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Care During Pregnancy (Antenatal Care)
What did we do?
Healthwatch Richmond gathered the views and experiences of over 100 women about the care they received during pregnancy (antenatal care). Feedback was collected through one-to-one discussions or online surveys (54 and 47 respectively) between March and April 2018. We have published a detailed report setting out the experiences of these women and made recommendations about how care could be improved.
Respondents were a good mix of the local population:
- Came from across the whole borough
- About half were first pregnancies and half had previous pregnancies
- Most had given birth in the last 6 months or were currently pregnant (70%).
- Most women had their care through Kingston Hospital (50%), or West Middlesex Hospital (30%).
What did we find?
Overall women are happy with the care that they receive and with the staff that care for them.
- 86% of respondents rated their care as very good (44%) or good (42%).
- The majority of women across all providers reported good access to information, emotional support (although more should be done to ensure that all women are informed about emotional support).
People rated their experiences at West Middlesex Hospital less positively than the average
- West Middlesex Hospital was positively rated by most patients however overall positive ratings were lower than the average (78% vs 86%) and fewer people rated the hospital as ‘Very good’ (28% vs average of 44%).
- 20 patients made negative statements about the way that care was given and the staff who provided the care. These people spoke about: feeling ignored by staff; finding staff unhelpful, insensitive or uncaring; and asking for care but not receiving it.
- A number of people also raised concerns about administration at West Middlesex Hospital. Several people said that their records were not updated despite having made repeated requests.
- Less than half of women said that they had enough contact with a midwife (45%) and less than 1 in 3 said it was easy to make contact with the hospital (27%%).
Women who self-refer to hospital experience fewer problems than those who go to their GP first
- About 1 in 3 women self refer to hospital (29%). Those that do reported better experiences and fewer mistakes.
- Relatively few people know that they can refer directly to hospital without having to see their GP first.
- GP's were ratedly positively overall but some people experienced problems with referrals or found their GP to be less caring or more rushed than they had hoped.
What happened as a result
- Overall Richmond patients reported very good antenatal care locally. Where people’s experiences have identified the need for improvements we are very pleased to see that providers have made commitments to meaningful changes to the care people receive locally.
- West Middlesex Hospital have acknowledged these findings and have set out a detailed action plan committing them to meaningful improvements to care. They have also told us that they are undertaking work to digitise notes which should improve the accuracy of maternity notes. We remain concerned however that recruitment and staffing problems are factors that may continue to lead to problems with administration including patient notes.
- We will ask Richmond CCG to ensure that all GP Practices are able to direct women to self-refer to more than one provider.
Both Kingston and West Middlesex Hospitals have welcomed this review and the recommendations that we made. Their responses have been published in full; summaries are given in the conclusions of the report.