Issue - meetings

28.1     The Committee considered a report by the Assistant Chief Executive providing an update from High Weald Lewes Havens (HWLH) CCG on maternity pathways in the High Weald.

28.2     Ashley Scarff and Richard Hallett also provided presentations to the Committee.

28.3     Ashley Scarff added that the patient records used in Crowborough Birth Centre will not be the same format as Pembury Hospital, Tunbridge Wells, but there will be fewer differences between the formats in future. Maidstone and Tunbridge Wells NHS Trust (MTW) and ESHT use the same ICT system but they use different versions of it; in the coming months they will go onto the same version which will also reduce the differences between patient records.

28.4     The Committee RESOLVED that it had considered and commented on the report and its appendices.

Report by the Assistant Chief Executive

To consider a progress report on the implementation of the service reconfiguration.

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38.1     The Committee considered a report of the Assistant Chief Executive updating it on the implementation of decisions made by East Sussex CCGs in relation to the configuration of maternity, paediatric and gynaecology services provided by ESHT.

Maternity pathways

38.2     In response to questions from HOSC there emerged the following clarifications and responses relating to maternity pathways:

• ESHT stated that it is examining the viability of providing sonography from the Crowborough Birthing Centre (CBC). However, there is a limited number of sonographers in East Sussex, meaning that ESHT will need to be first be certain that the availability of sonography to women elsewhere in the county would not compromised by opening a new service at the CBC.
• ESHT said that sonography at CBC will be dependent on cross-trust working, so firm dates for the start of a sonography service will require further discussion with the new Head of Midwifery at Maidstone and Tunbridge Wells NHS Trust (MTW) when they are in post and agreement over cross-border working.

• ESHT explained that it has developed pathways for cross-border working that work well, for example, women in the Seaford area wanting to use maternity services provided by Brighton & Sussex University Hospitals NHS Trust (BSUH) are able to access the Trust’s services seamlessly. ESHT intends to try to adopt the same model of cross-border working for maternity services in the North Weald area.
• ESHT stated that it is in the process of negotiating cross-border pathways with MTW. However, the situation had become challenging because MTW had not accepted ESHT’s proposed pathways. ESHT stated that discussions were progressing and that it was confident that it could satisfactorily address the outstanding problems given that it has the same aims as MTW. Further discussion will occur with the new Head of Midwifery at MTW.
• The HWLH CCG considered that if MTW were to take over maternity services at Crowborough, the ‘border’ (between MTW and ESHT) would ‘move south’ and simply displace any outstanding pathway problem to another geographical location. (However, HOSC considered that such a move would probably result in a more “natural” border were this to happen which would be welcome).

Serious incidents data (p53)

38.3     HOSC expressed concern at the serious incidents data. In response to questions from HOSC there emerged the following clarifications and responses:

• The CCGs acknowledged that the very small number of serious incidents made it difficult to demonstrate statistically significant impacts on safety since the reconfiguration. However, they had been looking at the pattern and nature of serious incidents, rather than just the number, and prior to the temporary reconfiguration a pattern of failure had begun to emerge that looked as though it would worsen unless the temporary reconfiguration was put in place. Since the reconfiguration, the pattern of serious incidents indicated that there had been improvements in safety.
• ESHT said that there is a clear national definition of a “serious incident”, for example, the admission of a baby or mother to intensive care, meaning  ...  view the full minutes text for item 38