1. Experience Led Commissioning Experience of Maternity care January 2015 Christine Armstrong, Regional Lead 10,000 Voices

2.  Context of Patient/Client Experience in NI  Central to strategic drivers – A Strategy for Maternity Care in Northern Ireland 2012 - 2018 /Quality 2020  Response to high profile inquiries “The patient voice should be heard and heeded at all times” (Berwick 2013) Overview of 10,000 Voices

3.  Improve patient experience  Influence how services are commissioned Aim of 10,000 Voices

4. Core Principles of Experience-based Design  Partnership approach between patients, staff and carers  Emphasis on experience rather than attitude or opinion  Narrative and storytelling approach to identify ‘touch points’  Emphasis on co-design of services  Systematic evaluation of improvement and benefits Experience-Led Commissioning A new model of commissioning

5. Experience-based Design is about: -  Capturing the experience  Understanding the experience  Improving the experience  Measuring the improvement Experience-Led Commissioning A new model of commissioning

6. Person and their experience Listening Learning Improving Influencing “Working together to make positive change” Trust action plans Regional action plans and commissioning priorities Patient stories

7.  Phase 1 – Unscheduled care  Phase 2 – Care in Home  Phase 3 – Staff experience Experience of nursing and midwifery care (regionally agreed Key Performance Indicators) Phases of 10,000 Voices

8.  Consistent delivery of midwifery care against identified need  Confidence in the knowledge and skills of the midwife  Sense of safety whilst under the care of the midwife  Involvement in decisions about midwifery care Experience of Nursing and Midwifery Care - Key Performance Indicators (KPIs)

9.  Time spent by midwives with the woman  Respect from the midwife for the patients preference and choice  Midwives support to care for themselves, where appropriate  Midwives understanding of what is important to the woman Experience of Nursing and Midwifery Care - Key Performance Indicators (KPIs)

10. A Strategy for Maternity Care in Northern Ireland 2012 - 2018  A quality maternity service is one which is both safe in terms of the physical and emotional needs of women and their babies, takes account of their opinions and experiences  Any quality monitoring must include patient experiences. Listening to experiences of maternity care

11. Stories collected across all 5 Trusts All areas of maternity care Experience of MLUs to inform regional guidelines Data collected in a variety of settings, for example: clinical settings/community groups/roadshows 10,000 Voices Experiences of Maternity Care

12. How safe did you feel while being looked after by the midwife… I felt safe all the time It depended on who was looking after me I always felt vulnerable and unsafe

13.  Strongly positive/ positive – 92%  Neutral/not sure – 5%  Strongly negative/negative -2.5%  Missing data – 0.5% How the overall experience of maternity care was rated

14. Theme – Feeling safe Safe in a crisis situation Keeping woman and her partner calm and relaxed Understanding anxiety of first time parents Providing reassurance “At all times I felt safe and in a controlled environment” Stories rated as strongly positive/positive

15. Theme – confidence in the skills of midwives Professionalism of staff Highly experienced staff Excellent clinical knowledge “Professional and personable staff with excellent clinical knowledge” Stories rated as strongly positive/positive

16. Theme – Communication with women and their partners Introductions and explanations of what was happening Listening to concerns and answering questions Keeping woman and partner informed Respectful of choices of women “For each person it is a unique experience, so no question felt too silly to ask” Stories rated as strongly positive/positive

17. Theme - Providing compassionate care Staff going the extra mile Dedication of staff to work Very helpful and friendly staff Made to feel very welcome Good teamwork “We had total trust in the hands of the professionals, who showed empathy, clarity, integrity and teamwork” Stories rated as strongly positive/positive

18. Theme – Staffing levels Staff overworked Staff have a lot of paperwork to complete Staff staying on after shift was finished “Felt that the staff had no time to spare” Stories rated as neutral/not sure

19. Theme – Staff attitude Staff appeared rude and abrupt Made to feel uncomfortable Not offering enough support “I experienced a lack of empathy and care that left me in tears” Stories rated as negative/strongly negative

20. Theme – Communication Mixed messages from midwives Women felt that they were not being listened to More information needed, for example miscarriage, consent for theatre “ I wish now that I had been more forthcoming and demanded that my voice be heard” Stories rated as negative/strongly negative

21.  Regional workshop and further analysis  Development of local and regional action plans  Further period of story collection Next steps

22. Christine Armstrong, Regional Lead 10,000 Voices Email: Christine.Armstrong@setrust.hscni.netChristine.Armstrong@setrust.hscni.net Telephone: 07711002069 Contact details