Bridgnorth Community Hospital

Updated 16 August 2017

The Shrewsbury and Telford Hospital NHS Trust is the main provider of district general hospital services for nearly half a million people in Shropshire, Telford and Wrekin, and mid Wales. Ninety per cent of the area covered by the trust is rural.

Deprivation is higher than average for the area, but varies (180 out of 326 local authorities for Shropshire and 96 out of 326 local authorities for Telford and Wrekin); 6,755 children live in poverty in Shropshire and 8,615 in Telford and Wrekin. Life expectancy for both men and women is higher than the England average in Shropshire but lower in Telford and Wrekin.

Bridgnorth Midwifery Led Unit (MLU) is based at Bridgnorth Community Hospital, a newly refurbished community hospital in south east Shropshire. The hospital is managed by Shropshire Community Health NHS Trust.

The MLU offers a friendly 'home-from-home' atmosphere with an emphasis on natural birth. The service is offered to women who will be at low risk of complications during labour, as there are no medical facilities. The consultant led unit is based at Princess Royal Hospital in Telford, 18 miles away.

The MLU has two labour rooms, a birthing pool and large bathroom with bathing facilities and relaxing coloured lighting. There were four beds available for women to stay with their baby post-delivery. The unit is staffed by a team of midwives and support workers, who also offer a community midwifery service to the local area.

There were 77 births at Bridgnorth MLU between November 2015 and October 2016. There were 270 births within the community midwife area. There were 116 admissions to the MLU, which included women who had chosen to give birth at the unit but were transferred to the consultant led unit and also those who chose to receive postnatal care as inpatients at the unit.

This inspection was a focussed follow up from the 2014 inspection. We previously rated this service as good overall.

We inspected this unit as part of our unannounced midwifery service inspection. During the inspection, we spoke with six members of staff and three women and their family members. We reviewed seven patient records. In addition to this, we reviewed information provided by the trust prior to and following the inspection.

Updated 16 August 2017

We inspected Bridgnorth Midwife Led Unit (MLU) as part of a focussed inspection of Shrewsbury and Telford Hospital NHS Trust in November and December 2016. We visited the MLU unannounced on 1 November 2016.

We rated Bridgnorth Midwife Led Unit as good overall.

• There were systems in place to ensure the service was meeting the individual needs for women using the service. We found the service to be very responsive to the requirements of women using the service at all stages of the patient journey.
• The service provided a range of choices for women during labour, which included pain relief and hypnobirthing. Women told us they felt involved with decisions in their care and we saw women were supported emotionally throughout their pregnancy, birth and postnatally.
• We saw that staff were following good practice with infection prevention and control, the unit was clean and there had been no incidents of infections such as MRSA or CDiff during the reporting period.
• Staff were all aware of how to report incidents and were encouraged to do so. We saw that staff had opportunities to learn from incidents across the trust and that incidents were investigated appropriately.
• We saw that robust clinical governance and risk management arrangements were in place.
• Women and the family members we spoke with described positive care experiences. The results of the friends and family tests showed that over 97% of women who participated would recommend the service to their friends and family.
• Staff had access to and followed policies and procedures that were based on national guidance.
• The MLU was accredited with the UNICEF Baby Friendly Initiative (BFI). We saw that the unit promoted breastfeeding and the important health benefits of this for mother and baby.
• We saw that there were good systems in place to ensure good working relationships with other teams within the trust and with external organisations.
• We saw a positive culture within the MLU with strong leadership. Staff and women using the service were encouraged to provide feedback into how improvements could be made.

However:

• The MLU had experienced closure due to staff being required to support the consultant unit.

We saw areas of outstanding practice including:

• Staff at the MLU had participated in hypnobirthing training to provide women with further choice during their labour. However, there were also areas of poor practice where the trust needs to make improvements.

Professor Sir Mike Richards

Chief Inspector of Hospitals

Updated 16 August 2017

There were systems in place to ensure the service was meeting the individual needs for women using the service. We found the service to be very responsive to the requirements of women using the service at all stages of the patient journey.

The service provided a range of choices for women during labour, which included pain relief and hypnobirthing. Women told us they felt involved with decisions in their care and we saw women were supported emotionally throughout their pregnancy, birth and postnatally.

We saw that staff were following good practice with infection prevention and control, the unit was clean and there had been no incidents of infections such as MRSA or CDiff during the reporting period.

Staff were all aware of how to report incidents and were encouraged to do so. We saw that staff had opportunities to learn from incidents across the trust and that incidents were investigated appropriately.

Women and the family members we spoke with described positive care experiences. The results of the friends and family tests showed that over 97% of women who participated would recommend the service to their friends and family.

Staff had access to and followed policies and procedures that were based on national guidance.

We saw that there were good systems in place to ensure good working relationships with other teams within the trust and with external organisations.

We saw a positive culture within the MLU with strong leadership. Staff and women using the service were encouraged to provide feedback into how improvements could be made.

However, the MLU had experienced closure due to staff being required to support the consultant unit.