Annual Report 2016/17

    Message from the Chair

    Since becoming Chair of Bromley Maternity Voices in January, I have been amazed by the commitment and energy of those involved, from the persistence of longstanding members to the frequency with which potential new members contact me to offer their time.

    This year has seen changes to our Committee, including a new Chair, new Head of Midwifery and other new professional and service user members. We have continued to facilitate communication across professional and organisation boundaries towards our shared goal of improving the maternity experience of women and babies in Bromley. We have been delighted to welcome some fantastic developments in our maternity services, including:

    • a new Perinatal Mental Health Service,
    • midwife-led meetings for pregnant women to learn about home birth,
    • UNICEF Stage 3 Baby Friendly accreditation for our health visiting service
    • the Labour Line now available 24 hours a day

    Bromley Maternity Voices is increasingly asked to share our experiences at a national level to demonstrate coproduction between service users and health professionals. The financial and other support we receive from Bromley CCG has been key to this and was recognised in January when Bromley CCG received an ‘outstanding’ rating from NHS England for its work to engage with the public. I am also particularly grateful for the ongoing support of senior staff from Kings College Hospital NHS Foundation Trust (KCH). We can, indeed, point to some fantastic examples of what our Committee has been able to achieve, some of which are described in this report.

    We know, however, that we can do more to ensure that all voices are heard in the development of maternity services in Bromley. The implementation of Better Births provides an opportunity to share learning between Maternity Systems and we intend to make the most of this opportunity to ensure that every woman knows how she can make her voice heard and that maternity services are truly responsive to the needs of the women who use them.

    Hannah Lynes
    September 2017

    1. What is Bromley Maternity Voices?

    Bromley Maternity Voices is the Maternity Voices Partnership (formerly Maternity Services Liaison Committee) for Bromley. A Maternity Voices Partnership (MVP) is an independent, multi-disciplinary advisory body which brings together service users, commissioners, providers, voluntary organisations and others with an interest in maternity to improve local women’s experience of maternity care.

    Bromley Maternity Voices is maintained by Bromley CCG and includes representatives from Bromley CCG, Bromley Council, Kings College Hospital NHS Foundation Trust (KCH), the health visiting service (provided by Bromley Healthcare for the period covered by this report), and the Bromley Children Project. Crucially, we have a number of dedicated service users who have used maternity services in the borough in the last three years and experienced maternity activists who also bring a service user perspective.

    The MVP exists in order to plan, monitor, develop and improve maternity care for women, partners and families in Bromley. As part of the implementation of the National Maternity Review’s report Better Births, Maternity Service Liaison Committees (MSLCs) across England have been renamed as MVPs and new guidance has been issued setting out how these Partnerships will work going forward.

    2. Our meetings

    We have continued to meet every two months, four times in the morning in Children and Family Centres and twice in the evening at the Princess Royal University Hospital (PRUH). Between 12 and 20 committee members attended each meeting in 2016/17, and our minutes are distributed to approximately 70 people. We discuss issues to do with the maternity care offered in the Borough of Bromley, from pre-conception through to antenatal care, birth and postnatal care and recommend changes and improvements where these are needed.

    Our November meeting was described as an example of “valuable co-production and improvement work“ in a blog by Florence Wilcock, Consultant Obstetrician at Kingston Hospital and founder of #MatExp, after she attended our meeting to learn more about how we work. Our January meeting was a Development Day, during which we took stock of progress and agreed priorities for the year ahead.

    Bromley Maternity Voices development day January 2017

    At our May meeting, we invited Chris Tuck, founder of Survivors of Abuse, to talk about how women who have experienced childhood abuse may experience maternity care and becoming parents.

    Bromley MVP meeting May 2017

    In July, we welcomed staff from Bromley and Lewisham Mind, who spoke about their Mindful Mums peer support programme.

    3. Chair Handover

    At the end of 2016, our Chair, Laura James, stood down. Laura had chaired the Committee for three years since it was re-established in 2013. We are immensely grateful to her for the time and energy she devoted to the role, and we are thankful that she has remained an active service user member of the Committee and is continuing to represent us at national and regional level meetings. Laura’s contribution was recognised in a personal letter of thanks from the Chief Officer of Bromley CCG, Dr Angela Bhan. Dr Bhan also wrote about the value of Bromley Maternity Voices (formerly Bromley MSLC):

    “the CCG is absolutely committed to involving patients both in their own care and in our commissioning decisions. The MSLC has a critical role in enabling us to deliver this commitment. It helps us ensure that women and their families have a voice and are able to influence important decisions about maternity care in Bromley. We have seen a number of real improvements in local maternity care over the last few years… The MSLC is an integral part of these improvements.” Dr Angela Bhan, Chief Officer, Bromley CCG

    Hannah Lynes became our new Chair in January 2017. Hannah is a service user and an NCT Breastfeeding Counsellor who had first joined Bromley MSLC after the birth of her first son in 2008.

    Hannah Lynes and Laura James

    4. Feedback and service user involvement

    This year, we have held four coffee mornings at service users’ homes. These are an opportunity for mothers to join us in an informal environment, to talk about their maternity experience, to share feedback with us and to find out more about Bromley Maternity Voices. We have shared the feedback from these events at our meetings and the feedback has been displayed at the PRUH.

    Feedback from our coffee morning on 9th November 2016

    Conversations at our coffee morning on 11th May 2017

    Coffee morning on 30th June 2017

    In addition to our public Facebook page, this year we have created a closed Facebook group for active service user volunteers. This has increased our ability to collaborate in between meetings. We have used this page to conduct a skills audit of service users, to learn more about the skills, interests and experiences of our volunteers, so that we can target requests for help to the right people. We would like to develop this online interaction to include our professional members too and are exploring what forum we could use for this purpose.

    We have explored new ways of sharing feedback at our meetings, by summarising feedback received from different sources. However, we have found that the more direct the feedback, the more staff feel able to learn from it and so we have supported service users to feed back directly to staff where possible.

    Service user members of our Committee have taken part in staff training events to enable staff to learn directly from their experiences and we have been able to make connections to facilitate this.

    5. Progress so far on our 2017 priorities

    At our Development Day in January, we agreed three priorities for 2017. These are the priorities and progress made so far:

    5.1 Supporting our local maternity services to become Baby Friendly

    Bromley Healthcare this year gained UNICEF Baby Friendly accreditation for Bromley’s health visiting service.

    KCH has started working towards Baby Friendly status. A new infant feeding specialist midwife and infant feeding team have been appointed. Bromley Maternity Voices will be working with KCH to support this process.

    We were quoted in Bromley News Shopper as part of Bromley CCG’s promotion of World Breastfeeding Week in August. This prompted service users to contact us about whether breastfeeding peer support could be developed in Bromley. We discussed this at the following meeting and will be asking if this can be looked at by the South East London Local Maternity System.

    Our Chair was quoted in Bromley News Shopper on 2nd August as part of Bromley CCG's campaign for World Breastfeeding…

    Posted by Bromley Maternity Voices on Monday, 21 August 2017

    5.2 Helping to protect physiological birth:

    • Ensuring that women requesting an elective caesarean birth get the support they need to make an informed decision
    • Providing better support for couples at home
    • Promoting home birth as an option

    KCH is now offering home birth meetings for pregnant women and their partners to learn about home birth and to hear from parents who have given birth at home.

    Since January 2016, the Labour Line, which provides telephone based support for women who think they are in labour, has been staffed 24 hours a day.

    We are planning to invite feedback from women who have requested a caesarean birth.

    We will be looking at the results of the CQC Maternity Survey to find out what support women in Bromley get to choose their place of birth.

    5.3 Antenatal education/information to support women in making informed decisions about their care

    Bromley Maternity Voices will be supporting KCH to review information about birthplace options given to pregnant women and their partners.

    Service user members of our Committee are working with KCH midwives and obstetricians to develop a list of options that women could use to personalize their experience of caesarean birth.

    6. Other action

    6.1 Reporting on Whose Shoes pledges

    At the end of 2016, we published Whose Shoes – One Year On – a summary of the pledges from our Whose Shoes engagement event in January 2016 and the actions taken as a result of those pledges.

    One pledge which has had far-reaching consequences was from our Vice-Chair, Michelle Quashie: “I will provide a platform for women to share their maternity experience. I would like to ensure that women’s voices are heard as part of training and development.” This idea became the Women’s Voices Conference, a national event on 1st October 2016 attended by around 110 health care professionals, service users and birth workers, at which women told their birth stories in their own words. This event is providing inspiration for others around the country, and even in other countries, to consider arranging similar events. Laura James spoke at the event about the important role of MVPs in changing maternity services.

    Laura James presenting at Women’s Voices conference 2016

    6.2 Home from home rooms

    We have continued to work with KCH to develop home from home rooms on the delivery suite at the PRUH, so that women who are not able to give birth in the Oasis Birth Centre can still experience a relaxed home-like environment. Equipment that the 4Louis Charity purchased for us including TVs, fridges, hairdryers, tea making facilities and sensory lights is now being used at the PRUH. We will continue to work with KCH to improve the décor of those rooms.

    6.3 Cool cot

    In August 2017, we sourced a cool cot for the PRUH. One of our professional members had told us about Cuddle Cots, which enable parents whose baby has died to spend some time at home with their baby. Following discussion at a Bromley Maternity Voices meeting, we made contact with the 4Louis Charity who put us in touch with Tracy and Richard Roper. Tracy and Richard were fundraising for a Cuddle Cot, in memory of their daughter, Lily Roper. The Ropers and their family and friends raised money for this cot through fundraising events including a coffee morning and a half-marathon.

    Tracy and Richard Roper, presenting the Cuddle Cot to Shereen Cameron, Head of Midwifery at the PRUH.

    7. Communication

    We have continued to use social media as a way of communicating with service users. Our public Facebook page has 353 followers, up from 274, and our Twitter account has 668 followers, up from 289. We use these accounts to promote our work, to invite feedback and to share opportunities for individuals to influence maternity services.

    We published our first Stellar Story, a report in pictures, entitled A Taste of Our Year at Bromley MSLC, which was well-received.

    We have launched our web site at www.bromleymaternityvoices.org.uk. It includes events listings, blog posts and news items, as well as giving information about local services for parents and how parents can feed back on their maternity experience.

    Our members have written articles which have been published on our web site and in the NCT Beckenham and Borders newsletter, First Words.

    In addition to the CCG’s campaign on breastfeeding, we were also quoted in its press release on Bromley’s new perinatal health service, recognising the role we had played in helping to shape this important new provision.

    8. Local representation

    We have regularly attended the Maternity Joint Commissioning Group, the Delivery Suite Forum at the PRUH and the Bromley Breastfeeding Strategy Group.

    We had a stand at four GP academic half days. We shared information with GPs about our Committee and also about breastfeeding dropins, Baby Cafes, Mindful Mums and Badgernet (the new electronic records system for maternity). At the November event which focused on perinatal mental health, we supported a service user to share her story with the GPs there.

    Bromley GP academic half day March 2017

    Bromley GP academic half day May 2017

    We attended the International Day of the Midwife celebration at the PRUH and spoke to thank our local midwives on behalf of the women of Bromley.

    We were on the maternity stand at Bromley CCG’s AGM, where the Clinical Chair referred to us as an example of the CCG’s patient and public involvement work.

    9. National and regional influence

    We worked with other MVPs to influence NHS England’s Implementing Better Births Toolkit, which sets out the importance of MVPs in implementing Better Births. Bromley Maternity Voices is featured in the toolkit as the example of best practice for an MVP.

    We worked with others to create the new National Maternity Voices umbrella organisation for MVPs.

    We ran a Walk the Patch breakout session at the NCT MSLC Update Day in for service user reps.

    We were founding members of the new London MVP Network.

    Mapping SouthEast London MVPs

    Laura James, Hannah Lynes and Michelle Quashie, with other members of the London MVP Network

    We coordinated a response from London MVPs to a consultation by the London Ambulance Service and NHS England on a Pan London Maternity Divert Policy, suggesting that the language could better reflect women’s autonomy and that MVPs should be involved in reviewing local policies.

    We initiated contact with the new South East London Local Maternity System about the role that MVPs will play in this new structure which will be responsible for implementing Better Births in South East London.

    We were listening to parents at the maternity stand for Our Healthier SouthEast London’s public engagement event on the local NHS Sustainability and Transformation Plan.

    10. What next?

    In the coming months, in addition to our ongoing representation work, we are planning to:

    • Play an active role at the SE London LMS, ensuring that MVPs across SE London have the resources they need to support the implementation of Better Births
    • Develop a better understanding of how maternity services can support women who have experienced domestic violence or sexual abuse and identify action we can take
    • Gather feedback from women who have requested a caesarean section, in order to inform our maternity services’ approach to supporting those women and to find out what might enable more women to feel comfortable about having a vaginal birth.
    • Look at data from the CQC maternity survey, especially relating to choice of place of birth, and assess whether women understand the benefits and risks of different birthplace options.
    • Consider gathering feedback on changes to the health visiting service following the change of service provider to Oxleas NHS Foundation Trust
    • Re-establish Walk the Patch
    • Request demographic data on women giving birth in Bromley and actively seek to involve younger mothers, BME women and women from other seldom heard groups in our work.
    • Consider developing infographics outlining the benefits, risks and alternatives of common interventions, to support conversations between professionals and service users.
    • Help to shape a GP academic half day on infant feeding to take place in May 2018.

    11. Get involved

    We are looking forward to continuing this work in the coming year. We are always delighted to welcome new service users and professionals to the committee. If you have had a baby in the last three years in the borough of Bromley, or have an interest in maternity and would like to be involved, we would love to hear from you. Please contact us with any questions on bromleymslc@outlook.com and follow us on Facebook and Twitter.