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Antenatal and newborn quality assurance
visits - findings
London Heads of Midwifery & Screening Coordinators
2 March 2018
Public Health England leads the NHS Screening Programmes
Governance & leadership
Accounts for over 30% of QA visit recommendations
Includes recommendations on:-
• Trusts internal governance structure
• Working relationship between trust and commissioners
• Management and coordination of the 6 ANNB screening programmes
• Guidelines/SoPs
• Incidents, risk management
• Audits
• User feedback
2 LCO & HoM Forum March 2018
Governance & leadership
What are the issues?
• Governance and escalation processes unclear
• TSSG ToR unclear and/or out of date
• No senior chair for the TSSG
• Limited attendance to TSSG by key staff
• Roles and responsibilities unclear
• Issues identified around staff capacity
3 LCO & HoM Forum March 2018
Governance & leadership
Guidelines/SoPs
• Do not include current NSC guidance and standards
• Not ratified
• Inconsistent with local practices
• Do not align with NHS service specifications
• Not accessible to all staff
• No audits of guideline compliance
• Work instructions/SoPs not documented
4 LCO & HoM Forum March 2018
Governance & leadership
Incidents, risk management
• Incidents not managed in accordance with PHE guidance
• Local policies do not reference ‘Managing Safety Incidents in NHS
Screening Programmes’
• No process for identifying and monitoring screening risks
Audits, surveys
• Screening audits not include in maternity audit cycle
• No user surveys for screening
5 LCO & HoM Forum March 2018
Some shared learning from other trusts
• Anonymised incident reports circulated to all staff for shared learning
• Screening questions included in ‘Friends and Family’ patient surveys
• Bloodspot screening survey accessible via an app
• New staff allocated time with screening coordinator
• Screening is a regular agenda item at senior midwives meeting
• Trust business continuity plan includes all aspects of the screening
programmes
• Early pregnancy assessment unit has access to the maternity
information system
• Link midwives identified for each screening programme so that
screening is not solely dependent on the screening coordinator
LCO & HoM Forum March 2018
Preparing for a visit
• Assess potential areas for recommendations within your trust and develop
processes to improve these
• Ensure guidelines are consistent with national standards
• Get IT support
• Discuss the QA visit process with a trust who has already undergone a visit
• View ANNB executive summary reports at the GOV.UK website (search
under ‘Screening quality assurance: local visit reports’)
• Access SQAS for advice and support
• Make sure all key staff in the 6 screening programmes attend QA bespoke
meeting (arranged following visit notification)
• Sign up to PHE blog to keep up to date with screening developments
7 LCO & HoM Forum March 2018
Any questions?

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Antenatal and newborn quality assurance visits findings

  • 1. Antenatal and newborn quality assurance visits - findings London Heads of Midwifery & Screening Coordinators 2 March 2018 Public Health England leads the NHS Screening Programmes
  • 2. Governance & leadership Accounts for over 30% of QA visit recommendations Includes recommendations on:- • Trusts internal governance structure • Working relationship between trust and commissioners • Management and coordination of the 6 ANNB screening programmes • Guidelines/SoPs • Incidents, risk management • Audits • User feedback 2 LCO & HoM Forum March 2018
  • 3. Governance & leadership What are the issues? • Governance and escalation processes unclear • TSSG ToR unclear and/or out of date • No senior chair for the TSSG • Limited attendance to TSSG by key staff • Roles and responsibilities unclear • Issues identified around staff capacity 3 LCO & HoM Forum March 2018
  • 4. Governance & leadership Guidelines/SoPs • Do not include current NSC guidance and standards • Not ratified • Inconsistent with local practices • Do not align with NHS service specifications • Not accessible to all staff • No audits of guideline compliance • Work instructions/SoPs not documented 4 LCO & HoM Forum March 2018
  • 5. Governance & leadership Incidents, risk management • Incidents not managed in accordance with PHE guidance • Local policies do not reference ‘Managing Safety Incidents in NHS Screening Programmes’ • No process for identifying and monitoring screening risks Audits, surveys • Screening audits not include in maternity audit cycle • No user surveys for screening 5 LCO & HoM Forum March 2018
  • 6. Some shared learning from other trusts • Anonymised incident reports circulated to all staff for shared learning • Screening questions included in ‘Friends and Family’ patient surveys • Bloodspot screening survey accessible via an app • New staff allocated time with screening coordinator • Screening is a regular agenda item at senior midwives meeting • Trust business continuity plan includes all aspects of the screening programmes • Early pregnancy assessment unit has access to the maternity information system • Link midwives identified for each screening programme so that screening is not solely dependent on the screening coordinator LCO & HoM Forum March 2018
  • 7. Preparing for a visit • Assess potential areas for recommendations within your trust and develop processes to improve these • Ensure guidelines are consistent with national standards • Get IT support • Discuss the QA visit process with a trust who has already undergone a visit • View ANNB executive summary reports at the GOV.UK website (search under ‘Screening quality assurance: local visit reports’) • Access SQAS for advice and support • Make sure all key staff in the 6 screening programmes attend QA bespoke meeting (arranged following visit notification) • Sign up to PHE blog to keep up to date with screening developments 7 LCO & HoM Forum March 2018