The Atlas of Shared Learning

Case study

Seeking maternity feedback to improve care

Leading Change

Midwives at the Pennine Acute Hospitals, Royal Oldham Hospital site lead a project to increase and strengthen how feedback is used to drive forward quality improvement within their maternity services.

Where to look

Following a regulatory Care Quality Commission inspection in 2016, Pennine Acute Hospitals reviewed their engagement with maternity service users and staff. The review identified that women’s feedback and experiences could be used more effectively to shape maternity services and drive forward quality improvements generally. Midwives worked closely with Trust colleagues to lead the introduction of new ways to engage with patients and use the information more effectively.

What to change

Evidence suggests that evaluating patients’ experiences in healthcare can provide opportunities to improve informed decision-making, reduce cost and meet expectations (Al-Abri, Al-Balushi 2014). Pennine Acute Hospital has historically relied heavily on the wide-ranging and well-established Friends and Family Test (FFT) for women’s feedback, however formal qualitative data wasn’t available using this method alone. The review undertaken highlighted other opportunities to use women’s thoughts and feelings to improve maternity services.

How to change

Pennine Acute Hospital secured a six-month trial with Care Opinion, a platform for users of healthcare to ‘tell their story’. Patients gave anonymous feedback online, via a leaflet or over the phone. To implement the pilot, a midwife was seconded to lead on patient experience, their role is to collate feedback from the women and their families about our services and triangulate it against other data the Trust held. This data was then used to recommend and roll out changes within services based on the feedback received. Using social media, notice boards in staff areas and a personal approach to staff, the midwife raised awareness of the projects and its aims. These systems were also used to keep staff up to date with feedback and changes. In addition, the Patient Experience Midwife:

  • Supported Band 2-4 Trust staff to become FFT Champions to increase the trust’s response rate
  • Initiated a Maternity Quality Improvement Forum utilising patient feedback to drive quality improvements in services. The panel includes midwifery managers, midwives, women and a local HealthWatch representative
  • Held a listening and engagement event
  • Introduced the NHS England Maternity Bereavement Toolkit into practice
  • Produced a monthly Patient Experience Report which was shared across the midwifery team.

Adding value

Better outcomes – Approximately 200 patient stories have been received via Care Opinion following the implementation of the project with 95% of these showing positive responses to the service. These have themselves go onto direct further improvements needed in care and service delivery

Better experience – Sharing positive stories has boosted staff morale, and the bespoke patient experience role is recognised as a positive influence. Patients are more empowered to give feedback. Examples of improvements include:

  • Chairs in the antenatal clinic were reported as uncomfortable for women with pelvic girdle pain. New ones were provided and the improvement is noted by patients using the service.
  • The antenatal clinic environment has been altered to improve privacy and dignity following feedback from a patient.

Better use of resources – Midwives are supported to deal with patient feedback concerns quickly and efficiently because of the project which means real time improvement in the quality of the patients experience and a reduction in the likelihood of patients feeling it necessary to raise formal complaints.

Challenges and lessons learnt

  • The midwifery team have an increased understanding of the value and power of women’s feedback which is positive following the project which is invaluable.
  • Concern regarding change and possible negative feedback was a challenge initially, but patient stories are now viewed as a positive influence for change and supportive of reflective practice
  • Social media has proved to be a vital tool in sharing women’s feedback with midwives, the public and the wider Pennine Acute Hospital staff team
  • The Patient Experience Midwife role has been so successful that it has now been made permanent role at Pennine Acute Hospital with further engagement events planned.

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