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NHS North Tyneside CCG. Maternity care research . September 2013. Delivered by Joanne Loughlin-Ridley. Project background . This section of the report provides detail on the research objectives, methodology and sample, providing context behind the insight. . Project background. - PowerPoint PPT Presentation
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NHS North Tyneside CCGMaternity care research
September 2013Delivered by Joanne Loughlin-Ridley
Project background This section of the report provides detail on the research objectives, methodology and sample, providing context behind the insight.
• Explain was commissioned in early 2012 by NHS North of Tyne to carry out a comprehensive evaluation of maternity care services across the North East
• The research detailed within this report aimed to build upon the qualitative insight that was completed and delivered to NHS North of Tyne in April 2012
• An on-street survey was commissioned by NHS North Tyneside CCG, to engage a random sample of local ‘mothers’ and ‘future mothers’– ‘Mothers’ includes women whose youngest child is five years or younger, and ‘future mothers’
includes pregnant women and those without children that plan to have a family of their own in the future
– Quotas / targets were set for the survey sample based on age using the most up to date birth data available publically
• Fieldwork took place across a four week period, ending in early September 2013. Alongside the on-street approach, researchers were able to flexibly attend relevant sessions at local children’s centers as a means to gain access to the eligible target audience
Project background
• As with any data collection where a sample is drawn to represent a population, there is a potential difference between the response from the sample and the true situation in the population as a whole (a census). This is known as a standard error which is estimated using statistical calculations based on the sample size and the population size, normally expressed as a confidence interval for the results
• To achieve 100% accuracy in results would require the entire population to participate (a census). The usual confidence interval used in market research is 95% which means that you can be confident that in 19 out of 20 instances the actual population behaviour will be within the confidence interval range. The table below gives an indication of the 95% confidence interval for the data within this report at different sample sizes
• For example, if a result was 50% we can be confident that the true result if a census was completed for an 1100 sample survey would be actually ±3.0 (therefore between 47% - 53%)
• Please also note that respondents that did not or could not answer a question were removed from the data and therefore the base size in charts fluctuates from question to question
Project background
Sample size 95% Confidence IntervalSample: 1100 ±3.0Sample: 600 ±4.0
Sample: 500 ±4.4
Sub-Sample: 100 ±9.8
Sub-Sample: 70 ±11.7
• 1,145 took part in the on-street survey, including 595 mothers and 553 future mothers
• 4% of mothers and future mothers indicated they suffered a long-term illness / disability• 7% of future mothers were pregnant at the point of interview• 46% of mothers had only one child, meaning 54% were ‘multiple mothers’ • 75% of mothers had a youngest child under 24 months,
Project background
16-19 20-29 30+ White - UK ABC1 C2DEAge Ethnicity Socio-economic group
26%
49%
26%
96%
38%
62%
46% 48%
6%
97%
42%
58%
7%
49%44%
96%
35%
65%
Overall (1144) Future mothers (552) Mothers (592)
• Whilst a target was set for an equal proportion of interviews to be carried out across the four areas within North Tyneside, researchers found it challenging to locate eligible women to take part in the North West area specifically
• Analysis has revealed interesting variations in response when comparing residents from the West (North West and South West) to the East (North East and South East) and so throughout this report comparisons are made on this basis
Project background
North West North East South East South WestArea of residence
11%
26%
34%
29%
11%
27%
32%30%
12%
24%
37%
28%
Overall (1139-1145) Future mothers (551-553) Mothers (588-592)
Antenatal careWithin this section of the report you will find details as to the quantitative insight generated from the mothers research which focused on antenatal care. Please note that future mothers were not asked questions relating to antenatal care on the basis that previous insight had confirmed a lack of knowledge and therefore expectations.
• The majority of mothers had experienced their most recent antenatal care in North Tyneside
• Mothers were asked to indicate in their own words, the ONE thing that could have been changed about their antenatal care experience that would have made it better
• Unprompted there was no evidence of a consistent area to improve and no significant variation found between care in Newcastle, North Tyneside and Northumberland
Antenatal care
Nothing /unsure(306 = 52%)
More appointments
(39 = 7%)
More information
(28 = 5%)
Attitude of staff (22 = 4%)
More hospital checks/scans
(21 = 4%)
More support/advice
(15 = 3%)
Closer to home(13 = 2%)
See same midwife
(13 = 2%)
Newcastle North Tyneside NorthumberlandWhere antenatal care had been previously experienced (Mothers overall 593)
35%
63%
3%
Antenatal care
‘Better staff, as they are not very friendly’
‘More classes throughout pregnancy, start them at an earlier stage of
pregnancy’
‘A consistent midwife
throughout pregnancy’
‘Every time I tried to discuss the
birthing plan it was put off’
‘It would have been better to stay at North Tyneside as I was taken
from hospital to hospital’
‘For someone to see me close to home’
‘Have more scans when you have complications’
‘More information in early stages and
more check ups’
Nothing /unsure(306 = 52%)
More appointments
(39 = 7%)
More information
(28 = 5%)
Attitude of staff (22 = 4%)
More hospital checks/scans
(21 = 4%)
More support/advice
(15 = 3%)
Closer to home(13 = 2%)
See same midwife
(13 = 2%)
• A series of statements were given to mothers for them to rate their level of agreement using a scale of 1 to 10 (1 was ‘Strongly disagree’ and 10 was ‘Strongly agree’)
• No significant variations were found by age, socio-economic group, number of children or where previous experience of antenatal care had been
Antenatal care
I w
I w
I w
I w
I w
Ante
nata
l car
e (m
othe
rs o
vera
l...
7.63
7.73
8.96
9.32
9.35000000000001
• When comparing responses from mothers that lived in the West to those that lived in the East, across three of the statements shown below there was significant variation found with mothers in the West more likely to ‘strongly agree’ and give 10 out of 10
Antenatal care
I w
I w
I w
Stro
ngly
agr
eed
(10
out .
..
60%
70%
65%
75%
80%
84%
66%
74%
72%
Mothers overall (591) West (234) East (357)
*significant variations are circled in the graph
• Mothers were then asked to indicate from a showcard, which of the following were MOST and LEAST important to them overall in regards to antenatal care
• With the exception of mothers aged 16-19, all profiles rated ‘Partners being given advice and information to help them prepare’ to be the LEAST important overall– Least important to 16-19s was ‘Having opportunities to meet other mothers’ (48%)
Antenatal care
Seeing the same midwife at each routine check
For midwife appointments to be carried out in the local
community, e.g. GP surgery, children's centres
Access to advice 24 hours a day by telephone
Having opportunities to meet other mothers
Partners being given advice and information to help
them prepare
Level of importance
47%
29%
18%
3% 3%6%
2% 5%
37%
50%
Most important (591) Least important (589)
Seei
ng th
e sa
me
mid
wife
at
each
routi
ne ch
eck
For m
idw
ife a
ppoi
ntm
ents
to
be ca
rrie
d ou
t in
the
loca
l co
mm
unity
, e.g
. GP
surg
ery,
ch
ildre
n's c
entr
es
Havi
ng o
ppor
tuni
ties t
o m
eet
othe
r mot
hers
Part
ners
bei
ng g
iven
adv
ice
and
info
rmati
on to
hel
p th
em p
repa
re
MOST important LEAST important
47%
29%
37%
50%45%
36%
44%47%48%
24%
32%
52%
43%
30%
40%
45%
50%
28%
35%
55%55%
20%
41%44%
42%
33%35%
53%
Mothers overall (589-591) West (232-234) East (357) First time mothers (271) Multiple mothers (317-319) ABC1 (205)C2DE (380-382)
• Variation in response was found for four of the statements rated in terms of what was MOST and LEAST important, when comparing responses by the area of residence and the number of children mothers had
Antenatal care
Labour and delivery careWithin this section of the report you will find details as to the quantitative insight generated from the mothers and future mothers research which focused on labour and delivery care. Please note that the sample of mothers and future mothers has also been combined within this section to give indications of trends by profile on a large sample base of over 1,100.
• The majority of mothers had experienced their most recent labour and delivery care in Newcastle
• Mothers were asked to indicate in their own words, the ONE thing that could have been changed about their labour and delivery care experience that would have made it better
• Unprompted there was no evidence of a consistent area to improve
• Those that had their care in Northumberland were more likely to state ‘Closer to home’
Labour and delivery care
Nothing / unsure(268 = 45%)
Attitude of staff / communication
(60 = 10%)
More midwives(33 = 6%)
Facilities / hospital policies
(24 = 4%)
Early admittance (21 = 4%)
Pain relief choice / administration
(22 = 4%)
Same midwife (14 = 2%)
Closer to home(12 = 2%)
Caesarean(10 = 2%)
Newcastle North Tyneside NorthumberlandWhere labour and delivery care had been received previously (Mothers overall 593)
63%
25%
13%
Labour and delivery care
‘I would prefer a private room
next time’
‘Nicer midwives, they have bad manners’
‘Same midwife, I had 3 different
ones’
‘More staff to assist you to
be more supportive’
‘Not to be sent home when in
labour’
‘Have more pain relief ’
‘I would rather have been closer to home than going to Wansbeck’
‘Give me more time to give birth instead of getting a C section’
‘The same midwife throughout labour’
‘The staff didn't care about me they just left me to get on with it’
‘You shouldn't be sent home when your
waters have broke’
Nothing / unsure(268 = 45%)
Attitude of staff / communication
(60 = 10%)
More midwives(33 = 6%)
Facilities / hospital policies
(24 = 4%)
Early admittance (21 = 4%)
Pain relief choice / administration
(22 = 4%)
Same midwife (14 = 2%)
Closer to home(12 = 2%)
Caesarean(10 = 2%)
• A series of statements were given to mothers and future mothers for them to rate their level of agreement using a scale of 1 to 10 (1 was ‘Strongly disagree’ and 10 was ‘Strongly agree’)
Labour and delivery care
I w
I w
I w
I w
I w
I w
I w
I w
I w
I w
I w
I w
I w
I w
I w
I w
Labo
ur a
nd d
eliv
ery
care
(ove
rall
1135
...
6.10
7.04
7.20
7.43
7.59
7.70
7.85
8.15
8.31
8.84
8.91
8.98
9.05
9.18
9.48
9.56
I w
I w
I w
I w
I w
I w
I w
I w
I w
Stro
ngly
agr
ee (1
0 ou
t ...
43%
43%
52%
43%
56%
62%
66%
71%
66%
31%
37%
45%
49%
43%
40%
48%
62%
60%
36%
40%
49%
49%
49%
51%
57%
66%
63%
Overall (1135-1143) Mothers (584-591) Future mothers (550-552)
• Across ten of the statements there was variation evident between mothers and future mothers in terms of the proportion that ‘strongly agreed’ and gave 10 out of 10
Labour and delivery care
*significant variations are circled in the graph
I w
I w
I w
I w
I w
I w
Stro
ngly
disa
gree
(1 o
ut ..
.
9%
5%
7%
3%
3%
1%
14%
11%
14%
11%
11%
5%
11%
8%
11%
7%
7%
3%
Overall (1135-1143) Mothers (584-591) Future mothers (550-552)
• Across six of the statements there was also variation evident between mothers and future mothers in terms of the proportion that ‘strongly disagreed’ and gave 1 out of 10
Labour and delivery care
*significant variations are circled in the graph
I w
I w
I w
I w
I w
I w
I w
I w
I w
I w
I w
Stro
ngly
agr
ee (1
0 ou
t ...
40%
42%
44%
53%
62%
64%
56%
65%
68%
78%
77%
46%
58%
55%
64%
73%
75%
73%
78%
80%
88%
89%
42%
49%
49%
57%
66%
68%
63%
70%
73%
82%
82%
Overall (1135-1143) West (455-458) East (679-684)
• Across 11 of the statements a significantly higher proportion of mothers living in the West ‘strongly agreed’ and gave 10 out of 10
Labour and delivery care
*significant variations are circled in the graph
I wan
t to
be in
a se
rvice
dur-
ing
early
labo
ur in
stea
d of
w
aitin
g at
hom
e to
pro
gres
s
I wan
t my
care
to b
e le
d by
a
mid
wife
I wan
t the
sam
e m
idw
ife to
ca
re fo
r me
thro
ugho
ut m
y la
bour
and
del
iver
y
I wan
t all
optio
ns fo
r pai
n re
lief a
vaila
ble
shou
ld I
need
th
em o
r cha
nge
my
min
d
I wan
t doc
tors
and
spec
ial-
ists o
n-ha
nd in
the
sam
e bu
ildin
g sh
ould
I ne
ed th
em
Strongly agree (10 out 0f 10)
45%
60%
71%
82% 82%
48%
64%
74%
84% 86%
46%
55%
68%
82%77%
33%
51%
61%
73% 75%
Mothers (589-591) Previous experience in Newcastle (369-371) Previous experience in North Tyneside (145)Previous experience in Northumberland (79)
• Across five of the statements there was variation found in terms of the proportion that ‘strongly agreed’ and gave 10 out of 10, when looking at the response of mothers in terms of where they had most recently experienced labour and delivery care
Labour and delivery care
*significant variations are circled in the graph
I w
I w
I w
I w
Stro
ngly
agr
ee (1
0 ou
t ...
31%
39%
48%
60%
37%
53%
56%
67%
40%
57%
67%
71%
36%
51%
57%
66%
Overall (1135-1143) 16-19 (295) 20-29 (551-554) 30+ (292-293)
Labour and delivery care
• Across four of the statements a trend was found whereby the younger the respondent, the higher the proportion that ‘strongly agreed’ and gave 10 out of 10
*significant variations are circled in the graph
I w
I w
I w
I w
I w
I w
Stro
ngly
agr
ee (1
0 ou
t ...
34%
39%
46%
46%
48%
72%
40%
48%
53%
54%
55%
66%
36%
42%
49%
49%
51%
70%
Overall (1135-1143) ABC1 (432-434) C2DE (7698-701)
• Across six of the statements there was variation found by socio-economic group in terms of the proportion rating ‘strongly agree’ and giving 10 out of 10
Labour and delivery care
*significant variations are circled in the graph
I wan
t opp
ortu
nitie
s to
mee
t ot
her m
othe
rs, e
.g. c
omm
unca
l ki
tche
n, T
V ro
om
I wan
t to
stay
in a
serv
ice fo
r a
num
ber o
f day
s afte
r giv
ing
birt
h
I wan
t to
be in
a se
rvice
dur
ing
early
labo
ur in
stea
d of
wai
ting
at h
ome
to p
rogr
ess
I wan
t one
to o
ne su
ppor
t with
br
eastf
eedi
ng in
the
serv
ice
I wan
t my
part
ner t
o be
show
n ho
w to
care
for b
aby,
e.g
. ba
thin
g, n
appi
es, d
ress
ing
I wan
t to
be sh
own
how
to ca
re
for b
aby,
e.g
. bat
hing
, nap
pies
, dr
essin
g
Strongly disagree (1 out of 10)
11%10%
8%
11%
7% 7%7%6%
5%
8%
2%3%
14%13%
7%
13%
8% 8%
12%
9%
11%10%
11%10%
16%
11%10%
12%
7%8%8%
10%
6%
10%
7% 7%
9%10%
7% 7%
5%6%
13%
11%
8%
13%
8% 8%
Overall (1135-1143) 16-19 (293) 20-29 (551-554) 30+ (291-293) West (457) East (680)ABC1 (430-436) C2DE (701)
Labour and delivery care
• Across six of the statements variation was found by area of residence, age and socio-economic group in terms of the proportion that ‘strongly disagree’ and gave 1 out of 10
*significant variations are circled in the graph
• Mothers and future mothers were then asked to indicate from a showcard, which of the following were MOST and LEAST important overall in regards to labour and delivery care
Labour and delivery careSt
ayin
g in
a se
rvice
in e
arly
labo
ur ra
ther
than
wai
ting
at
hom
e to
pro
gres
s
Care
bei
ng le
d by
a m
idw
ife
Doct
ors a
nd sp
ecia
lists
on-
hand
in th
e sa
me
build
ing
shou
ld th
ey b
e ne
eded
The
sam
e m
idw
ife to
pro
vide
care
thro
ugho
ut th
e la
bour
an
d de
liver
y ex
perie
nce
Havi
ng a
ll pa
in re
lief o
ption
s ava
ilabl
e
Birt
hing
poo
l
The
serv
ice to
hav
e a
hom
ely
feel
rath
er th
an li
ke a
hos
pita
l
Priv
ate
room
with
en
suite
bat
hroo
m
Birt
hing
par
tner
to st
ay u
ntil d
ischa
rge,
inclu
ding
ove
rnig
ht
Bein
g sh
own
how
to ca
re fo
r the
bab
y, e
.g. B
athi
ng,
napp
ies,
dres
sing
Part
ner t
o be
show
n ho
w to
care
for t
he b
aby,
e.g
. Bat
hing
, na
ppie
s, dr
essin
g
One
to o
ne su
ppor
t with
bre
astfe
edin
g
Opp
ortu
nitie
s to
mee
t oth
er m
othe
rs, e
.g. C
omm
unca
l ki
tche
n, T
V ro
om
Stay
ing
in th
e se
rvice
for a
num
ber o
f day
s afte
r giv
ing
birt
h
Dedi
cate
d m
ater
nity
car p
arki
ng
Free
car p
arki
ng
Level of importance
12%
7%
33%
15% 14%
2% 2%1%
8%
2% 1% 2% 1% 0% 0% 1%5%
0% 0% 1% 0%
22%
1% 2% 1% 1% 2%4%
12%
5%
11%
32%
Most important (1137) Least important (1127)
Staying in a service in early labour rather than
waiting at home to progress
Birthing partner to stay until discharge, including
overnight
Staying in the service for a number of days after
giving birth
Opportunities to meet other mothers, e.g.
Communcal kitchen, TV room
Birthing pool Free car parking
MOST important LEAST important
12%
8%
5%
12%
22%
32%
11%9%
6%
9%
25%
34%
15%
7%
4%
13%
21%
32%
8% 7% 8%
13%
20%
29%
17%
5% 5%
16%
25% 26%
9% 10%
6%
9%
20%
35%
Overall 1127-1137) 16-19 (292) 20-29 (545-552) 30+ (290-293) West (451-457) East (675-679)
• Variation in response was found for six of the statements rated in terms of what was MOST and LEAST important, when comparing responses by age and area of residence
Labour and delivery care
*significant variations are circled in the graph
• Following a description of what it would mean to give birth at home, in a midwifery led unit, a maternity care unit and a birthing centre, mothers and future mothers were asked to indicate which option they would choose if giving birth in the future
• First time mothers were more likely than multiple mothers to opt for a ‘Birthing centre’ (21% V 13%), and were less likely to select ‘Home’ (8% V 13%)
• Respondents from the West were more likely to opt for a ‘Birthing centre’ (21% V 12%)
Labour and delivery care
Home Midwifery led unit Maternity care unit Birthing centreChoice of birth place
9%15%
61%
16%
6%
13%
67%
15%11%
17%
55%
17%
Overall (1123) Future mothers (542) Mothers (581)
*significant variations are circled in the graph
Labour and delivery care
Home (95 = 9% overall)
Midwifery led unit(169 = 15% overall)
Maternity care unit(682 = 61% overall)
Birthing centre (177 = 16% overall)
Comfortable / relaxing (63 = 66%)
• When asked to explain the reason for their choice, the following themes were found
Family to be there (15 = 16%)
Don’t like hospitals (7 = 7%)
Convenience (4 = 4%)
No intervention (3 = 3%)
Previous experience (2 = 2%)
Level of care / staff(51 = 30%)
Homely / relaxed (42 = 25%)
Previous experience (20 = 12%)
Facilities (28 = 17%)
Closer to home (21 = 12%)
Recommended (10 = 6%)
Clinical staff on-hand (189 = 28%)
No choice (risk) (46 = 7%)
Previous experience (30 = 4%)
The ‘norm’ (8 = 1%)
Recommendation (10 = 1%)
Atmosphere (53 = 30%)
Just ‘in case’ (22 = 12%)
Previous experience (21 = 12%)
Level of care / staff (18 = 10%)
Natural (8 = 5%)
Partner can stay (7 = 4%)
Recommendation (3 = 2%)
Private (4 = 2%)
Facilities (23 = 13%) Just ‘in case’ (185 = 27%)
Facilities (120 = 18%)
Pain relief (97 = 14%)
Convenience (13 = 2%)
Labour and delivery care
Home (95 = 9% overall)
Midwifery led unit(169 = 15% overall)
Maternity care unit(682 = 61% overall)
Birthing centre (177 = 16% overall)
Comfortable / relaxing (63 = 66%)
• When asked to explain the reason for their choice, the following themes were found
Clinical staff on-hand (189 = 28%)
Atmosphere (53 = 30%)
Just ‘in case’ (185 = 27%)
‘It is more natural and
homely’
‘It will be more comfortable at
home’
‘There is more one to one support’
‘There are doctors on duty’
‘It is more relaxed at
home’
‘I would feel more comfortable having
family with me’
‘It was comfortable and has brilliant staff, it wasn't like a cattle
market’
‘It has a homely feel and a nicer environment’
‘There are doctors there ’
‘I would feel safer’
‘In case something goes wrong ’
‘It is a more relaxing place’
‘It has a more relaxed atmosphere
and it is more like home’
‘They are more caring’
Level of care / staff(51 = 30%)
Homely / relaxed (42 = 25%)
Labour and delivery care
Not a home birth(1028 = 92%)
Not a midwifery led unit (954 = 85%)
Not a maternity care unit (441 = 39% )
Not a birthing centre (946 = 84% )
• When asked why they would not choose the other options, the following themes were found
Just ‘in case’ (448 = 44%)
No clinicians (92 = 9%)
Pain relief (73 = 7%)
Scared (62 = 6%)
Messy (60 = 6%)
Couldn’t (40 = 4%)
Inconvenient (35 = 3%)
Unsure (80 = 8%)
No equipment (36 = 4%)
Transfer time (32 = 3%)
Not sterile (31 = 3%)
Negative (31 = 3%)
Pain relief (266 = 28%)
No clinicians (161 = 17%)
Transfer (80 = 8%)
Dislike hospitals (45 = 5%)
Facilities / equipment(45 = 5%)
Couldn’t (40 = 4%)
Just ‘in case’ (38 = 4%)
Prefer hospital (27 = 3%)
Not 1st choice (16 = 2%)
One to one care (11 = 1%)
Dislike hospitals (98 = 22%)
Unsure (90 = 20%)
Too busy (86 = 20%)
Impersonal care (39 = 9%)
Not 1st choice (32 = 7%)
Unnecessary (21 = 5%)
Too far away (16 = 4%)
Unsure (192= 20%)
No clinicians (90 = 10%)
Pain relief (50 = 5%)
Prefer hospital (30 = 3%)
Transfer (51 = 5%)
Unfamiliar (39 = 4%)
Not 1st choice (18 = 2%)
Just ‘in case’ (18 = 2%)
Facilities (27 = 3%)
Dislike hospitals (39 = 4%)
Couldn’t (22 = 2%)
Too far away (17 = 2%)
Labour and delivery care
• When asked why they would not choose the other options, the following themes were found
Just ‘in case’ (448 = 44%) Pain relief (266 = 28%)
No clinicians (161 = 17%)
Dislike hospitals (98 = 22%)
Unsure (90 = 20%)
Too busy (86 = 20%)
Unsure (192= 20%)
No clinicians (90 = 10%)
‘No reason’
‘It is too clinical ’
‘I don't think it is as safe ’ ‘Limited pain control’
‘I would be scared things
would go wrong ’
‘In case things went wrong’
‘In case of any complications’
‘There is not enough pain relief’
‘Not enough medical back up staff if needed’
‘There are no doctors ’
‘It is a hospital environment’
‘No reason’
‘It is too busy’
‘There is no doctor on duty, would not
feel as safe’
‘There are no doctors there’
‘It is too busy it is like a cattle market ’
‘There are not as many medical staff ’
‘The staff are not experienced enough’
Not a home birth(1028 = 92%)
Not a midwifery led unit (954 = 85%)
Not a maternity care unit (441 = 39% )
Not a birthing centre (946 = 84% )
• When provided with a list of current options in the North East, the RVI’s maternity care unit was found to be most preferable by both mothers and future mothers
• First time mothers were more likely than multiple mothers to opt for ‘Birthing centre – RVI’ (21% V 15%)
• There was no significant variation found by age when comparing responses
Labour and delivery care
Hom
e
Mid
wife
ry le
d un
it -
Rake
Lane
, Nor
th
Shie
lds
Mat
erni
ty ca
re u
nit -
W
ansb
eck,
Ash
ingt
on
Mat
erni
ty ca
re u
nit -
RV
I, Ne
wca
stle
Mat
erni
ty ca
re u
nit -
Cr
amlin
gton
(due
to
open
in 2
015)
Birt
hing
cent
re -
RVI,
New
cast
le
Specific choice of birth place
7%
22%
6%
49%
2%
15%
6%
21%
4%
54%
2%
13%9%
22%
7%
43%
1%
18%
Overall (1141) Future mothers (551) Mothers (590)
*significant variations are circled in the graph
• When comparing choice of service type by the location of the mothers most recent experience of labour and delivery care, variation was found
• Mothers that most recently experienced labour and delivery care in North Tyneside were more likely to opt for a ‘Midwifery led unit’ and were less likely to opt for a ‘Maternity care unit’
• Mothers that most recently experienced labour and delivery care in Newcastle, were more likely to opt for a ‘Birthing Centre’
Home Midwifery led unit Maternity care unit Birthing centreChoice of birth place
11%
17%
55%
17%
9%11%
57%
23%
12%
29%
50%
8%
13%
23%
60%
4%
Mothers overall (581) Previous experience in Newcastle (363)Previous experience in North Tyneside (145) Previous experience in Northumberland (77)
Labour and delivery care
*significant variations are circled in the graph
Home Midwifery led unit - Rake Lane, North
Shields
Maternity care unit - Wansbeck, Ashington
Maternity care unit - RVI, Newcastle
Maternity care unit - Cramlington (due to
open in 2015)
Birthing centre - RVI, Newcastle
Specific choice of birth place
7%
22%
6%
49%
2%
15%
8%13%
1%
56%
1%
20%
7%
27%
9%
43%
2%
12%
6%
25%
7%
46%
1%
17%
8%
20%
5%
51%
2%
14%
Overall (1141) West (458) East (664) ABC1 (435) C2DE (701)
• Comparing response by area of residence and socio-economic group revealed variation
Labour and delivery care
*significant variations are circled in the graph
Labour and delivery care
• When asked why they had chosen that specific option, the following themes were found
RVI, maternity care unit (553 = 49%)
Rake Lane, midwifery led unit
(248 = 22%)
RVI, birthing centre (172 = 15%)
Home (83 = 7%)
Wansbeck, maternity care unit
(67 = 6%)
Cramlington, maternity care unit
(17 = 2%)
Past experience / familiarity (47 = 19%)
Recommendation (12 = 5%)
Past experience / familiarity (24 = 14%)
Quality of care (10 = 6%)
Good reputation (15 = 9%)
Partners can stay (3 = 2%)
Close to home (137 = 55%)
Atmosphere (29 = 12%)
Close to home (9 = 5%)
Atmosphere (35 = 20%)
Only birthing centre (11 = 6%)
Clinicians nearby (16 = 9%)
Quality of care (41 = 17%)
Comfortable / relaxing (68 = 82%)
Family can be there (9 = 11%)
Previous experience / familiarity (42 = 63%
Close to home (14 = 21%
Reputation / better than others (10 = 15%
Clinicians on-hand (6 = 9%
It’s a new unit (10 = 59%)
Close to home (9 = 53%
Specialists / doctors on-hand (56 = 10%)
Big / good hospital (55 = 10%)
Previous experience / familiarity (55 = 10%)
Safer (26 = 5%)
Good reputation / better than others (85 = 15%)
Facilities (67 = 12%)
Quality of care (40 = 7%)
Close to home (54 = 10%)
Labour and delivery care
• When asked why they had chosen that specific option, the following themes were found
RVI, maternity care unit (553 = 49%)
Rake Lane, midwifery led unit
(248 = 22%)
RVI, birthing centre (172 = 15%)
Home (83 = 7%)
Wansbeck, maternity care unit
(67 = 6%)
Cramlington, maternity care unit
(17 = 2%)
Specialists / doctors on-hand (56 = 10%)
Big / good hospital (55 = 10%)
Previous experience / familiarity (55 = 10%)
‘Family had their babies there, they say it's good and
it has a better reputation’
‘It is a better hospital overall’
‘Rake lane has a bad reputation’
‘There are doctors on hand if needed’
‘They have excellent
staff’
‘Excellent after care’
‘Has everything on hand’
‘I had a good experience the first time’
‘I would feel safe’
‘It has got all the
things you need’
‘It is the closest maternity care
hospital’
‘It is a bigger hospital’
‘It is the best
option’
Good reputation / better than others (85 = 15%)
Facilities (67 = 12%)
Quality of care (40 = 7%)
Close to home (54 = 10%)
Safer (26 = 5%)
• The maternity care unit at the RVI was also most preferred for mothers and future mothers, should they need to stay within a service for several days following delivery
• First time mothers were more likely than multiple mothers to opt for ‘Birthing centre – RVI’ (12% V 7%), whilst being less likely to opt for ‘Maternity care unit – RVI’ (53% V 63%)
• There was no significant variation found by age or SEG when comparing responses
Mid
wife
ry le
d un
it - R
ake
Lane
, Nor
th S
hiel
ds
Mat
erni
ty ca
re u
nit -
W
ansb
eck,
Ash
ingt
on
Mat
erni
ty ca
re u
nit -
RVI
, Ne
wca
stle
Mat
erni
ty ca
re u
nit -
Cra
m-lin
gton
(due
to o
pen
in
2015
)
Birt
hing
cent
re -
RVI,
New
cast
le
Choice of aftercare, if required to stay in a service
20%
7%
61%
3%8%
20%
5%
64%
4%7%
20%
9%
58%
3%9%
Overall (1141) Future mothers (553) Mothers (588)
Labour and delivery care
*significant variations are circled in the graph
• When comparing specific choice of service by the location of the mothers most recent experience of labour and delivery care, variation was found
• Mothers that most recently experienced labour and delivery care in North Tyneside were more likely to opt for ‘Rake Lane’
• Mothers that most recently experienced labour and delivery care in Newcastle, were more likely to opt for a ‘RVI – maternity’ and ‘RVI – birthing centre’
• Mothers that most recently experienced labour and delivery care in Northumberland, were more likely to opt for ‘Wansbeck’
Home Midwifery led unit - Rake Lane, North
Shields
Maternity care unit - Wansbeck, Ashington
Maternity care unit - RVI, Newcastle
Maternity care unit - Cramlington (due to
open in 2015)
Birthing centre - RVI, Newcastle
Specific choice of birth place
9%
22%
7%
43%
1%
18%
8%11%
2%
56%
0%
24%
10%
48%
8%
25%
1%
8%11%
27%
34%
18%
5% 5%
Mothers (590) Previous experience in Newcastle (371)Previous experience in North Tyneside (144) Previous experience in Northumberland (79)
Labour and delivery care
*significant variations are circled in the graph
Mid
wife
ry le
d un
it -
Rake
Lane
, Nor
th
Shie
lds
Mat
erni
ty ca
re u
nit -
W
ansb
eck,
Ash
ingt
on
Mat
erni
ty ca
re u
nit -
RV
I, Ne
wca
stle
Mat
erni
ty ca
re u
nit -
Cr
amlin
gton
(due
to
open
in 2
015)
Birt
hing
cent
re -
RVI,
New
cast
le
Choice of aftercare, if required to stay in a service
20%
7%
61%
3%8%
14%
2%
69%
3%
12%
24%
11%
56%
3%6%
Overall (1141) West (458) East (682)
• There was variation evidence in choice of service when comparing responses by area of residence
• Significantly more respondents living in the East opted for ‘Rake Lane’ and ‘Wansbeck’
• Significantly more respondents living in the West opted for the ‘RVI’ (maternity care unit and birthing centre)
Labour and delivery care
*significant variations are circled in the graph
Labour and delivery care
• When asked why they had chosen that specific option, the following themes were found
RVI, maternity care unit (694 = 61%)
Rake Lane, midwifery led unit
(229 = 20%)
RVI, birthing centre (94 = 8%)
Wansbeck, maternity care unit
(83 = 7%)
Cramlington, maternity care unit
(35 = 3%)
Good reputation / better than others (150 = 22%)
Previous experience / familiarity (68 = 10%)
Quality of care (57 = 8%)
Specialists / doctors on-hand (188 = 27%)
Facilities (144 = 21%)
Close to home (84 = 12%)
Atmosphere (6 = 1%)
Atmosphere (39 = 16%)
Previous experience / familiarity (27 = 11%)
Quality of care (27 = 11%)
Close to home (149 = 60%)
Facilities (14 = 6%)
Quality of care (14 = 15%)
Atmosphere (35 = 37%)
Good reputation (8 = 9%)
Clinicians nearby (26 = 28%)
Only birthing centre (8 = 9%)
Close to home (16 = 19%)
Quality of care (14 = 17%)
Previous experience / familiarity (18 = 22%)
Atmosphere (14 = 17%)
Specialists / doctors on-hand (16= 46%)
Close to home (7 = 20%)
It’s a new unit (4 = 11%)
Specialists / doctors on-hand (12= 14%)
Labour and delivery care
• When asked why they had chosen that specific option, the following themes were found
RVI, maternity care unit (694 = 61%)
Rake Lane, midwifery led unit
(229 = 20%)
RVI, birthing centre (94 = 8%)
Wansbeck, maternity care unit
(83 = 7%)
Cramlington, maternity care unit
(35 = 3%)
Good reputation / better than others (150 = 22%)
Previous experience / familiarity (68 = 10%)
Quality of care (57 = 8%)
Specialists / doctors on-hand (188 = 27%)
Facilities (144 = 21%)
Close to home (84 = 12%)
Atmosphere (6 = 1%)
‘There are more doctors there ’
‘There are specialists on
hand’
‘It has the best reputation ’
‘It is a better hospital ’
‘There are more specialist staff
‘They have everything there’
‘It has everything you need ’
Postnatal careWithin this section of the report you will find details as to the quantitative insight generated from the mothers research which focused on postnatal care. Please note that future mothers were not asked questions relating to postnatal care on the basis that previous insight had confirmed a lack of knowledge and therefore expectations.
• The majority of mothers had experienced their most recent postnatal care in North Tyneside
• Mothers were asked to indicate in their own words, the ONE thing that could have been changed about their postnatal care experience that would have made it better
• Unprompted there was no evidence of a consistent area to improve and no significant variation found between care in Newcastle, North Tyneside and Northumberland
Postnatal care
Nothing / unsure(293 = 49%)
More advice/support/information
(56 = 9%)
Earlier follow-ups / longer visits
(51 = 9%)
Staff attitude / training (24 = 4%)
Same midwife / health visitor
(23 = 4%)
Hospital policies(21 = 4%)
Newcastle North Tyneside NorthumberlandWhere postnatal care had been received previously (Mothers overall 593)
31%
66%
4%
Postnatal care
‘Friendly midwife where you can feel comfortable with them
as they are the same one’
‘I was left on my own, there was no space in Rake Lane for
me, more help with breastfeeding’
‘At the RVI I didn't like being
on ward, I could not relax’
‘More health visits after you get home’
‘To see the midwife for a longer period of time at home’
‘To be more aware of where I can get
help after the birth’
‘Midwife to be more
caring after I got home’
‘For the midwives to be more pleasant and to give more
hands on help’
‘To see the same midwife each time would be better’
‘Just being allowed visitors anytime’
‘For my partner to be able to stay with me
longer after the baby is born’
‘Help with breast feeding’
Nothing / unsure(293 = 49%)
More advice/support/information
(56 = 9%)
Earlier follow-ups / longer visits
(51 = 9%)
Staff attitude / training (24 = 4%)
Same midwife / health visitor
(23 = 4%)
Hospital policies(21 = 4%)
• A series of statements were given to mothers for them to rate their level of agreement using a scale of 1 to 10 (1 was ‘Strongly disagree’ and 10 was ‘Strongly agree’)
• There was no significant variations found by age or where the mothers had previously experienced postnatal care from
Postnatal care
I w
I w
I w
I w
I w
I w
Aft
Post
nata
l car
e (m
othe
rs o
vera
ll 58
...
6.72
6.74
6.92
7.37
9.08
9.13
9.36000000000001
I wan
t gro
up su
ppor
t with
br
eastf
eedi
ng w
here
I ca
n m
eet
othe
r mot
hers
I wan
t my
part
ner t
o be
giv
en
advi
ce a
nd in
form
ation
to h
elp
them
care
for t
he b
aby
I wan
t one
to o
ne su
ppor
t with
br
eastf
eedi
ng
I wan
t the
sam
e he
alth
pro-
fess
iona
l to
visit
my
hom
e fo
r ro
utine
chec
ks e
ach
time
After
hom
e vi
sits s
top
I wan
t ap
poin
tmen
ts to
be
carr
ied
out
with
in th
e lo
cal c
omm
unity
su
ch a
s bab
y w
eigh
-in cl
inics
Strongly agree (10 out of 10)
34% 36%
44%
66%71%
34%38%
49%
73%
83%
34% 35%41%
61% 63%
38% 40%
50%
65%71%
30% 32%
39%
66%71%
38% 40%
51%
68%71%
31%34%
40%
64%
71%
Mothers overall (589-592) West (232-234) East (356-358) First time mothers (270-272) Multiple mothers (317-319) ABC1 (205) C2DE (380-383)
• Across five of the statements variation was found by area of residence, socio-economic group and number of children mothers had, in terms of the proportion that ‘strongly agreed’ and gave 10 out of 10
Postnatal care
*significant variations are circled in the graph
I wan
t opp
ortu
nitie
s to
mee
t ot
her m
othe
rs
I wan
t gro
up su
ppor
t with
bre
ast-
feed
ing
whe
re I
can
mee
t oth
er
mot
hers
I wan
t my
part
ner t
o be
giv
en a
d-vi
ce a
nd in
form
ation
to h
elp
them
ca
re fo
r the
bab
y
I wan
t one
to o
ne su
ppor
t with
br
eastf
eedi
ng
Strongly disagree (1 out of 10)
14%
17%
14% 14%
20%
17%
14%
12%11%
17%
15% 15%
11%
13%12%
10%
17%
20%
17% 17%
10%
13%
11%
9%
17%
20%
17% 17%
Mothers overall (590-592) West (232-234) East (356-358) First time mothers (270-272) Multiple mothers (317-319) ABC1 (204-205) C2DE (380-383)
• Across five of the statements variation was found by area of residence, socio-economic group and number of children mothers had, in terms of the proportion that ‘strongly disagreed’ and gave 1 out of 10
Postnatal care
*significant variations are circled in the graph
• Mothers were then asked to indicate from a showcard, which of the following were MOST and LEAST important to them overall in regards to antenatal care
• With the exception of mothers living in the West, all profiles rated ‘Partners being given advice and information to help them care for the baby’ to be the LEAST important overall– Least important to mothers from the West was ‘Having opportunities to meet other mothers’ (30%)
Postnatal care
Seei
ng th
e sa
me
prof
essio
nal a
t ea
ch h
ome
visit
For a
ppoi
ntm
ents
such
as b
aby
wei
gh-in
clin
ics to
be
carr
ied
out
in th
e lo
cal c
omm
unity
afte
r ho
me
visit
s sto
p
One
to o
ne su
ppor
t with
bre
ast-
feed
ing
Grou
p su
ppor
t with
bre
astfe
ed-in
g w
here
you
mee
t oth
er
mot
hers
Acce
ss to
adv
ice 2
4 ho
urs a
day
by
tele
phon
e
Havi
ng o
ppor
tuni
ties t
o m
eet
othe
r mot
hers
Part
ners
bei
ng g
iven
adv
ice a
nd
info
rmati
on to
hel
p th
em ca
re fo
r th
e ba
by
Level of importance
41%
24%
12%
2%
17%
2% 2%4%
1%
8%
15%
10%
25%
36%
Most important (589) Least important (587)
Seeing the same professional at each home visit For appointments such as baby weigh-in clinics to be carried out in the local community after
home visits stop
One to one support with breastfeeding
MOST important
41%
24%
12%
46%
31%
7%
38%
19%
15%
43%
19%16%
41%
27%
9%
Mothers overall (589) West (233) East (356) ABC1 (205) C2DE (380)
• Comparing results of MOST important, there were interesting variations found by area of residence and socio-economic group when looking at three statements in particular
Postnatal care
*significant variations are circled in the graph
One
to o
ne su
ppor
t with
br
eastf
eedi
ng
Grou
p su
ppor
t with
bre
ast-
feed
ing
whe
re y
ou m
eet
othe
r mot
hers
Havi
ng o
ppor
tuni
ties t
o m
eet
othe
r mot
hers
Part
ners
bei
ng g
iven
adv
ice
and
info
rmati
on to
hel
p th
em
care
for t
he b
aby
LEAST important
8%
15%
25%
36%
5%
22%
30%28%
10% 10%
22%
42%
8%
18%
25%
33%
9%
13%
26%
40%
Mothers overall (587) West (232) East (355) First time mothers (270) Multiple mothers (316)
• Comparing results of LEAST important, there were interesting variations found by area of residence and the number of children mothers had, across four statements
Postnatal care
*significant variations are circled in the graph
Next stepsBased on the quantitative insight, Explain has developed within this section of the report key considerations and recommendations for NHS North Tyneside CCG, to inform plans for the future.
Key considerations
High levels of agreement were found across the maternity care journey in regards to what local women want from services (top five overall are displayed in the graph below)
Postnatal care - I want to have access to advice 24 hours a day by telephone
Antenatal Care - I want my midwife appointments to be carried out in the local community
Postnatal care - After home visits stop I want appointments to be carried out within the local community such as baby weigh-in clinics
Labour and delivery care - I want all options for pain relief available should I need them or change my mind
Labour and delivery care - I want doctors and specialists on-hand in the same building should I need them
9.13
9.35000000000001
9.36000000000001
9.48
9.56
Whilst many mothers indicated ‘nothing’ could be improved about their experience, when looking across the whole of the maternity care journey, the most common theme in the literal comments collected calls for consistency in seeing the same health professional
Key considerations
When asked to indicate what was MOST important, consistency in seeing the same health professional for antenatal and postnatal care stood out overall (top three shown below)
Revealed as the LEAST important overall was ‘Partners being given advice and information to help them prepare’ in regards to antenatal care (50%), followed by postnatal care (36%)
Labour and delivery care - Doctors and specialists on-hand in the same
building should they be needed
Postnatal care - Seeing the same professional at
each home visit
Antenatal care - Seeing the same midwife at each
routine check
33%
41%
47%
Key considerations
A majority of 61% would opt for a maternity care unit in the future, with high ratings given to statements regarding ‘doctors and specialists’ as well as ‘pain relief’
Most mothers (63%) had experienced labour and delivery care in Newcastle, a trend that is anticipated to continue with 64% overall opting for the RVI if giving birth in the future
The RVI was found to have a strong and positive reputation, notably very popular with residents of the West as well as future mothers
Variations found by demographic profiles as well as by location, confirm that a ‘truly ideal’ maternity care service would require a high level of flexibility and tailoring to the individual