Agenda item

Representatives from Calderdale and Huddersfield NHS Foundation Trust, and Mid Yorkshire Teaching NHS Trust will attend to provide an update on maternity services.

Contact: Yolande Myers, Principal Governance Officer Tel: 01484 221000 yolande.myers@kirklees.gov.uk

Gemma Puckett, Director of Midwifery for Calderdale and Huddersfield NHS Foundation Trust (CHFT) shared an update with the Committee with regards to maternity services and advised that:

•         The number of midwife vacancies had reduced but there was still some risk in relation to the skill mix of staff.

•         Calderdale Birth Centre was open 24/7 due to an increase in birth rate.

•         A review of Huddersfield Birth Centre was due to take place at the end of April.

Kerry Reedefield, Director of Midwifery at Mid-Yorkshire NHS Teaching Trust (MYTT) advised the Committee that:

•         There was a fully established staffing at MYTT).

•         A 12-week consultation on Wakefield Birth Centre was continuing.

•         A 12-month review of Bronte Birth Centre would take place in September 2025.

The Committee questioned the soft launch of Bronte Birth Centre and whether this would be more widely publicised, and in addition, if the Birth Centre at Huddersfield Royal Infirmary would re-open in next three years.

Ms Puckett responded and advised that due to midwife shortages, CHFT were anticipating a difficult period over the next couple of years. The review at the end of April was to consider the demographics and complexities, and the likelihood of the Birth centre re-opening would depend on that data to ensure a workforce with the right skill set would be in place. The Committee was advised that the birth centre was presently being used as a community midwifery hub to run anti-natal and post-natal services.

The Committee queried the difficulties with regards to retention of staff and were advised that CHFT were retaining 100% of their student midwifes.

In response to the Committees query regarding anti-natal classes across both Trusts and women falling through the net, the Committee were advised that anti-natal classes were being run by the Public Health team at Calderdale Royal Hospital. A piece of work was being undertaken to understand if this could be delivered more locally within communities, as well as understanding the best approach to engage with the hardest to reach women i.e. via social media, virtually etc.

The Committee queried the proportion of international recruitment and if there were places at university for all students wanting to train as midwives. Ms Reedefield responded and informed the Committee that MYTT had a large proportion of international midwives as the current workforce was an ageing one, so there was an increasing need to fill the gaps.

The Committee highlighted the Local Maternity Network System (LMNS) workstream and the 30% dropout rate and the Committee noted the negative picture portrayed around maternity services and previous issues with funding which had impacted on the number of people willing to train to become midwives. Shortened programmes and apprenticeship programmes were an idea of growing the workforce but this did not resolve the issue immediately. There was a constant drive to recruit and grow the workforce to develop midwifery pathways.

The Committee questioned whether maternity services could be presented in a more positive way to encourage more people into the profession and was advised that an LMNS video to show the career pathway, joined up recruitment to ensure graduates were in the right place and remain, flexible working and how to support a good work life balance was available.

In repose to the Committees query regarding midwifery being incorporated into Registered Nurse (RN) training, the Committee was advised that RN posts were limited but that it would be something they supported. Ms Puckett added that work had be undertaken with Bradford to offer post RN qualifications but there had been complications around qualification and financial difficulties, but that they would support a Lobby nationally for funding for post RN training.

The Committee raised their concern regarding women being given a choice of the different birthing options and were advised that the Community Matron was undertaking a piece of work to ensure the Bronte Birth Centre was being promoted. The birth centre at Calderdale provided a level of reassurance being close to the obstetric unit for pain relief, however it was important to ensure those robust discussion were being undertaken with patients.

The Committee highlighted the Ockenden Report and queried whether a change in workforce would be required. The Committee was advised that a large proportion of the midwifery training was mandatory. Workforce models had not always been sufficient which had changed the workforce demand. The priority over the next couple of years would be to roll out the community workforce.

In response to the Committees query regarding the responsive model, Ms Puckett shared that this was in response to staffing challenges at Calderdale Roal Hospital. Staff had to be deployed to the Labour Ward to maintain safe staffing levels which resulted in the birth centre being closed and a reduction in birthing options at that time. Feedback regarding this had been mixed but the decision had been taken in line with national advice.

The Committee raised a question regarding midwifery becoming more medicalised, and if that was a reason for staff leaving.  Ms Puckett advised that staff retention was 100% in 2022/23 and that midwives delivered a variety of care and therefore choice was offered to midwives to ensure a good skill mix.

The Committee acknowledged that women wanted to be assured that birth centres were safe and asked how they were assessed and what were the transfer rate was for those need intervention.

Ms Reedefield responded and shared that a risk assessment was undertaken, and the appropriateness of birth location was reviewed at each point of contact. A booklet of care provided an awareness of the different options to be considered but it was important to be clear on the positives and negatives of those. Midwives were able to identify when intervention was required within a timely manner to reduce the risk.

RESOLVED: The Committee noted the update and agreed that:

1)    A further meeting be arranged to consider the findings of the review of Huddersfield Royal Infirmary Birth Centre and Bronte Birth Centre.

2)    The Committee be provided with up-to-date information regarding midwife training dropout rates locally.

3)    The Committee be provided with information relating to the review of choices at CHFT.

4)    The Committee be provided with further information in relation to transfer rates from the Bronte Birth Centre.