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‘Safety phrase’ scheme improves maternity care patient experience, says midwife

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An initiative to ensure maternity staff at Kettering General Hospital NHS Foundation Trust listen to patients and each other has led to a reduction in complaints and boosted teamwork, says the senior midwife behind the scheme.

Mara Tonks, lead midwife for the hospital’s delivery suite, introduced the Listen To Me scheme in response to local and national data showing mothers and couples often did not feel their concerns were taken seriously during labour.

“My biggest challenge in doing this was my own fear of it not working”

Mara Tonks

The pilot scheme, launched in April last year, involves the introduction of the safety phrase “I need you to listen to me”, which features on posters and is explained in leaflets given to patients.

If a pregnant woman, relative or any member of the team says those words then staff are obliged to listen to their concerns and take immediate action.

Ms Tonks was speaking earlier this week at an NHS Improvement conference to launch a nationwide scheme to improve the quality of maternity services and reduce stillbirths, neonatal deaths and injuries.

She said Listen To Me was an example of a “very simple”, low-cost project that had helped improve her service and made a real difference to families.

She explained that the initiative was sparked by a serious incident at her unit in 2014 and subsequent efforts to identify improvements.

The serious incident occurred when a cardiotacograph (CTG) was misinterpreted, delaying delivery and leading to a baby being born with brain damage from lack of oxygen.

Ms Tonks, who went on to get involved in NHS Improvement’s Avoiding Term Admissions Into Neonatal units programme and the asphyxia working group, said a common theme to emerge from that and other national research was parents not feeling listened to.

Meanwhile, this was echoed in local data from the Care Quality Commission’s maternity survey and direct feedback from mothers about their experiences of giving birth at Kettering General.

While the majority of births went smoothly, Ms Tonks said she was both dismayed and motivated by comments from some women, including one mother who genuinely “thought she was going to die” after suffering a post-partum haemorrhage.

Another said she was “too afraid to say something” to midwives when she realised her unborn child’s heart rate was dropping, and a distressed couple described waiting for “what felt like a lifetime” for an emergency caesarean section, believing their baby’s life was in danger.

“I was fed up with handling complaints and doing birth reflections and wondering ‘how can women leave my delivery suite feeling like that?” she told the audience of fellow midwives and other maternity experts.

Under the project, delivery suite co-ordinators, who are supernumerary staff at Kettering General, have become Listen To Me champions.

They explain the initiative to all mothers brought into the department and make it clear families can go to them if they feel they are not being listened to.

Before the scheme was introduced, it was agreed by managers, consultants and midwifery staff and families who were also asked for their views, said Ms Tonks.

She said she was initially worried about how midwives would react to the concept and expected it to be “fiercely challenged” by senior staff, but found it was welcomed “especially by junior midwives”.

While there have been no reported instances of the safety phrase being used, Friends and Family Test data had shown a real improvement in whether mothers felt listened to or not since the scheme was launched.

Most importantly, there have been no formal complaints about mothers’ experiences at the delivery suite since the start of the project.

“One of the key things for me is there has also been a change in culture and an increase in multi-disciplinary team interaction,” said Ms Tonks.

“It feels like there has been an improvement in professional respect including between the delivery suite co-ordinators and midwives, and between junior midwives and senior midwives,” she said.

The Listen to Me scheme is now being rolled out throughout the department, including into postnatal care, where early results have also been positive.

Meanwhile, the scheme has been embraced by the director of nursing and incorporated into the trust’s strategy for 2017.

“My biggest challenge in doing this was my own fear of it not working,” said Ms Tonks. “So it shows that if you have the guts to go with something, you can make a difference.”

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