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How digital midwives are improving care for mothers and babies

In June 2021, the NHS invested in the digital transformation of maternity services. Misbah Mahmood, lead digital project midwife at Leeds Teaching Hospitals NHS Trust, specialises in finding digital solutions for maternity services. She describes the difference digital is making for women, babies and the staff who care for them.

Digitising our maternity services is transforming the way we work. Digital midwives are leading this change; digitising records, notes and systems, so we’re no longer reliant on paper-based processes. This is empowering health and care professionals to safely and securely access, manage and share information as part of a multidisciplinary team to make informed, timely decisions.

Being able to give secure access to other health and care professionals who have a legitimate need to view the records or notes; such as GPs, health visitors, community midwives or social workers, is crucial to delivering quality care, and supporting robust information governance and security. It saves time and makes the clinical process more efficient, secure and reliable - leading to improvements in joined up care, policies and guidelines.

For example, when all our processes were paper-based, women in our care would have their whole maternity record in a paper folder. Sometimes they would lose their folder or bits of paper from it - one woman’s folder was stolen, which was very distressing. There have even been instances where women have written notes on napkins and on bits of paper, and we’ve then had to try and piece it all together.

Information security and human error is another huge factor - women’s notes can get mixed up and can only be corrected if someone spots the error. All this used to make it much more difficult to build a complete clinical picture. This can have an impact on the quality of care and compromise information integrity and security - especially when health and care professionals are trying to access and compile a care plan across different settings.

For midwives, one of the issues with paper records is that they can become out of date very quickly. You may have recorded the details of an antenatal consultation in the morning, and by that afternoon the woman may have had a bleed, so the earlier record is already out of date. Also, when you’re moving women and babies to other hospitals, you have to photocopy multiple paper records and notes - all extremely time consuming.

It is really important to many women that they own and see their own records digitally - much like they could when they were all on paper. Since September 2020, we’ve been able to provide secure online access to records and notes (with two factor authentication for added security) to the women in our care. We make sure that these records are as accessible as possible. We use digital tools such as ‘Browsealoud’ which reads out the woman’s records and notes in their preferred language - 15 different languages such as Welsh, Punjabi, Urdu, Chinese, Bengal, French, Polish and Somali. Our website also has this feature, along with easy read versions of our leaflets.

It is extremely rewarding to know that I play an integral role in enhancing the personalised care we provide to women in Leeds; improving their antenatal, birth and post- delivery experience. But it doesn’t stop there.

At Leeds Teaching Hospitals NHS Trust we have almost 10,000 deliveries every year, providing care to a lot of women who live on the borders of Leeds and Harrogate (with some cared for at more than one hospital). Of course, capturing quality end-to-end pregnancy data is invaluable for auditing and evidencing risk assessments in our Trust. We’re also able to digitally feed this information directly into the national maternity data-set, as well as segment it for regional and local dashboards. This helps us to understand how we are performing relative to other regional services and where improvements can be made. It also allows us to understand the local needs of our diverse population and tailor our services to them.

We’ve definitely had to adapt our ways of working as a result of the pandemic. It has taught us that there are a variety of ways to deliver our services, whilst maintaining the quality of care, and we’re now offering a mix of services through face to face coupled with remote monitoring, telephone and video consultations and, in the future, hubs in the community.

When I started in this role there were only a few digital midwives. Now we have a national digital midwife in Jules Gudgeon and every NHS trust is recruiting a digital midwife. It’s great to be part of the change and it is definitely making a really positive impact in Leeds - and from what I understand - across the rest of the country. The future is full of exciting opportunities, and I’m looking forward to being a part of that change.

Information:

Misbah Mahmood has worked as a midwife for many years and has now transitioned into digital midwifery at Leeds Teaching Hospitals NHS Trust. Misbah is also a Florence Nightingale digital scholar.

She has worked with her team to successfully implement a variety of digital initiatives including an end-to-end electronic patient record system called K2MS, and managed the rollout of the Trust’s secure online notes portal, which can be accessed by both health and care professionals and the women in their care.