Maternity Services Real World Coproduction Workshop Project Report

Healthwatch Sandwell facilitated three Real World Coproduction workshops between July 2017 and March 2018 with maternity services at City Hospital, part of Sandwell and West Birmingham Hospitals NHS Trust. The workshops brought together women, their partners, frontline staff, and managers to share experiences of maternity care and develop practical suggestions for service improvement. More than 40 people participated, and over 30 ideas for improvement were generated. 

The workshops examined three stages of the maternity pathway: access to maternity services up to 24 weeks of pregnancy, care between the first appointment and birth, and the birth experience itself. Participants also identified examples of good practice that should be maintained. 

For early access to maternity services, participants highlighted the need for greater awareness that pregnant women can self-refer directly to maternity services without first visiting a GP. Suggested actions included providing information in GP practices, educating reception staff, and placing information alongside pregnancy testing kits. Participants also proposed reminder calls from interpreters to reinforce the importance of attending early maternity appointments and recommended that community midwives provide clearer information about available choices of maternity services and locations. 

For the period between the first appointment and birth, participants identified several "quick wins" to improve communication and patient experience. These included providing clearer appointment information, offering an overview of the pregnancy care pathway, improving signposting to online information, keeping contact details for midwives up to date, and improving signage to maternity services, clinics, delivery suites, and the Serenity unit. Participants also raised concerns about temporary blood clinic closures and recommended better communication with patients when disruptions occur. 

Workshop attendees highlighted several areas where they believed existing procedures should already be happening consistently, including providing clear explanations about care and tests, ensuring consistent advice from midwives, and listening to patients' wishes and preferences. Additional suggestions included improving continuity of care by reducing the number of different midwives involved in a woman's care, improving referral pathways, and supporting better sharing of maternity records between hospitals.

Discussions about the birth experience identified further improvements, including checking women in triage more regularly, following up missed or cancelled appointments, providing tours of the Serenity unit for high-risk mothers, and avoiding assumptions about the knowledge of women who have previously given birth. Participants also noted that waiting times in triage should already be displayed consistently. 

One aspect of care identified as particularly good practice was the breastfeeding support offered to mothers when they were tired, which participants felt should continue.

Feedback on the workshops was overwhelmingly positive, with all participants rating them as either good or excellent. Participants valued having their views listened to, hearing different perspectives, identifying service gaps, and seeing that patient experiences were being taken seriously. Many commented that the sessions were productive and should continue. 

Overall, the project demonstrated that co-production involving service users, families, staff, and managers can generate practical and patient-focused ideas for improving maternity services, while also highlighting existing strengths within the service.