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Vaughan Gething, Minister for Health and Social Services

First published:
22 March 2021
Last updated:

I last updated Members on progress within maternity and neonatal services at Cwm Taf Morgannwg University Health Board on 02 February. This followed the publication of the first thematic report from the Independent Maternity Services Oversight Panel (IMSOP) describing the themes and learning emerging from the maternal category of the Clinical Review Programme. I also confirmed that I had accepted a recommendation from Mick Giannasi, IMSOP Chair to enhance the Panel membership to include neonatal expertise. I am now in a position to confirm that Dr Alan Fenton and Ms Kelly Harvey will join the Panel with immediate effect.

Dr Fenton has been a Consultant Neonatologist in Newcastle since 1995. He has had a major role in developing perinatal services at the national level and was President of the British Association of Perinatal Medicine 2014-17. He was the neonatologist in the core team of the 2016 National Maternity Review (Better Births) and is a member of the Maternity Transformation Programme Stakeholder Council. He has been part of the MBRRACE-UK collaborative since 2018.

Ms Harvey has over 18 years’ experience as a neonatal nurse and Advanced Neonatal Nurse Practitioner and is currently lead nurse for the North West Neonatal Network supporting quality improvement and governance across a regional footprint. She has recently become a member of the Neonatal Nurses Association Executive Committee.

Both have also been involved with the IMSOP Clinical Review Programme for some time, as members of the Quality Assurance Panel, so are fully versed in the work and are able to transition to full Panel members immediately. This is timely given that the neonatal reviews are underway and it will be important to ensure that as the learning emerges it can be fed into the wider improvement programme.

Alongside this, they will begin by undertaking a deep dive into the neonatal service to take stock of the current neonatal service and its improvement plan to provide assurance that services are safe, effective, well led and importantly, integrated with the maternity service to provide a seamless service for women and babies. The health board has welcomed this development and the opportunity to draw on Dr Fenton and Ms Harvey’s experience and expertise to inform the improvements they are making on their journey to provide exemplar maternity and neonatal services.

I also wanted to advise Members that I have accepted a recommendation from the IMSOP Chair to defer the production of their next full progress report. Mr Giannasi has recently written to me to set out the rationale for this. When the Panel last reported in September 2020, it concluded that the health board had done remarkably well to maintain the focus and momentum of its Maternity and Neonatal Improvement Programme (MNIP) during the first wave of the COVID-19 pandemic.

The Panel has continued to maintain oversight of the improvement programme throughout this last period. However, all their work is still being undertaken virtually and they advise it has become increasingly difficult to assess evidence of improvement in a robust and thorough way because of not being able to meet with staff face to face and visit the hospitals to assess whether the improvements which have been delivered on paper have been embedded in day to day operational practice.

At the end of February, the Panel conducted an interim assessment of the progress which the health board has made in the last six months and concluded that whilst there were no signs of regression, in comparison to previous reporting periods, the level of tangible progress has slowed. They also assessed progress against the ten ‘next steps’ actions which were highlighted in the September 2020 Progress Report and concluded that the majority of those remained work in progress and a substantial number, including some which are key enablers for longer term improvement, have been delayed or deferred due to the impact of COVID-19. 

Importantly, the Panel believes that despite the challenging circumstances in which the health board has been operating over the past twelve months, the maternity service has ‘kept its head above water’ in a way which would almost certainly not have been possible without the improvements of the past two years. In particular, there is no sign of regression in any of the key performance indicators (sickness absence excluded) and safe staffing levels have been maintained, despite the high levels of sickness absence which have been experienced. There is also evidence that the service has shown innovation and creativity in responding to the implications of COVID-19, particularly in the way it has used social media and other forms of remote technology to engage and build co-production with women and families using the service.

In the circumstances which have prevailed over the past twelve months and the last six months in particular, the Panel has advised me that the current pace of progress is entirely understandable in their view. The Panel has identified the key areas of focus to regain momentum over the coming months and determined that September would be an appropriate time to next provide a full report on progress.

In tandem, the Clinical Review Programme is continuing, albeit that the pace of that work has also been slightly impacted due to the pandemic. However the Panel will in the coming weeks conclude the reviews of those babies who sadly were stillborn. Arrangements are being finalised to share individual findings with women and families affected and to ensure all appropriate support is in place.

I will continue to keep Members informed.