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Question 1

Recommendations from Francis report 2013

Answer 1

Openness, transparency, duty of candour, improved support for compassionate, caring and committed care.

Question 2

Tell me about Morecambe Bay Kirkup 2015

Answer 2

Lack of clinical competence. Poor working relationships. Pursued natural childbirth at any cost. Failure to assess risks. Failure to investigate and learn from mistakes. 20 instances of significant or major failures of care.

Question 3

Moorcambe bay Kirkup recommendations 2015

Answer 3

44 recommendations: Review skills of all obstetric staff. MDT to be implemented. Recruitment and retention strategy to be put into place for a balanced work force. Incident reporting to be addressed. Openness and honesty to be review in trust policy.

Question 4

Ockenden Shrewsbury and telford interim recommendations 2017

Answer 4

Enhance safety. Listen to women. MDT training. Managing complex pregnanies. Risk assessment throughout pregnancy. Monitor fetal well being. Informed consent

Question 5

Ockenden immediate and essential 2022

Answer 5

Safe staffing. Escalation. Leadership. Learning from maternal deaths. MDT training. Complex antenatal care. Preterm birth. Labour and birth. Obstetric anaesthesia. Better Postnatal care. Bereavement care. Neonatal care. Supporting families.

Question 6

Lessons learnt? following ockenden

Answer 6

Learning lessons to be held frequently. Debriefing sessions. Incident feedback pathways. Developing a learning culture.

Question 7

East kent kirkup 2022 findings

Answer 7

Not recognising trends in poor care. Compassionate care is missing. Failures in teamwork, bullying harassment. Lack of honesty regarding poor outcomes at trust level.

Question 8

CQC state of care

Answer 8

Poor relationships between obstetrics and midwives. Poor staff training. Unclear escalation pathways. Inequalities- MMBRACE. Poor staffing. Limited learning.

Question 9

Missed opportunities to act

Answer 9

CQC 2014. Kirkup 2015. RCOG review 2016.

Question 10

Key maternity drivers

Answer 10

Better births. Saving babies lives. MMBRACE. BFI UNICEF.

Question 11

7 themes of better births

Answer 11

Personalised care. COC. Safer care. Better PN and perinatal MH. Working across boundaries. MDT. Payment system.

Question 12

NHS long term plan 2019

Answer 12

COC for vulnerable mothers. COC for BAME mothers and most deprived groups.

Question 13

MMBRACE 2021

Answer 13

Treat women who may become pregnant, are pregnant, or have recently been pregnant the same as non-pregnant women unless clear reason not to. Reassess risk. Avoid gaps in care or treatment. Postnatal care. Understand and tackle inequality. Individualise care. Safety net advice

Question 14

Saving babies lives

Answer 14

Reduce smoking in pregnancy. Risk assessment for FGR. Raised awareness of RFM. Fetal monitoring in labour. Reducing preterm birth.

Question 15

UNICEF BFI?

Answer 15

unicef baby friendly initative. protects, promotes and supports breastfeeding to strengthen mother-baby and family relationships. not only breastfed babies.

Question 16

Current maternity challenges

Answer 16

Workforce shortage and burnout. The complexity of care. Inequalities. Underfunding. Covid. COC.

Question 17

4 themes of NMC code

Answer 17

Prioritise people. Practice effectively. Preserve safety. Promote professionalism and trust,

Question 18

Challenges to women centered care

Answer 18

Women who request care outsdie fo guidance. Defensive practice in NHS. Fear of litigation. Fear of poor outcomes.Professional responsibility

Question 19

Human rights ACTS

Answer 19

2 The right to life- and life saving care. 3 Freedom from torture or inhuman/degrading treatment -analgesia. 8 Respect for private and family life -consent, right to choose birth place. 14 protection from discrimination- protected characteristics, equal access to care

Question 20

Consent

Answer 20

Right to decline. Right to withdraw consent. Able to ask for more time to make a decision. Must be provided with appropriate evidence based information. None judgemental way. HCP to respect decisions even if don’t agree. Even if treatment will benefit baby, can be declined- baby has no rights until birth.

Question 21

When might you not need consent?

Answer 21

When woman is unable to make a decision: in an emergency, lacking mental capacity (MCA 2005). Decisions should be made in best interests.

Question 22

Evidence based information is found:

Answer 22

NICE guidance. Cochrane studies. Trust policy. Green top guidance. RCM.

Question 23

Holistic care

Answer 23

Physical, emotional, psychological, and social needs to be met. Respect and dignity upheld—awareness for cultural beliefs. The right to autonomous decisions.

Question 24

4 ethical principles

Answer 24

Autonomy- right to make own decisions. Beneficence- care to benefit the patient, non-maleficience- to cause no harm, justice- equal treatment.