Midwifery boss at John Radcliffe 'incredibly proud' of maternity unit improvements
We've been given an exclusive tour of the changes made at the Women's Centre after scrutiny from families
Maternity services at Oxford's John Radcliffe Hospital have undergone a series of improvements, with more on the way as the hospital works to create better experiences for women and families.
Greatest Hits Radio has been given an exclusive tour of the Women's Centre to see the changes made across its maternity facilities.
These include changes to how pregnant women are assessed, refurbished bereavement suites and greater support for new parents.
The developments come amid ongoing scrutiny of maternity care at Oxford University Hospitals (OUH), with the trust part of a national maternity and neonatal investigation over the past year.
Maternity services at the John Radcliffe were rated 'Good' overall by the Care Quality Commission (CQC) in June, although inspectors said further improvements were needed to patient safety, which was rated 'Requires Improvement'.
Milica Redfearn, Director of Midwifery at OUH said: "For me what's really important is that we are giving the best care possible to our women and families that we're caring for.
"It has been challenging in relation to some of the external investigations and the CQC. However, it's really important that we identify those areas where we need to improve."
She added that feedback from families are at the heart of changes.
"It's important that they are helping inform the improvements that we make," she said.
"My job is to facilitate that with my teams, with the wider organisation, to listen, to learn and make the improvements together."
New triage system coming soon
One of the key developments is a new pathway through the hospital's maternity assessment unit.
The CQC previously raised concerns about delays in assessing women, with inspectors finding that some patients were not being seen within the nationally recommended 15-minute timeframe.
Under the new system, women arriving for assessment are intended to be seen by a midwife within 15 minutes and given a risk rating using a nationally recognised triage system.
Patients will be categorised according to the urgency of their needs, helping staff determine what further monitoring or treatment is required.
Rooms are also being adapted to accommodate three cardiotocography (CTG) monitors, which are used to monitor babies' heart rates.
Ms Redfearn said the new pathway was expected to be operational within weeks.
The hospital also has a dedicated 24-hour telephone triage service, allowing pregnant women to seek advice at any time of day.
A quieter space for families experiencing baby loss
Another significant improvement has been made to the hospital's bereavement facilities.
Concerns have previously been raised about the privacy and dignity of families experiencing pregnancy loss, while the national maternity investigation heard from families who described inconsistent support following harm or the loss of a baby.
The Butterfly Suite on the delivery ward has been refurbished to provide a more peaceful and private environment for families experiencing the loss of a baby.
The room has been soundproofed following feedback from bereaved parents who said they could previously hear babies crying and activity elsewhere on the busy delivery ward.
It now includes softer lighting, facilities for making drinks and a pull-down bed so families can stay together.
The hospital has also improved its bereavement facilities on level seven, including a dedicated garden area and quieter spaces where families can spend time together.
Further refurbishment work is planned to provide additional accommodation, including a double bed and seating area.
Specialist bereavement support is available 24 hours a day, seven days a week.
More support for new parents and babies
Changes have also been made on the hospital's postnatal ward, which has 42 beds and a further eight transitional care beds.
A dedicated infant feeding team is now based on the ward to provide additional support.
Staff are available to help new parents, while six breast pumps have been introduced with help from charities.
The ward has also been divided into smaller zones, with teams of midwives, nurses and support workers responsible for caring for mothers and babies in their designated areas.
The aim is to provide more consistent care and advice, addressing concerns about continuity and communication between staff.
Another change allows women to have one nominated support person stay with them around the clock.
That person can be a partner, parent, sibling or another individual of their choice.
Shower facilities and a visitors' kitchen are available to help families staying overnight.
Ms Redfearn says feedback about the change has been positive, with families reporting that they feel better supported after giving birth.
Keeping families together
The hospital has also expanded the care available to babies who need additional medical support after birth.
Its transitional care unit allows some babies who are not well enough for standard postnatal care, but do not require admission to the neonatal unit, to remain alongside their mothers.
Staff have received additional training so certain treatments, including tube feeding and intravenous antibiotics, can now be provided at the bedside.
Previously, some babies would have needed to be separated from their families to receive this care.
More choices during labour
Women giving birth at the John Radcliffe also have access to improved facilities on the delivery suite.
A birthing pool has been introduced in a room within the higher-risk delivery area, allowing some women who require additional monitoring to consider a water birth where clinically appropriate.
The room has also been decorated and fitted with improved lighting to create a more welcoming environment.
Meanwhile, the hospital's midwife-led unit on level seven has three spacious birthing rooms, each with its own pool.
The changes are intended to give women more choice about their birth experience, where it is safe to do so.
Improvements for maternity staff
Alongside the changes for patients, the hospital says it has been working to improve the experience of its maternity workforce.
The CQC has previously raised concerns about staffing pressures, while the national maternity investigation also highlighted the pressures facing staff and the impact this could have on the care families received.
Staff have been involved in the improvement programme, with changes including better break facilities and wellbeing pods where employees can spend time away from busy shifts.
Reflecting on the work so far
The hospital is continuing to gather feedback from families through surveys and electronic feedback devices on its maternity wards.
Staff say this allows them to identify concerns and make changes in response to patients' experiences.
While a number of improvements have already been introduced, work is continuing in other areas.
Ms Redfearn said: "I'm incredibly proud actually of where we've come as a maternity service and the improvements that we've made."
She added: "We can see that through working with our staff and working with our families, we will continue on that improvement journey.
"What's really important is to keep listening, learning, and improving together."