Cwm Taf Maternity Services – Update 2
This is my second update on the review of maternity services in the former Cwm Taf Health Board area. This follows on from the intervention made by the Health Minister after the Independent Review and report by the Royal Colleges.
You can read my first update here.
Work of the Independent Panel
The Independent Maternity Services Panel was appointed following the Health Minister’s intervention in order to oversee the improvement process in this service. The Health Minister has provided the first update on the first phase of their work. You can read his statement here and further reports will follow in late September, early December 2019 and then March 2020.
Meeting with Panel Chair
Earlier this week I met with the Chair of the Independent Review Panel, Mick Giannasi, at Prince Charles hospital and we shared views on the issues that have come to light as a result of the Review. Given what has been reported neither of us are in any doubt as to the depth and range of work that could be required to help improve, and then maintain a quality of maternity service that we would wish for all women and families. It will be likewise for any lessons that will inevitably emerge for the leadership of the whole health board.
Together we also visited the maternity unit at Prince Charles to discuss issues with some of the staff who were on duty at that time.
Assembly Committee Scrutiny
As members of the Independent Panel Mick Giannasi and Cath Broderick attended the Assembly’s Health, Social Care and Sport Committee today to be scrutinised on their work programme including the progress made, to help clarify AMs understanding about those matters that lie within their Terms of Reference, to improve clarity on how their work streams and processes are being managed and how the clinical review of past cases will take place.
The Panel submitted written evidence to the Health Committee which you can read here.
You can follow the Committee session on Senedd TV here.
I am no longer a member but the Committee asked a number of similar questions to those that I had also discussed with Mick Giannasi earlier in the week, and the queries being made strike a balance between the action needed to help improve the service moving forwards, and having a much better understanding of how past incidents arose, so we can avoid repeating the same mistakes.
The Review Panel have a number of work streams to help them cover all the issues that were raised in the review and report. In summary these cover service improvements, patient engagement and communication and the clinical review of cases. The work is detailed in the Oversight Panel’s Newsletter.
As the Chair stressed to me in our meeting the real test is to see actual evidence of the changes and improvement in the maternity services, and across the wider Health Board as required. The evidence from the clinical review of past cases will determine what further work is required.
In evidence to the Assembly Committee the panel said “It is also likely to be twelve months to two years before it is possible to say with confidence that sufficient momentum has been achieved” and while not suggesting the Panel will need to be in place for that length of time “it is important to recognise that there is no quick fix and that change of the type which is necessary in Cwm Taf Morgannwg will not be delivered overnight”.
The Panel do however see the initial twelve months as being an important milestone for their work. The work is being helped by a number of new appointments made by the Health Board in recent months.
Women and families
I have had contact from a small number of women and families about their experience with the Health Board. In some cases, and by agreement, matters have been referred for consideration by the complaints process.
I have also had one contact offering thanks and praise for their recent experience with staff in the maternity service at Prince Charles.
The Independent Panel are still welcoming contact from any women and families who have concerns to share about their experience of care. I recognise that this is a personal decision for those concerned. For those wishing to make contact the First Point of Contact is [email protected]; or [email protected];
Culture, behaviours and complaints
In my discussion with the Panel Chair, also clear in the evidence presented to the Health Committee, and in wider discussions about this service, I am struck by patients comments about some of the behaviours experienced by women and families. There are also lots of comments about the culture in the Health Board’s complaints process.
I have little doubt that these will be a major theme in the improvement work which lies ahead, and the Health Board are already investing in changes to their system.
While noting that some problems are being addressed immediately I am also clear that some of the improvements required will take time to become a part of a new patient experience.
Some of the issues which arise will probably apply to the whole work of the Health Board, and possibly further afield.
The independent clinical review of 43 pasts cases will be undertaken, and based on what is learnt (the evidence) this part of the independent review may well need to go further back in time.
While some problems are being addressed immediately I am also clear that some of the improvements required in this service will take time to become a part of a new patient experience.
I will continue to update constituents as the work moves forwards.