Better Births Lincolnshire Annual Report 2019/20
Contents Page No.
Executive Summary………………………………………………..…….1
Background…………………………………………………………..………2-3
Overview of Performance………………………………………..…..4
Local Maternity and Neonatal System Achievements
Choice and Personalisation…………………………………………….5-7 Post-Natal Care………………………………………………………………7-8 Continuity of Carer…………………………………………………………9-10 Digital…………………………………………………………………………….11 Safety…………………………………………………………………………….12-13 Perinatal and Post-Natal Mental Health………………………….14-15 Neonatal Care……………………………………………….……………….16-19 Co-production Maternity Voices Partnership…………….……20-23 Governance………………………………………………………………..…23
Better Births Team………………………………………………………..24
Appendix Links ……………………………………………………………..25
Contact Details………………………………………………………………26
Complied by Sue Jarvis Maternity Transformation Manager Approval at LMNS on 15th July 2020
Executive Summary
In 2017, we launched our Lincolnshire Better Births Strategy in which we outlined our strong vision and ambition to ensure that maternity services across the county are safe, personalised, kind, professional and family friendly. So, we are delighted to present our second Annual Better Births Report.
Better Births Lincolnshire has continued to support transformation of Maternity and Neonatal services which will mean improved outcomes for Mothers and families across the county.
This year we have continued to engage with families through listening clinics, social media and working with the Maternity Voice Partnership (MVP). In September 2019, we welcomed the new chair to post Amanda Pike; she has already increased awareness of the benefits of the MVP and been a clear voice for the families in Lincolnshire when attending the Local Maternity and Neonatal System (LMNS) meetings.
We have continued to focus on personalised care developing the ‘Choice Leaflet’ and Post- Natal pathways as well as continuity of carer and care closer to home as we expand the Community Hub offer.
We are proud of the achievements made so far by the Lincolnshire Better Births team and partners and have again this year shared our work at Regional and National Conferences. We were delighted to be shortlisted for the “Clinical Team of the Year” at the Lincolnshire Health Awards 2019. We are also very proud to be the first area with a parent voice for Neonatal Care; two of these parents are now working with the Regional and National programme, ensuring the Lincolnshire voice is heard.
We continue to strengthen the links between the Better Births programme and partners across Lincolnshire, with clear governance and reporting structures now embedded into the programme. This collaboration will support our ambition for better outcomes for women and their families.
We have not yet finished; and our plans for the next year are outlined in the report, which are equally as ambitious to ensure women and their families have a positive birth experience.
Tracy Pilcher John Turner
Director of Nursing, AHP’s and Operations / Chief Executive Lincolnshire Clinical Commissioning Deputy Chief Executive, LCHS Group SRO Local Maternity and Neonatal System (LMNS) Lincolnshire 1
Background
The vision for maternity services across England is for them to become safer, more personalised, kinder, professional and more family friendly; where every woman has access to information to enable her to make decisions about her care; and where she and her baby can access support that is centred on their individual needs and circumstances. And for all staff to be supported to deliver care which is women centred, working in high performing teams, in organisations which are well led and in cultures which promote innovation, continuous learning, and break down organisational and professional boundaries.
NHSE/I Better Births report Four Years On March 2020 takes a stock take of progress reflects on success and discusses remaining challenges.
There has been a 21% fall in the stillbirth rate during 2010-2018, meaning the NHS in England has met the 2020 20% reduction ambition two years ahead of schedule.
There has been a reduction in the combined perinatal mortality rate of 15.1% reduction over the same period, also in line with the 2020 ambition. Maternal Deaths, which are a very rare occurrence, are also falling. There has been a 14% reduction in the triennial maternal mortality rate up to 2015- 17, which is in line with the trajectory required to meet the 2020 ambition.
The latest women’s experience survey shows a steady improvement nationally in what women say about their care.
These improvements are being driven by the 44 Local Maternity Systems across the country, through which commissioners, providers, clinical teams and service users are redesigning services and delivering them to meet the needs of their communities.
In 2019, Better Births Lincolnshire developed the Long Term Plan for Maternity services across Lincolnshire, it has been developed to demonstrate the framework for safe and improved local maternity and neonatal services that recognises and reflects the individual personal needs and choices of women and families in Lincolnshire. This strategy continues to be built on the extensive engagement with women and their families, staff and others involved in the commissioning, provision and support of local maternity and neonatal services to ensure an honest and accurate assessment of current services and co-produce the vision for what best practice should look like for women and their families in Lincolnshire. We have created an approach to communication and engagement which has been inclusive and involves our diverse communities across Lincolnshire. Given the rurality of our county, we have fully utilised the potential of social media, listening events, survey’s to gather feedback and experiences and co-production with Lincolnshire Maternity Voices. Our focus is on ensuring that every woman has a personalised maternity care and that it is delivered
2 as close to home as possible through local community midwifery teams and expansion of the Community Hubs. We have established a Local Maternity Neonatal System (LMNS) with the leadership, governance and the clinical commitment required to secure the delivery of safe and improved maternity care in Lincolnshire. We continue to participate in and make use of nationally developed data collection tools, Clinical Networks and the Maternity and Neonatal Safety Collaborative, using this intelligence to improve services, including learning from incidences of harm. We are currently working within environments where we need to use our resources intelligently to achieve the best outcomes for our women and their families. The LMNS has been aligned to the Lincolnshire Long Term Plan to ensure that there is a consistent strategic vision for maternity and neonatal care in Lincolnshire.
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Overview of Performance
Lincolnshire Ambitions for 2019/2020 Work stream/ We said We did Enabler Choice and All women to have personalised Care plans Personalisation Post-Natal Care Post-Natal Improvement plan Continuity of Care 35% women to receive Continuity of Carer by March 2020 Digital Digital Care Record Safety National ambition to halve the rates of stillbirths, neonatal deaths, maternal deaths and brain injuries during birth Perinatal Mental Expansion of service Health Services Neonatal Care Engage with Neonatal Operational Delivery Network to deliver safe and sustainable services Co-production Continuous listening and feedback
A detailed performance by each work stream is provided below which evidences the overall rating awarded in the table above (Those work streams with amber ratings have been affected by the recent pandemic where work had to be suspended)
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Local Maternity and Neonatal System Achievements
This section identifies progress to date in relation to the maternity transformation programme deliverables, including safer maternity care, choice and personalisation; Choice and Personalisation
Women’s maternity care should be personalised to their needs and those of her baby and family. Every woman should therefore have access to information to make informed decisions and access support centred on their individual needs and circumstances. Choice & Personalisation are high on the agenda for the transformation team, and remain one of the deliverables for 20/21. As such there has been much work dedicated to the roll out of this improvement for maternity services. The Personalised Care and Support Plans are an information tool which will be utilised by women and their families to educate, highlight and signpost them to the information they both need and deserve when beginning on their pregnancy journey. To begin this process we scoped and researched the subject and sought opinion and leadership from service users as to what our local communities actually wanted from this concept, we also reviewed what had been achieved from the Early Adopter Teams. A Survey Monkey and poll gave us more clarity around the information women desired, this showed that women fundamentally want, choice, compassion, effective communication, understanding and honesty from professionals. Women want to be more involved in their care and to be heard when they have concerns over their own health or that of their baby. Professionals also want information that’s shared to be consistent and from the same place. As a result of this gathering of information two pieces of work have been completed; the “Choice” leaflet and the “Birth Document”. The ‘Choice’ leaflet which will inform women where they can have their baby, whether at home or in hospital also outlines the Continuity of Carer model and highlights what is available to them in their area. It will ensure that those first steps into pregnancy and beyond are clear and that by the time they meet with their Midwife for their booking appointment certain decisions have already been thought about and/or concluded. ‘My Vision, My Choice, My Pregnancy’
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The ‘Choice’ Leaflet Appendix 2 was launched in October 2019 and is accessed and signposted from very early pregnancy.
Choice Leaflet Activity
200 150
100 Link Clicks 50 Likes 0 Shares Total Views
Promotion dates on social media platforms
The second document, the Birth Document, has been completed and is awaiting a digital platform in order to allow women to access it. The function of the ‘Birth Document’ is again an information tool. This will encompass far more detail for pregnancy and is vast in its content. The document is broken down into chapters which will make it easier for women and families to access. It will ensure that women can individualise their care as they can access topics relevant to their needs.
‘My Birth, My Journey, My Choice’
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From August 2020, we will be working on Lincolnshire ‘Mum & Baby App’. This is a major success for our Digital projections, and once created and in use, will be hugely beneficial to all our women and families in the area. From the start of pregnancy to early parenthood, this app will support women and their families. The app aims to improve women’s experiences of maternity care and ensures that the information they receive is consistent no matter where they choose to give birth in the local area.
Post-Natal Care
As part of the Deliverables for 2019/20, it was agreed that all providers and commissioners would work towards a Post-Natal Improvement Plan for women and their families. Subsequently, NHS England/Improvement deferred the improvements until March 2021. The Post-Natal Pathway model of care emphasises the importance of a system approach to working, ensuring that women and their families can access all the support and advice they may require in order to ensure that their parent journey is a positive and fulfilling time. The new process will signpost, advise, support and encourage women and their families to embrace their new role as parents, whilst also ensuring that they feel able and confident to access all the varying aspects of care they may need. Some families already have additional support in place, and it is hoped that by creating a more system wide approach to post-natal care that the follow up of care will be more seamless and ensure that gaps are not created or indeed exist that allow people to feel alone and lost. The NHS Long Term Plan (LTP) was published in January 2019, setting out key ambitions for the health service over the next 10 years. A number of maternity commitments relate to post-natal care. These are:- • To be provided with personalised, kind care in the post-natal period. • Receive effective transfer of care and quality information when returning home. • Be supported in their return to physical health, including follow-up of complications in pregnancy and clear pathways for referral when issues are identified.
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• Be supported to successfully feed their babies, including a tailored breast feeding strategy across the LMNS.
• Receive improved mental health assessment, identification, and access to emotional and mental health support, including for bereavement and when babies need neonatal care.
• Receive seamless care between midwifery, health visiting and general practice.
• Increasing access to specialist perinatal mental health services.
• Improvements to Neonatal Critical Care.
• Improving access to post-natal physiotherapy.
• All maternity providers working towards breast feeding accreditation.
During 2019/20, an Improvement Plan was created ensuring all the above were taken into consideration and an Action Plan developed which outlines how, when and who will implement the various elements of the improvements. The draft pathway is now complete, and a work stream meeting is pending to begin mapping out how and who will take the actions agreed forward. (This work was suspended in March 2020 due to the COVID-19 pandemic, hoping to recommence August 2020).
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Continuity of Carer
At the heart of the Better Births vision is the idea that women should have continuity of the person looking after them during their maternity journey, before, during and after the birth. This is based on a plethora of published evidence that continuity of care and relationships between care giver and receiver, has been proven to lead to better outcomes and safety for the woman and baby; as well as offering a more positive and personal experience. The National trajectory has been set for each LMNS to achieve 35% by March 2020 and 51% by March 2021. The Lincolnshire focus has been very much on building sustainable models that truly transform the models of care offered to women to achieve the Better Births outcomes of improved safety and sustainability. The models that have been implemented and planned for implementation are designed with fidelity to the evidence base. Whilst the progress has been slower than the national target, the aim is to maintain safety whilst also transforming the models of care.
The plan for 2020-21 Current Teams 2019 2020
Gainsborough team Operational
Sleaford team Operational
Suspended March 2020, Homebirths Operational reinstated May 2020 due to pandemic In Development
Skegness team N/A
High-risk team N/A
Grantham team N/A
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The Gainsborough COCO’s (Continuity of Carer Offers Outstanding Support) team have been providing continuity of carer for the women and families in Gainsborough since February 2019 and attending births since September 2019 with 90% of women receiving their labour care from a COCO’s midwife. Positive feedback has been received from women:
“They are an incredibly caring group of midwives, who go above and beyond what is expected of them.”
“The care given was 100% from start to end we are blessed to have these ladies looking after us all in the Gainsborough area.”
“The care from the Coco’s team was absolutely wonderful. As first time parents we felt completely reassured at every step. It was like having a group of aunties looking out for us!”
A number of midwives from the team were nominated for awards for the excellent care they have provided to the women of Gainsborough.
Due to the staffing challenges of the COVID-19 pandemic providing intrapartum care has not always been possible since March 2020.
The Sleaford COCO’s team has been booking women onto the pathway since October 2019 but due to COVID-19 have been unable to commence intrapartum care.
All plans for future teams were suspended due to the COVID-19 Pandemic; the focus of the community service was to maintain core services, ways of working altered and where possible face to face contact was replaced by video consultations. The homebirth service was temporarily suspended but was re-instated on the 18th May 2020 utilising support from the continuity of carer teams.
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Digital
The Digital arm of the maternity transformation project has been to harness digital technology, to help NHS England/Improvement meet its objective of improving outcomes in maternity services in England and supporting the Long Term plan.
Four main projects have been set out:
Interoperable maternity records. Women’s digital care records. Digital maturity. Digital toolset to help offer trusted and reliable sources of maternity information for women.
In Lincolnshire, we have been working with the system planning for interoperability, developed a self-referral scheme on the Lincolnshire Care Portal and working to develop the digital care record. https://www.patientportal.lincolnshire.nhs.uk/public/index.html#/home
In conjunction with the Maternity Voice Partnership, social media and films have been used to offer information to families. Families are able to access Lincolnshire information via Better Births Lincolnshire, website, Facebook, Twitter, Instagram and You-Tube. They also have access to MVP Facebook and a dedicated Facebook page for MVP members.
During the time of the pandemic digital technology has supported the teams to deliver video consultations, as well as online support for breast feeding.
The genie has now escaped from the bottle and access to health care has now moved into another era, future plans to enhance the technology will be looking at home monitoring of blood pressures and blood sugars. The Children Centres have been offering family sessions via zoom and the MVP plan to use video technology to engage more families across Lincolnshire.
We will be engaging with our families and collating ongoing feedback on what works well and not so well and evaluate this feedback in order to make improvements going forward.
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Safety
Improving safety and quality of maternity services is the central driver underpinning the Maternity Transformation Programme. By optimising the care and outcomes for women and babies we can influence the life course trajectory for families. Lincolnshire Local Maternity and Neonatal System laid out a clear vision for improvement in the Better Births Strategy and Implementation Plan (2017) and much has been achieved through engagement with the various national quality improvement programmes. Smoking, obesity and diabetes remain our most significant risk factors for poor outcomes both during the perinatal period and beyond.
Smoking CCG % % Region/National Maternities Smokers Smokers Unknown Comparisons
Lincolnshire 2036 405 20 1 East CCG
Lincolnshire 2194 334 15 1 West CCG
Lincolnshire 1319 175 14 5 South CCG
Lincolnshire South West 1007 142 14 2 CCG
NHS Midlands 48,582 4941 10 2 and East
England 591,701 61339 11 20
NHS Digital 2018/19
During 2019, Smoking in Pregnancy Group was established and all stakeholders across Lincolnshire have representation.
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Achievements ULHT has been a smoke free hospital. Smoking cessation films developed and distributed. CO testing offered to all women at booking, 28 weeks and 36 weeks and result recorded on Medway. Smoking Cessation part of Mandatory Midwifery training. Working in Partnership with Lincolnshire County Council, One You for smoking cessation support.
Obesity The national increase in obesity is reflected in increasing numbers of women with raised BMI becoming pregnant. Maternal obesity is recognised as an important risk factor for adverse outcomes in maternity care including still birth. During 2019 the programme worked with partners to support families to manage diet and exercise. The team have been part of the Lincolnshire County Council Whole Systems Healthy Management workshops, Lincolnshire Physical Activity Taskforce and working with colleagues to have physical exercise as part of an offer across Lincolnshire for pregnant women.
Diabetes It is estimated that Nationally between 2% and 3% percent of pregnant women are affected by gestational diabetes during pregnancy. In Lincolnshire that figures increases to 10%. Working with the Diabetic Transformation team, a focus has been on implementing effective preconception care for those most at risk, whilst this remains a challenge, there has been work in partnership with colleagues, which has highlighted the importance of the specialist needs of women of childbearing age with diabetes in order to optimise their outcomes should they become pregnant when they access primary care services. Further work is planned in Primary Care looking at women in the post-natal period who have experienced gestational diabetes; a pilot is planned for later in 2020. The importance of training and development to enable safer care is a strong theme throughout our programme this year, we have seen training delivered to staff across the system in a variety of areas. Motivational interviewing Obstetric emergency in the community training Enhanced and redeveloped mandatory training Increased Fetal Monitoring training During 2020 plans have been formulated to appoint a Safety Lead Midwife to support safety and quality improvement.
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Perinatal and Post-Natal Mental Health
The Perinatal Mental Health Team in Lincolnshire has celebrated a number of successes during the year. After much planning and recruitment the team became fully staffed, enabling them to offer a complete service, they now have a psychologist as part of their offer after many years of working towards this goal. The team successfully piloted joint clinics with the Midwifery service starting in Lincoln County Hospital in January 2019, followed by Pilgrim Hospital in August 2019. The next steps will be to provide community outreach clinics based in the Hubs across the county and a pilot site will be chosen by the end of 2020. Team group meetings have been piloted in Lincoln and Spalding due to service user need, these have been very successful and plans are now in place for another group in the Mablethorpe area. During 2019, the Perinatal Mental Health team were relocated to new accommodation. This has not only been of benefit to the team but to the families as well as the environment is more conducive to their needs. A professional email address has been established for medication advice. This offers GPs the opportunity to ask for advice and answer queries in a timelier manner, ensuring women receive consistent and evidence based care. The team were delighted to receive a successful CCQI (College Centre for Quality Improvement) visit and met their NHSE/I target for women accessing their service.
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Future plans The team are looking to develop a new system wide pathway with an ambition for this to be completed by July 2020 (this may be delayed due to the pandemic).
Pilot sites for Community Outreach Clinics are planned for the coming year supporting women closer to home, awaiting further information from NHSE/I.
DadPad project. DadPad is a practical guide, designed to enable new dads and partners to gain the confidence and skills necessary to being a new parent – and to help them learn how they can take care of their own mental health and emotional wellbeing while raising a child.
Perinatal Referrals 2018 & 2019
80 71 67 70 59 61 57 55 60 51 52 53 47 49 48 47 50 42 42 40 31 30 18 20 8 10 10 5 6 3 5 4
0
Jul Jul
Jan Jan
Jun Jun
Oct Oct
Apr Apr
Feb Feb
Sep Sep
Dec Dec
Aug Aug
Nov Nov
Mar Mar
May May 2018 2019
Rolling Access Figures % of patients seen in last 12 months 5.00% 4.50% 4.00% 3.50% 3.00% 2.50% Trust 2.00% 1.50% Target 1.00% 0.50% 0.00%
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Neonatal Care
There is overwhelming evidence that separation of mother and baby so soon after birth interrupts the normal bonding process, which can have a profound and lasting effect on maternal mental health, breast feeding, long-term morbidity for mother and child. This makes preventing separation, except for compelling medical reason, an essential practice in maternity services and an ethical responsibility for healthcare professionals.
Better Births Lincolnshire’s vision for neonatal care across the system is to provide a quality seamless service, for families whose baby is born prematurely or sick. Family Integrated Care is at the forefront of the Better Births neonatal pathway and the “Neonatal Parent Voice” central to the transformation programme. Neonatal care is inextricably linked to maternity and Obstetric services, community services and the children and young people’s pathway. The importance of collaboration throughout this pathway ensures a fully integrated neonatal service across the system.
Nationally approximately 10% of all births received some type of neonatal care (i.e. Special Care, High Dependency Care and Intensive Care Services). Lincolnshire’s Neonatal Service is a low throughput service in which clinical expertise is a key determinant of the quality of the outcomes for the baby.
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Transfers from the region There is a growing body of evidence both nationally and internationally that suggests that caring for babies born before 27 weeks and those in other higher risk category groups (e.g. sick, more mature babies requiring prolonged intensive care) should be concentrated in relatively few centres. Neonatal Operational Delivery Networks have strict pathways in place to ensure that babies are born in the right place to improve babies’ chances of survival and minimise the morbidity associated with being born either premature or term and sick. Therefore mothers in Lincolnshire threatening to deliver a high risk baby will need to be transferred out of the county, before birth, for specialist neonatal care that is not provided in their local unit. Prevention of preterm birth is now a national priority and local neonatal safety plans are in place to improve early recognition and management of the deteriorating mother and baby in labour including; greater use of electronic MEWS (Modified Early Warning Signs) on labour ward and a prompt transfer of those high risk mothers before they deliver. The development of an East Midlands Multi-Professional working group, including transport service and East Midlands Ambulance service (EMAS), evolved in 2020 to address Element 5 of “Saving Babies Lives”.
Each Network should have the capacity to provide all neonatal care for at least 95% of babies born to women booked for delivery in the network (i.e. no more than 5% of babies born to booked women should be transferred out of network for inappropriate reasons). Lincolnshire’s neonatal units have met this target however, some mothers and babies in Lincolnshire may need to be transferred out of the network to receive the care they require and some mothers may be transferred to 2-3 different hospitals.
Neonatal Critical Care Review 2020 has seen the start of the implementation of the recommendations and deadlines from the Neonatal Critical Care Review (NCCR). The review highlights and details three main commitments:-
1. Developing neonatal capacity.
2. Developing the expert neonatal workforce.
3. Enhancing the experience of families.
Better Births Maternity Transformation Neonatal work stream Leads are working in partnership with ULHT and East Midlands Neonatal Operational Delivery Network (EMNODN) to ensure recommendations are addressed in Lincolnshire. This included attendance at the neonatal oversight meetings, with specialist commissioners, EMNODN and Neonatal Leads at ULHT and the planned GIRFT meetings (Get it Right First Time).
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Achievements Neonatal Voice The Neonatal Parent Voice has raised the profile of neonatal care in Lincolnshire and representatives have presented at national conferences. To date six mothers have agreed to be a Neonatal Voice across Lincolnshire, and one mother to be a voice for those babies requiring special consideration/care.
The Neonatal Voice:
Acts as a voice for Lincolnshire and resource for parents who have a premature baby, sick baby, or baby with special considerations.
Collaborates with users, stakeholders and providers across the system and attends the Neonatal Operational Delivery Network Parent Advisory group.
Has set up support sessions in the community for those parents discharged home.
Provides links with parents through the social media and on line support groups.
Has helped develop and support “Better Births” Neonatal on line presence.
Is a resource and opinion for parent information and new developments in neonatal care.
Advocate for parents and parent stories.
We heard and acted on feedback.
Continuity of Support from hospital to home
You said: We did:
“Coffee mornings for parents/carers “After being in a neonatal unit for so long and living in a bubble with all within the neonatal units are now in the support around us we felt progress. completely on our own once home”. Coffee mornings will help provide a seamless transition for home and are used for support, information giving and signposting support and services. Community hubs, Fab worker, perinatal mental health team, health visitors and mental health team are involved in a rolling programme. Once home a health visitor plan and specific neonatal support groups within the community are now in place.
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Co-production with maternity service post-natal
Midwives are now visiting neonatal mothers for 28 days as they will now be classed as vulnerable women.
“Birth afterthoughts” available for neonatal mothers and can be accessed much later after birth.
Post-natal pathway for neonates to be strengthened, especially for those mothers transferred out of the region.
Stork Project
You said: We did:
“Engaging the public to knit Storks “Too much information, don’t know where these hold cards containing specific to look. When baby was born and poorly valuable links to resources to start did not read information booklets given “ families on their journey. The storks are given as a keepsake on admission to a neonatal unit.”
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Co- production
‘I’m Amanda and I came into the post of MVP chair for Lincolnshire in September 2019. I quickly got to work on growing our little team of volunteers, to, as it stands today some 50 members. We have a wonderful mix of MVP voices from diverse, varied and interesting backgrounds, being service users, service users’ representatives and professionals, which will help focus and aid us in giving a voice to so many in Lincolnshire.
We held a meet and greet in the centre of the county, which was really well attended, where in co- production with the Better Births Lincolnshire team we gave a full and thorough overview of what an MVP is and how we tie into Maternity services.
We are growing our social media platforms and, with the help of one of our members who is a Social Media Manager, are going great guns, during the pandemic phase alone (which as of today still isn't over) our page followers have gone from 200 to over 600 followers, with some posts reaching over 10,000 plus people.
We now have a dedicated MVP page within the Better Births website with a direct feedback form, as does our Neonatal voice arm of our MVP, of which we have had reports that another MVP group have subsequently shared with their LMNS as they were so impressed. We have visited mothers at home to gain feedback and listened to their stories, enabling us to pick up trends and that we plan to work more in specific areas on.
We have travelled the length and breadth of the county to meet with professionals and to co-produce/update across borders and within Lincolnshire itself.
We have attended conferences, meetings and met with staff in North Lincolnshire and Goole Hospital NHS Trust (NLaG) and at children's centres. Held some Lincolnshire MVP meetings and had interesting discussions with service users and professionals alike.
I represent families at Trust meetings, LMNS and LCC to update and gain information.
Our first topic to tackle is infant feeding, and so have created a campaign "Latch On Lincolnshire." in co- production with Better Births Lincolnshire.
We have involved shops and businesses to display a poster to demonstrate that they are breast feeding friendly spaces, displaying a list of those involved on the Better Births website with an interactive map for breast feeding people to reference and find somewhere welcoming if they are perhaps nervous as one for instance.
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As part of this campaign, we want to learn more about why people feed their children the way they do; so undertook a survey which had been completed over a phenomenal 500 times and has given us a wealth of truly valuable information we shall be looking into and work on in greater detail. Sue Jarvis and I attended BBC Radio Lincolnshire to promote this campaign, and broadcast countywide.
We look forward to picking up where we left with "Latch On Lincolnshire", to continue the drive; we had a whole day dedicated to all things Breast Feeding, scheduled for July where we planned to have speakers, stalls, families and professionals interacting together. It promises to be a fun and interesting day, which will be re scheduled.
We also had a meeting scheduled with counsellors in Mablethorpe to speak to them regarding how to help families utilise all the services offered at the children's centre there.
A '15 steps' visit was also scheduled at Lincoln and Pilgrim hospitals, but sadly due to COVID- 19 we had to postpone, but will re-arrange as soon as possible.
During the Corona virus pandemic we have tried to best support various health care branches, midwifery, health services etc. and we are currently in the process of co- producing another survey to gain feedback from families during this period so we can adapt in the future wherever possible and necessary.
We also helped Maternity services with the idea to create some breast feeding tips videos answering the public's questions which we then collected for them, this idea also resulting in them deciding to also create antenatal education videos.
I must take this moment to say how lovely and thoughtful so many who we have been co- producing with have been; the support has been heart-warming and something I will look back on with fond memories when all this is over.
On to our Neonatal parent voices, which I am more than a little proud to tell you about next:
We were the very first LMS to rename to the LMNS in 2019 and were the first to create a Neonatal voices arm to our MVP as we recognised that the needs and voices of neonatal families need to be heard. An amazing group of passionate mothers became our Neonatal voices and have proved real trail blazers. We are incredibly proud to have such a fantastic group who go above and beyond. They are effective, efficient and caring which really helps in that particular area as it is so specialised.
Among other things, they attend Parent Advisory Group meetings and network events; attend regional and national groups, for the transferring of neonatal babies and for reviewing data and the National Neonatal Audit Programme.
Some visit the settings and speak with families face to face on the neonatal units to gain information, experience and feedback directly.
They also run baby groups dedicated to neonatal children and their families, taking the time to support these families face to face in Lincoln and Boston, all in their own time.
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They are also part of the preterm working group. A member attended the network peer review, at both units, in July 19, which was invaluable. We have Neonatal voice members who are also in regional and national groups, for the transferring of neonatal babies and for reviewing data. A member has joined the National Neonatal Audit Programme. They attend ‘Parent Advisory Group meetings’ and network events.
The Lincolnshire Neonatal parent voice also co-produced with Better Births Lincolnshire our Stork initiative enabling the public to donate home-made Stork teddies for the parents as a keepsake of their time on the units. Attached to these Storks is information about the neonatal network, health visiting services and children's centres along with mental health support links and a contact card for our Neonatal/MVP group. These have been really well received which has been lovely to see.
Other achievements include gaining donated incubator covers, both a real help to the units and a comfort for parents to look at as they have been made so beautifully.
They even assisted a United Kingdom (UK) mother and baby who were in NICU in Singapore, ensuring they had the professional support they needed once they made it back home, how amazing is that!
Most recently they have joined the National WhatsApp and Facebook group for MVP neonatal voices which has just been created called UK Neonatal Working Group.
To demonstrate our commitment and the importance we attach to Our Neonatal MVP arm, our Vice chair is also a neonatal voice, attending trust meetings and giving findings directly which is important when some cases are so intricate and specialised.
They are a really fantastic element to our MVP that was much needed and I do think they deserve a lot of recognition and respect for all they do especially being the first to take such a leap and start, with no other model to work from for advice. They along with Better Births Lincolnshire have put families first, heard their voices and been proactive in improving services and support which this demographic truly needed due to how special and unusual that experience is. I am sure I speak for all involved with our MVP to say that we are so incredibly lucky to have the caring and kind members we do, they are a real asset and I am
22 as proud as punch of them all and feel very fortunate indeed to work with them and Better Births Lincolnshire.’
Priorities are for MVP for 2020/21 are: 15 steps Antenatal and post-natal exercise Films Low level mental health issues Case studies of women journey Smoking Infant feeding Post-natal care
Amanda Pike - Chair, Lincolnshire MVP
Governance
Governance has developed through the year with performance reports submitted to the LMS and Women’s and Children’s Board as well as the STP as outline below:
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Better Births Team
There is still much transformation we aspire to achieve in our quest to ensure that women and families receiving consistently outstanding maternity care.
We have outlined the ambitions in the Long Term Plan Lincolnshire Better Births see Appendix 2.
The team works really closely with many of the midwives at ULHT and other staff from a huge range of organisations such as Public Health, Early Years, Mental Health, Health Visitors as well as building relationships with crosses border partners.
In the 2020/21 following year these are some of the areas we plan to focus:-
Work in co-production with the MVP Offer continuity to more women across Lincolnshire Continue to develop Community Hubs Launch the Mother and Baby App Support The PMH team in the development of Outreach Clinics Launch the ‘Dad’s Pads in conjunction with LPFT Support the expanded offer of a Home Birth Service Pilot electronic Maternity records ‘Latch on Lincolnshire’ event and then to develop a Lincolnshire Breast Feeding Strategy to support mother across Lincolnshire Work with the Neonatal Operational Delivery Network on the Neonatal Critical Care Review
Thank you to all our partners for supporting improvements in Maternity and Neonatal Service and ensuring better outcomes for the families of Lincolnshire
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Appendix
1 Choice Leaflet http://betterbirthlincolnshire.co.uk/wp-content/uploads/2019/10/My-Choices-V.03b-FINAL.pdf
2 Better Births Long Term Plan – strategy for BBL. http://betterbirthlincolnshire.co.uk/wp-content/uploads/2020/01/Better-Births-Strat-2019-24- final.pdf
Both of these documents are available via our website.
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www.BetterBirthLincolnshire.co.uk
BetterBirthsLincolnshire
@BetterBirthLinc
@BetterBirthsLincolnshire
NHS Better Births Lincolnshire
01522 515404
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