Maternity & Community Midwifery Services protocols

Patient presents - ? pregnant.

• GP sends a pregnancy test if required.
• When the pregnancy test result is back it is work flowed to the individual doctor.
• Result stamped electronically and, if positive and patient proceeding with pregnancy, the GP completes a midwife referral form.
• An appointment for the booking clinic should then be sent out.
• Nominated person to process booking clinic (send out appointments, write up details in book). See detailed procedures below.
• Book of all antenatal/postnatal information to be kept by nominated person.

Midwife will initiate green patient-held folder.

• After booking clinic, ensure appropriate details on GPM form are completed and enter into master book.
• Midwife will give green antenatal folder to nominated person to take two photocopies of maternity sheet (first page at front of records). One to be kept in midwife’s records and one to be kept in GP records. The green folder should then be returned to the midwife.

Discharge letter after delivery

• Nominated person to complete details on GPM form and initiate new baby file.
• Workflow discharge letter to GP.
• Maternity details are recorded into the GPASS clinical system.
• Nominated person to send out postnatal appointments when due (six weeks after delivery with own GP, if possible).
• DNAs – send a further appointment.
   

DETAILED PROCEDURES

To be undertaken by nominated staff member responsible for maternity clinic.

BOOKING CLINIC

• Make appts. in midwife booking clinic diary – write in name, address, DOB and GP (or use label) and send out an appointment card.
• Enter onto GPASS.
• Indicate in book (beside patient details) when appt. is sent out (or details given over the telephone).
• On day of clinic, pull records and attach the following to the front of each set:-
• Maternity Medical Services Record & Claim Form (GPM).
• Maternity Exemption Form (FW8).
• Envelope (small brown one!) with Primary Care Services label on it.

DISCHARGES

When pink A4 discharge sheet comes in from the hospital (or given via midwife)

• Scan into Docman, workflow to GP and computer.
• Retrieve existing GPM form for patient and complete the details (date of delivery, etc.) and pencil in postnatal due date.
• In Maternity book, write details of date of delivery, and pencil in postnatal due date in appropriate columns - check the date on the yellow/red sticky label at front of patient’s records to quickly find the patient’s details in this book (entered chronologically).
• Once details copied from pink discharge sheet, initial to indicated that it has been dealt with, then place with other correspondence filing.
• A new baby file needs to be initiated at this stage. At the top of a new clinical sheet, leave the first name blank (or write “baby” in pencil) – write the surname, address, DOB, GP and telephone number. Stick one of the pre-printed labels for babies (red for girls and blue for boys) onto the clinical sheet and complete using the details from the discharge form. Put this sheet into Joan’s yellow folder inside the plastic “new babies” wallet.

Community Midwifery Services

Once a patient has a positive IPT they are referred by the GPs to the Howden Health Centre Midwives booking clinic. A designated member of the administrative team is responsible for organising the antenatal clinics (see above).  

Appointment System

The midwives clinics are as follows:

Antenatal Clinics are held on a Tuesday afternoon (Nan Crichton) and Thursday afternoon (Glynis Meechan).  If one or other Midwife is unavailable the other will cover the appropriate clinic. 

It is the patients’ responsibility to make their antenatal appointment. Antenatal appointments are not sent out by post. The patient is informed of this, as well as information about the clinics and contact details by letter at the time of booking. Appointments can be made either at the Health Centre reception desk or by telephoning the Health Centre on 01506 423800.

The midwives are contactable Monday – Friday between the hours of 9am-5pm on the following numbers or if there is no reply, on the main Health Centre number.

• Nan        01506 423846

• Glynis     01506 423847

Routine Antenatal visit includes the following checks:

• Urinalysis

• B.P.

• Fundal height

• Fetal movements

• Palpatation

• Ausciltation

• Check for Oedema              

The early pregnancy unit and the Day Bed Unit are both available at St. John’s Hospital, Livingston, if required. Patients can self refer to these units if desired.

Local West Lothian Division clinical guidelines are followed for conditions that may arise during pregnancy,  for example raised B.P. and gestational diabetes.

Following delivery the midwife is informed of discharge and visit as negotiated with patient until day 10 (longer if required to a maximum of 28 days) after which care is transferred to the appropriate Health Visitor.