MATERNITY NETWORK WALES Why? What? When? How? The initial driver for the establishment of a national maternity network for Wales was the Strategic Vision for Maternity Services in Wales (WG 2011), when the Quality and Safety Sub Group of the All Wales Maternity Service Implementation Group (AWMSIG) published its report in June 2013. The AWMSIG consisted of five sub groups tasked with translating the themes of the strategy into practice. The Quality and Safety Sub Group made six recommendations (WG 2013a), all of which related to having a national maternity network. Simultaneously, in February 2013 the National Assembly for Wales Health and Social Care Committee held a One day Inquiry into Stillbirths in Wales. One of the nine recommendations was that Welsh Government scope the viability of establishing a maternity network to drive the standardisation of care in Wales (NAW 2013). Welsh Government responded with a scoping paper (July 2013b) and concluded that a maternity network was needed to focus on the implementation of guidance developed following the publication of the Maternity Strategy for Wales. They considered four options of how to develop the network and recommended it was established within the 1000 Lives Improvement Service. A full time, permanent network manager was recruited and commenced in post on the 21 st July 2014. Claire Roche is a midwife who has worked in Cwm Taf, Abertawe Bro-Morganwg and Aneurin Bevan Health Boards. Prior to taking up this role, she was the Senior Manager at the Royal Gwent Hospital, Newport. Claire is supported by a Consultant Obstetrician, Claire Francis (Cardiff and Vale HB) who works for the network one session per week. A Steering Group was established on the 26.01.15. Membership is made up of representatives from all Health Boards and all disciplines within maternity services, Public Health Wales, Royal Colleges, Welsh Government, Universities, the Deanery, the Neonatal Network and a representative from the Maternity Service Liaison Committee provides the service user voice. There was a focus of ensuring that there was a wide spread membership that accounted for all settings of the maternity service and that all Health Boards were equally represented (appendix 1). The steering group will meet quarterly and is responsible for setting the priorities for the network. Members are expected to take responsibility for the organisation and discipline they represent and all members of either the steering group or the sub-groups have been given specific roles and responsibilities that they have been asked to agree to (appendix 2). The network manager and clinical lead are committed to establishing a network where there is clarity about roles and responsibilities and that facilitates and fosters a culture of dignity and respect amongst its members. During the first year, three sub-groups will establish. A visual representation of the structure of the network for 2015 can be found in appendix 3.
1) The National Stillbirth Working Group (NSWG) has been re-convened. The original group last met in November 2013 due to the Maternity Collaborative ending in March 2014. The NSWG has also been established in such a way that all Health Boards are represented (appendix 4) and is now chaired by Professor Jean White (CNO). There are a number of interventions being over-seen by the NSWG with the aim of reducing stillbirth rates in Wales. They are responsible for a number of the recommendations from the Health and Social Care Committee inquiry (NAW 2013), which remains an open inquiry. There is a significant amount of work to be done within the NSWG and the perinatal pathology sub group that is tasked with addressing the uptake of post-mortems. This sub group consists predominantly of lead midwives in HBs with a role in bereavement care and staff from the paediatric pathology department at UHW. Work to date includes the development of a training package for obtaining consent for post mortem, the development of a study day for cascade trainers (27.05.15), a review and update of the information given to parents regarding post-mortem and it is also in the early stages of developing quality standards around the arrangements for post-mortem and the communication of the report with parents and families. 2) A Quality and Safety sub group established on the 13.04.15 and this group is made up of a midwife and obstetrician from each HB with a lead role for risk management and governance and staff from Welsh Risk Pool (appendix 5). This group will aim to take forward the recommendation of the Quality and safety Sub Group (WG 2013) and have already started work to develop a national maternity dashboard. Welsh Risk Pool will be using this forum as the national repository for lessons learned that need to be shared across Wales. 3) The maternity network is committed to working in partnership with women and families to foster and build a culture of co-production. A Woman s Forum will be established in September2015. This will bring together members of local Maternity Service liaison Committees (MSLCs) but will also explore creative partnerships to engage women and families from vulnerable sections of society that do not traditionally engage in such groups. This forum will support the women/service user voice on the steering group. For more information, contact Claire Roche: Claire.roche@wales.nhs.uk References National Assembly for Wales, Health and Social Care Committee (2013) One day Inquiry into stillbirths in Wales www.naw.gov.uk Welsh Government (2011), A Strategic Vision for Maternity Services in Wales www.cymru.gov.uk Welsh Government (2013a), Welsh Government Maternity Strategy: Report from the Quality and Safety Sub Group www.cymru.gov.uk Welsh Government (2013b), A Maternity Network for Wales www.cymru.gov.uk
Appendix 1 Membership of the Maternity Network Steering Group NAME DESIGNATION REPRESENTING ORGANISATION CHAIR Claire Francis Clinical Lead: Maternity Maternity Network Wales/ Cardiff and Vale Network C&VUHB Claire Roche Manager: Maternity Network Maternity Network Wales PHW: 1000 Lives I Jonathon Pembridge Consultant Obsterician/Clinical CDs: Obstetrics/ Cwm Taf Cwm Taf HB Director: Obstetrics Kay Cotter Head of Heads of Hywel Dda Advisory Group/ Hywel Dda Sarah Fox/ Maggie E Consultant Midwife Consultant midwives in ABMUHB Davies Wales/ ABMU HB Matt Turner Consultant anaesthetist Obstetric anaesthetists in Aneurin Bevan UHB Wales/ ABUHB Fiona Giraud Associate Chief of Staff - Nursing and Polly Ferguson Maternity Lead : WG Welsh Government WG Karen Stapleton Manager : NNW Neonatal Network Wales NNW Lindsey Phillips Maternity Service Liaison Committee (MSLC) Chair (POWYS HB) Women and Families Powys MSLC Helen Rogers Chris Roseblade Director: Royal College of Midwives (Wales) Fellows Representative for Wales on RCOG Council 2014 RCM Royal College of Obstetricians and Gynaecologists/ NSAG RCM Sara McAleese Midwife Midwives/ Powys HB Powys HB Amy Shacaluga Obstetric trainee Deanery Wales (obstetrics) Cardiff and Vale Moe Wolfe Supervisor of Midwives Local Supervisory Committee (LSA) Health Inspectorate Wales (HIW) Sharon Hillier Asst Director of Screening Ante-natal Screening Wales PHW (ASW)/Public Health Wales Janine Wyn-Davies Professional Head of Education Lead Midwives for Education/ Universities University of South Wales Obstetrics Obstetrics Anaesthetics Obstetrics / Cardiff and Vale Hywel dda ABMU Cwm Taf Aneurin Bevan Powys
Appendix 2 MATERNITY NETWORK WALES Steering Group Roles and responsibilities of members The Maternity Network for Wales is committed to collaborative team working. In order to improve, develop and transform the Maternity Services in Wales, effective professional relationships built on mutual respect and understanding will be core values of the Maternity Network Team. Therefore providing clarity on the roles and responsibilities of steering group members supports such a culture. The SG member will: 1. Be clear about who they represent on the network 2. Have responsibility for communicating and providing feedback between those they represent and the network steering group. 3. Commit to attending four steering group meetings per year (some will be available via VC) 4. Nominate a named deputy and where in exceptional circumstances, are unable to attend will request and arrange for their deputy to attend in their place 5. Work in partnership with the Network Manager and Clinical Lead to support local visits to their individual organisation 6. Be aware of who represents their organisation/discipline on the sub-groups of the network and ensure regular communication takes place 7. Have a clear understanding that their membership of the network will not be permanent in response to the fixed term nature of the Clinical Lead Role 8. Respect their member colleagues and conduct themselves in a professional manner during meetings and virtual communications 9. Recognise that they are an ambassador for the network, promoting its work and modelling positive attitudes to service improvements 10. Promote and engage with network initiatives within their organisation
Appendix 3 MATERNITY NETWORK WALES (Structure 2015) Maternity Network Manager: Claire Roche 1000 Lives Improvement Service Steering Group Clinical Lead: Claire Francis Sub Group: National Stillbirth Working Group Chair: Prof J White (CNO) Peri-natal Pathology Sub Group Chair: C Roche STEERING GROUP Chair: TBC (C Francis) Sub Group: Quality and Safety Group CHAIR: C Francis Sub Group: Women s Forum (Interim Chair: C Roche)
Appendix 4 National Stillbirth Working Group Group Membership Name Designation/ Representing Organisation Prof jean White CNO: WG (CHAIR) Welsh Gov Claire Francis Clinical Lead: Maternity Network Maternity Network Claire Roche Maternity Network Manager Maternity Network Polly Ferguson Maternity Lead: WG (Deputy Chair) Welsh Gov Jane Phillips Acting HoM / HOMAG ABMUHB Madhu Dey or Consultant Obstetricians/ ABMUHB ABMUHB Marsham Moselhi Heather Payne WG Welsh Gov Bryan Beattie Fetal Medicine Specialist/ Fetal Medicine Cardiff and Vale Janet Quarmby Outpatient Matron / Karen Jewell Consultant Midwife/ Consultant Midwives Cardiff and Vale Nicola Piskorowskyj Consultant Obstetrician/ Hywel Dda Hywel Dda Gordon Vujanic Consultant Pathologist / Paediatric Pathology Cardiff and Vale Isobel Smith WRP WRP Myfanwy Ellis Lead Midwife Clinical Risk/Cwm Taf Cwm Taf HB Manju Nair or Delyth Consultant Obstetrician/ ABUHB Aneurin Bevan HB Rich Donna Owen Lead Midwife Clinical Risk/ Powys Powys Dawn Kelly SoM/ Supervsion LSA / HIW Dr Roshan Adappa Clinical Lead / AWPS AWPS Shantini Paranjothy PHW PHW Ruth Lawler ASW ASW Janet Scott/ Heather- Jane Coombes Sands SANDS Cardiff and Vale Hywel dda ABMU Cwm Taf Aneurin Bevan Powys
Appendix 5 QUALITY AND SAFETY SUB GROUP MEMBERSHIP Name Designation/ Representing Organisation Claire Francis Clinical Lead: Maternity Network (Chair) Maternity Network Claire Roche Maternity Network Manager Maternity Network Kath Graves Risk Midwife ABMUHB Marsham Moselhi Consultant Obstetrician ABMUHB ABMUHB Sarah Spencer Governance Midwife Cardiff and Vale Pina Amin Lead Obstetrician: Labour Ward Cardiff and Vale Adele Roberts Senior Midwife Hywel Dda Richard Husicka Consultant Obstetrician Hywel Dda Jonathan Pembridge Consultant Obstetrician Cwm Taf HB Myfanwy Ellis Lead Midwife Clinical Risk/Cwm Taf Cwm Taf HB Sajitha Parveen Consultant Obstetrician/ ABUHB Aneurin Bevan HB Jayne Beasley Lead Midwife Risk/Governance Aneurin Bevan HB Donna Owen Lead Midwife Clinical Risk/ Powys Powys Kalpana Upadhyay Consultant Obstetrician Gaynor Lloyd Risk Midwife Isobel Smith WRP WRP Helen MacArthur WRP WRP Cardiff and Vale Hywel dda ABMU Cwm Taf Aneurin Bevan Powys