A survey of the quality of maternity care at the Norfolk & Norwich University Hospital NHS Foundation Trust

Abstract

This study was planned to assess the quality of maternity care provided in a busy teaching maternity unit. An anonymous questionnaire based on the Royal College of Obstetricians and Gynaecologists (RCOG) standards of maternity care document (2008) was distributed among all women delivered at Norfolk and Norwich University Hospital between February and July 2009. 1 Women who delivered stillbirths and babies in a very poor condition were excluded. The questionnaire included 11 questions based on the RCOG standards and included a space for free comments. The authors received responses from a total of 302 patients. The data were spread and analysed using Microsoft Excel and the patients comments were studied using a combination of content and thematic analysis. The survey showed that 90% of patients did not think that prepregnancy counselling was important and only 4% was offered such a service. 42% of women did not develop their own care plan during pregnancy. The majority of patients were satisfi ed with the care they received. However, 21% of patients rated the community care as poor. Hospital care during pregnancy, labour and during postnatal period was rated as poor by 11-13% of patients. 65% of patients did not receive postnatal advice about contraception. 47% of patients added their own comments were 62% were positive, 18% negative and 20% were mixed. The comments covered three areas: level of care, staff and facilities. Although the survey in general showed a positive picture, still there is a lot of room for improvement.

Expectations and experiences of hospital postnatal care in the UK: a systematic review of quantitative and qualitative studies

“…Of the 33 studies using surveys, 25 had response rates of at least 50%, and of those 8 studies had response rates over 70%,26 27 29 32 33 36 43 45 although in 1 study the denominator was women who had already agreed to participate 29. However, response rates were not reported and not possible to calculate in two studies 35 46. Sample selection was not clearly reported across the included studies, and in the majority of the studies the population had mixed risk status rather than low risk.…”

“…About three-quarters of women reported being satisfied or very satisfied with care,3 10 11 19 and between 46% and 81% reported being very satisfied with care27 28 37 42; however, the figure of 81%42 was from a survey distributed by midwives at 10 days post partum so may be biased. Good or excellent quality postnatal care was reported by 83%–86% of women in two Scottish surveys,24 25 and as poor by 11%–13% of women in another study 35. Forest plots of the proportion of women who were satisfied with overall postnatal hospital care are presented in figure 3.…”

“…The study objectives were clearly prespecified in most of the included studies, but the research question was unclear in 11 studies 3 10 21–25 28 30 35 40. All the studies except one35 involved predefined populations. Of the 33 studies using surveys, 25 had response rates of at least 50%, and of those 8 studies had response rates over 70%,26 27 29 32 33 36 43 45 although in 1 study the denominator was women who had already agreed to participate 29.…”