Spring Update on Maternity Services and Targeted Intervention – Cwm Taf Morgannwg University Health Board

Today marks one year since I published the Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives joint report, following their review of maternity services at the former Cwm Taf University Health Board.

Over the last 12 months the Independent Maternity Services Oversight Panel has been monitoring and supporting the health board with the necessary challenge and scrutiny to ensure that improvements are being made in an open and transparent manner.

Despite the unprecedented times that we find ourselves in, I want to assure women and families affected by the Royal Colleges’ review that they have not been forgotten. The work of the Panel continues, although their working practice has clearly had to adjust in the context of the COVID-19 outbreak. Nevertheless, the clinical review work is still very much ongoing. The learning from this work will continue to influence how maternity care is provided in Cwm Taf Morgannwg University Health Board.

Today I am publishing the Panel’s Spring Quarterly Progress Report. This is the third update from the Panel and provides further evidence of the ongoing improvement work within the health board. It is reassuring to hear that the Panel have assessed that further incremental progress has been made during the last three months and that they believe that the health board is firmly on track to deliver against all of the Royal Colleges’ recommendations.

It is a credit to both the health board and the Panel that just over half of the recommendations have been addressed and are being embedded in operational practice. I have emphasised since the start of this process that it is vital the work is completed thoroughly instead of quickly so that sustainable changes are made.

The Panel has set out its expectations for the areas needing particular attention over the next few months. This includes further development of the Maternity Improvement Plan and Integrated Performance Assessment and Assurance Framework with an increased focus on neonatal services. It is essential the health board does not lose sight of these areas over the coming months although I fully appreciate that progress will be on a slower trajectory given the current circumstances.

In terms of the clinical review work, it is positive to hear that there are now six independent clinical teams undertaking reviews and the quality assurance process has been established. As I explained in my last statement, the first phase of clinical reviews will focus on the care of mothers and babies between 01 January 2016 and 30 September 2018. Advocacy support through the Cwm Taf Morgannwg Community Health Council remains available for women and families whose care is being reviewed. I want to thank the women and families who have come forward already to share their story. It is vital their voices remain at the centre of the clinical reviews and the wider improvement work.

I understand the Panel has updated its Clinical Review Strategy to take account of the learning from the programme to date, including feedback and findings from the pilot exercise that was completed at the start of this year. I look forward to receiving further updates on this work in due course.

The Panel has proposed that in view of the progress which is being made within maternity services that the reporting cycle be extended to six months. I have accepted this recommendation and can confirm that I will be publishing their next report at the end of September 2020. I will of course update Members should there be anything further to report prior to this.

Importantly, the learning from maternity is also informing the wider organisational improvement needed following the organisation’s escalation to targeted intervention. We had previously determined that improvement was required in three key areas: quality and governance; leadership and culture; and rebuilding trust and confidence. This aligns with the recommendations from the Healthcare Inspectorate Wales and Wales Audit Office joint review of the health board’s quality governance arrangements. As with maternity, a maturity matrix approach has been agreed to track and evidence improvement. A number of actions were already well in train including the introduction of a new values and behaviours framework and the new operating model. Despite early progress being made in many areas, it has clearly been essential for the health board to focus its efforts on preparing and managing the impact of the COVID-19 outbreak in recent weeks. However, whilst this may impact on the pace of change I’m confident that the Board is committed to do all that is needed to be a truly quality driven organisation. That is the only outcome that is acceptable to me.

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