SY
Tel: 01382 632107, Email: kay.forsyth@nhs.net

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NHS Western Isles

  1. The Board undertook a patient satisfaction survey between May 2004 and May 2005. The survey highlighted a high level of satisfaction with the service and reflected similar results from a survey undertaken the previous year.

For more information contact:
Catherine MacDonald, Senior Midwife
Western Isles Hospital
MacAulay Road, Stornoway
Isle of Lewis, HS1 2AF
Tel: 01851 404704

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