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Guy’s & St. Thomas’ NHS Foundation Trust Lynne Pacanowski

Guy’s & St. Thomas’ NHS Foundation Trust Lynne Pacanowski. The maternity unit. Serves: Lambeth Southwark & Lewisham Tertiary Referral centre: SE England for fetal cardiac conditions Maternal and Fetal Medicine Level 3 neonatal unit. Antenatal Clinic and FMU.

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Guy’s & St. Thomas’ NHS Foundation Trust Lynne Pacanowski

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  1. Guy’s & St. Thomas’ NHS Foundation Trust Lynne Pacanowski

  2. The maternity unit • Serves: • Lambeth • Southwark & • Lewisham • Tertiary Referral centre: • SE England for fetal cardiac conditions • Maternal and Fetal Medicine • Level 3 neonatal unit

  3. Antenatal Clinic and FMU • Consultant-led specialist clinics • Anti-D clinic • Pre assessment LSCS clinic • Comprehensive antenatal screening service including nuchal, quad testing, CVS, amniocentesis, One stop screening • Fetal medicine unit

  4. ADU and Triage • Antenatal day assessment Unit • Daytime and weekend opening • Scanning facilities available • Triage • Currently open Monday to Friday 9.30am till 9pm • Parent education centre

  5. The Birth Centres • Home from Home (midwife led) • 9 rooms • 2 birthing pools • Hospital Birth Centre (obstetric led) • 20 rooms • Includes 2 SANDS rooms • Includes 1 room with inbuilt ceiling hoist • 2 Obstetric theatres • 3 bedded HDU

  6. Postnatal wards • The postnatal ward • 38 beds • 6 side rooms • Dayroom • Lansdell (private) postnatal ward • 6 en-suite rooms

  7. Statistics 2007/8 • Total births = 6582 • NHS births = 6191 • Private births = 391 • Home births = 2.6% • Home from Home births = 19.3% • Caesarean section rates (NHS) = 27.9% • Induction rate = 18.6%

  8. Statistics 2007/8 (2) • Parity • 59.4% primiparous • Age at delivery • 1.8% < 18 y.o. • 3.9% > 40 y.o. • Multiple births • 4.3% twins • 0.2% triplets or more • Gestation • 10.6% <37 weeks (1.5% <24 weeks)

  9. The workforce: community 1 Children’s Centre Team • 4 other children centre midwives • 7 Case-loading teams • 1 specialist team for teenagers • 4 Traditional Teams • Public Health Consultant Midwife

  10. The workforce: the hospital • Core staff in all areas • Consultant midwives in Home from Home & ADU • Specialist team 1: SLE/APS, maternal cardiac disease and pre-existing and gestational diabetes • Specialist team 2: Sickle Cell disease, renal disease, monochorionic twins, triplets, fetal cardiac abnormalities, substance misuse problems and severe mental health problems

  11. Specialist Midwives • Female Genital Mutilation • Sexual Health • Mental Health • Antenatal Education • Fetal medicine • Bereavement • 2 Practice Development Midwives • Research midwives • Breastfeeding co-ordinator

  12. The workforceTraining and Development • 5 midwives undertake the Examination of Newborn course each year at KCL • Several midwives completed or currently completing MSc’s • Aromatherapy workshops continue • All midwives have had the opportunity to attend Dennis Walsh Normalising Birth workshops • 2 fetal monitoring study days run in 2008 • All midwives now rostered to attend a week-long mandatory update programme

  13. The workforceMidwifery students & newly qualified midwives • Midwifery students • Student numbers negotiated with KCL and close monitoring of placements undertaken • SOM now nominated to commence group supervision with all student cohorts • Funding secured for 2 Clinical Practice Facilitators: initial discussions held with KCL • Newly qualified midwives • Orientation facilitated by PDM

  14. Induction and Orientation Programme Starts 20.10.08 Welcome to Guy’s and St Thomas’ Hospital NHS Trust. Please find below your Trust and Department’s induction and orientation programme. If you have any problem with the arrangements made for you please contact the Professional Development Midwives on 83654.

  15. Training and Development Days Mandatory Study Week : 10.11.08 EPR Training: 09.12.08 Healthware Training: 29.10.08 10:00 Genetics Training: 30.10.08 Thames Day 05.11.08 Tower Day 06.11.08 Meetings Lynne Pacanowski (Director of Midwifery): 22.10.08 Geraldine Joyce (ANC Matron): 24.10.08 Susan Lancaster (Customer Care Manager) 31.10.08  Manjit Randhawa (Gynae & High Risk Team Matron) 04.11.08

  16. HCC review • Service evaluation of all maternity units in England included user satisfaction • 27 NHS Maternity Units in London • 4 outcomes: • 19 scored ‘least well performing’ • 7 scored ‘fair performing’ • 1 scored ‘better performing’ • 0 scored ‘best performing’

  17. Solutions and new initiatives Controlling activity • Out of area referrals capped from July 08 Working smarter • Midwifery phoneline • 24 hour triage • One stop antenatal screening • MSW programme Increasing resources • Successful bid for additional £415,000

  18. Achievements 2008 • HCC report • Implementation of MSW programme • Positive feedback from the students • RCM award • BFI Certificate of Commitment • Very low vacancy rate • Low staff turnover • ICM presentations

  19. Future plans • Strive to provide effective, supportive supervision eg through training more SOMs • Continue to recruit and retain • Business case for 7,000 (NHS) births • Reconfigure service provision • Increase normal birth rate • Involvement in AHSC discussions (to include closer working with KCL) • Plan for the impact of an all-graduate midwifery workforce

  20. Thank you. Any questions?

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