Healthcare Commission's Survey Results for
Essex Rivers Healthcare NHS Trust

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Survey Results

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Women's views	Trust Average	English Average
Women's satisfaction with their care during pregnancy	76.0%	73.2%
% women always treated with understanding and respect during antenatal care	76.0%	73.2%
Women's satisfaction with their care during labour and birth	81.5%	76.8%
% women who were always treated with understanding and respect during labour and birth	81.7%	73.4%
% women who considered they were treated with understanding and respect after the birth	65.5%	60.2%
Women's satisfaction with their care after birth	68.8%	64.2%

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Antenatal, access and booking	Trust Average	English Average
% women whose first contact with a healthcare professional is a midwife	7.1%	18.8%
% of women who first see a GP	91.6%	78.3%
% women given a choice of where check ups took place	33.1%	23.5%
% antenatal appointments offered outside the main maternity unit	28.4%	66.5%
Target date (weeks gestation) for booking	12 (Weeks gestation)	9.8 (Weeks gestation)
Average number of weeks pregnant at booking appointment	11.3 (Weeks)	10.9 (Weeks)
% women more than 12 weeks pregnant when they are first seen	3.2%	6.1%
% women receiving a copy of 'The Pregnancy Book'	79.8%	74.6%
Items covered in booking appointment	16 (Score out of 17)	16.0 (Score out of 17)
% of clinic locations with appointments outside weekdays 9 to 5 (consultant)	0.0%	1.5%
% of clinic locations with appointments outside weekdays 9 to 5 (midwife led)	0.0%	12.7%
% of clinic locations with appointments outside weekdays 9 to 5	0.0%	4.5%

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Antenatal appointments	Trust Average	English Average
% women seeing only midwives for check ups	23.8%	34.1%
% women seeing only midwives / GPs for check ups	40.4%	40.4%
Time allocated for booking appointment(s)	60 (Minutes)	103 (Minutes)
Time allocated for routine antenatal check	30 (Minutes)	16.1 (Minutes)
Planned number of antenatal checks for primip	10	11.6
Average number of antenatal checks for primips	8	7.6
Planned number of antenatal checks for multip	7	9.2
Average number of antenatal checks for multips	7	6.9

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Continuity of care	Trust Average	English Average
% women reporting they mostly saw the same midwife for check-ups	53.1%	57.3%
% women reporting they mostly saw the same doctor for check-ups	37.7%	38.9%
Percent midwives sharing caseload	68.3%	30.4%
Percent midwives carrying own caseload	31.7%	23.7%

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Antenatal classes	Trust Average	English Average
% women attending NHS antenatal classes who wanted to	62.5%	58.3%
% women who did not attend antenatal classes due to lack of space	4.2%	3.4%
% women having first baby attending antenatal classes	85.9%	78.9%
% women whose partners were allowed to attend antenatal classes	100%	94.6%
% women who considered classes were at convenient location	95.0%	93.7%
% women who considered classes were at convenient time	85.0%	85.1%
% who considered content of classes appropriate	83.1%	79.6%
Length of antenatal classes (sessions)	4 (Hours)	4.2 (Hours)
% who considered classes were about right number	84.7%	71.0%
Proportion of primips offered classes	6.0%	5.7%
Proportion of multips offered classes	6.0%	5.2%

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Care for women with high risk pregnancies	Trust Average	English Average	Clacton Midwife Led Unit	Colchester General Hospital	Harwich Midwife Led Unit
% of women getting 20+ antenatal checks	4.0%	2.9%
Antenatal day attendances per delivery	1	1.3		1
% conditions where there is a specialist midwife	5.3%	22.7%
Average number of consultant attendances per booked women	1.4	2.3
% women referred to consultants in pregnancy (survey)	60.0%	59.9%
% of women surveyed with an antenatal admission involving an overnight stay	17.4%	18.9%
Places per 1000 deliveries pa in nearest mother and baby unit	0.3 (Places per 1000 deliveries)	0.2 (Places per 1000 deliveries)
% women referred to consultants during pregnancy	47.3%	70.2%
% women referred for specialist psychiatric care		3.9%
Ratio of antenatal attendances to antenatal admissions	1.4 (Ratio)	2.5 (Ratio)		1.4 (Ratio)
Minimum referral waits for a psychiatrist	2 (Time interval)	1.6 (Time interval)
Maximum referral waits for a psychiatrist	3 (Time interval)	2.8 (Time interval)

Tests and screening

No results for this category.

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Dating scans	Trust Average	English Average
% eligible women offered dating scan	100%	98.0%
% women given a choice on whether to have a dating scan	64.7%	70.4%
% women with reasons for dating scan clearly explained	87.0%	88.0%
% eligible women having dating scan	100%	93.2%

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Testing procedures	Trust Average	English Average
% women offered an informed choice for screening tests	82.5%	83.6%
% of tests where written information is provided	100%	98.1%
% of tests where written information is provided at least 24 hours prior to procedure	0.0%	79.5%
% women with reasons for 20 week scan clearly explained	88.8%	91.7%
% women given a choice on whether to have a 20 week scan	63.6%	72.9%

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Screening	Trust Average	English Average
% women who were given a choice on having Downs syndrome screening test	94.7%	87.9%
% women with reasons for Downs syndrome screening clearly explained	93.4%	89.2%
% women eligible for amniocentesis or CVS who were tested	55.9%	63.3%
% women having CVS of those having amniocentesis or CVS	12.9%	23.7%
% of amniocentesis or chorionic villus downs syndrome test results which are negative	91.8%	93.1%
% eligible women offered Rubella testing	100%	98.6%
% eligible women tested for Rubella	100%	95.0%
% eligible woman offered fetal anomaly scan	100%	97.1%
% eligible woman having fetal anomaly scan	98.9%	94.8%
Attributes checked in fetal anomaly scan (max 11)	11	10.5
% women having both NT and blood test (survey)	14.8%	24.9%
% women having blood test only (survey)	80.5%	58.8%
% women having NT test only (survey)	4.7%	16.3%
% eligible women offered Hepatitis B testing	100%	98.6%
% eligible women tested for Hepatitis B	100%	95.4%
% eligible women offered HIV testing	100%	98.3%
% eligible women tested for HIV	96.6%	92.3%
% eligible women offered Syphilis testing	100%	98.6%
% eligible women tested for Syphilis	100%	96.7%

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Birth location and choice	Trust Average	English Average	Clacton Midwife Led Unit	Colchester General Hospital	Harwich Midwife Led Unit
% women given a choice of where to have their baby at the start of the pregnancy	71.1%	74.7%
% women having vaginal birth	76.6%	76.1%		73.9%	100%
% women reporting they got enough information about where to have you baby	44.8%	38.4%
% women with 'normal' vaginal birth (no induction or epidural)	51.5%	41.7%	100%	45.2%	100%
% women given the choice of a home birth	53.1%	47.6%
% women with vaginal birth without instruments	67.5%	65.0%	0.0%	63.6%	100%
% women not offered home birth because of medical reasons	20.0%	14.8%
Number of home births	167	114
% home births	4.5%	2.3%
% home births which were planned for home	91.0%	85.6%
% home deliveries which were for primips	12.6%	20.1%
% births in GP or midwife led unit	19.9%	5.8%
Number of deliveries in obstetric units	2793	3843
% births in consultant led unit	75.6%	91.4%

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Pain relief	Trust Average	English Average	Clacton Midwife Led Unit	Colchester General Hospital	Harwich Midwife Led Unit
% women who got the pain relief they wanted	79.6%	77.5%
Birthing pools per 1000 deliveries	1	0.5	7.3	0.3	8
% women using birthing pool who deliver in pool	100%	53.3%		100%	100%
Average number of deliveries utilising birthing pool	16 (Number per month)	17.6 (Number per month)	0 (Number per month)	24 (Number per month)	24 (Number per month)
Midwives trained to deliver in birthing pools per pool	15.3	45.2	10	25	11
% women having at most gas and air for vaginal birth without instruments	58.7%	58.7%
% women having at most painkiller for vaginal birth without instruments	89.0%	83.4%
% women using medication (beyond Entonox) as pain relief	49.3%	51.3%
% women having epidural pain relief for unassisted vaginal birth	6.3%	13.9%		7.5%	0.0%
Weekday hours Epidural available	24 (Hours per day - weekday)	23.3 (Hours per day - weekday)	0 (Hours per day - weekday)	24 (Hours per day - weekday)	0 (Hours per day - weekday)
Weekend hours Epidural available	24 (Hours per day - weekend)	23.9 (Hours per day - weekend)	0 (Hours per day - weekend)	24 (Hours per day - weekend)	0 (Hours per day - weekend)

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Quality of care in labour	Trust Average	English Average
% women cared for by one midwife during labour and delivery	16.4%	19.8%
% women who had met at least one midwife caring for them during labour	26.1%	21.4%
% women left alone during labour	17.8%	20.5%
% women left alone shortly after the birth	10.5%	11.4%
% women left alone during labour or shortly after the birth	24.3%	26.6%
Average number of midwives caring for women during labour	3	2.6
% of women able to move around some of the time in labour	78.7%	73.2%
% women giving birth off the bed or in water	5.8%	7.8%
% women who gave birth lying down	54.5%	56.6%

Interventions and clinical care

No results for this category.

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Induction	Trust Average	English Average	Clacton Midwife Led Unit	Colchester General Hospital	Harwich Midwife Led Unit
% women given a choice on how their labour was induced	59.5%	56.6%
Days past term when inductions planned to take place	10 (Days)	12.7 (Days)
% women induced	22.7%	18.8%	0.0%	25.7%	0.0%
% women whose labour was induced medically (surgically)	27.5%	25.2%
% inductions which lead to the successful onset of labour and vaginal delivery	84.4%	76.1%		84.4%
% vaginal deliveries following induction which are assisted	9.3%	22.9%		9.3%

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Vaginal birth	Trust Average	English Average	Clacton Midwife Led Unit	Colchester General Hospital	Harwich Midwife Led Unit
% women having vaginal birth	76.6%	76.1%		73.9%	100%
vbac (vaginal birth after caesarean) rate	26.6%	32.0%
% women with 'normal' vaginal birth (no induction or epidural)	51.5%	41.7%	100%	45.2%	100%
% women with vaginal birth without instruments	67.5%	65.0%	0.0%	63.6%	100%
% women having epidural pain relief for vaginal birth with instruments	44.8%	54.1%		44.8%
% women with vaginal birth where ventouse or forceps used	11.8%	14.7%		13.9%	0.0%
% instrument births using ventouse	65.4%	61.1%		65.4%

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Caesarean	Trust Average	English Average	Clacton Midwife Led Unit	Colchester General Hospital	Harwich Midwife Led Unit
% women having caesarean	23.7%	23.5%	0.0%	26.9%	0.0%
% women having caesarean adjusted for age	22.2%	22.4%
% women having caesarean adjusted for age and ethnicity	22.4%	22.2%
vbac (vaginal birth after caesarean) rate	26.6%	32.0%
% emergency caesareans following previous caesarean	20.8%	21.8%
% of emergency caesareans undertaken within 30 minutes of decision	89.4%	92.8%
% caesareans which are non-elective	56.9%	59.0%		56.9%
% women under 35 having caesarean	21.7%	22.4%
% women over 35 having caesarean	35.7%	33.3%
% primips having caesarean	25.2%	24.1%	0.0%	27.1%	0.0%
% multips having caesarean	24.7%	26.8%	0.0%	26.8%	0.0%
% emergency caesareans for 2nd or subsequent child	11.1%	11.5%	0.0%	12.0%	0.0%
% women having general anaesthestic for caesarean	9.1%	9.9%
% women having general anaesthestic for elective caesarean	3.2%	4.7%

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Breech babies	Trust Average	English Average
% women offered ECV for a breech	22.6%	58.3%
Babies turned using ECV	35.7%	41.2%
% singleton breech babies at 36 weeks where ECV attempted	22.6%	35.0%
% singleton breech deliveries which were diagnosed prior to labour	4.0%	19.5%
% singleton babies breech at term	3.4%	3.8%
% elective caesareans for breech prior to week 39	33.3%	42.2%
% singleton breech babies at term delivered by caesarean	89.5%	84.9%

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Problems immediately after the birth	Trust Average	English Average
Women per 1000 deliveries with eclampsia	1 (Number per 1000)	1.3 (Number per 1000)
% Women who delivered vaginally who had an episiotomy	14.5%	16.7%
% women who had an episiotomy or tear who received stitches in <1 hour	89.7%	87.4%
% women who had an episiotomy or tear who received stitches in <20 minutes	48.3%	57.7%
% Women from survey with 3rd or 4th degree perineal tear	9.2%	8.6%
% Women who delivered vaginally with 3rd or 4th degree perineal tear	2.3%	2.2%
% Women experiencing a primary postpartum haemorrhage (1000ml or more)	2.1%	3.3%
% Women with a primary postpartum haemorrhage of 2500ml or more	0.4%	0.2%
% women transferred to intensive care after a postpartum haemorrhage	5.1%	3.9%
Women per 1000 deliveries transferred to intensive care	2 (Number per 1000)	1.2 (Number per 1000)

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Hospital care	Trust Average	English Average	Clacton Midwife Led Unit	Colchester General Hospital	Harwich Midwife Led Unit
% women who considered their length of stay was about right	65.5%	72.3%
% women who considered their length of stay was too short	19.0%	13.1%
% women who considered their length of stay was too long	15.5%	14.7%
Average length of postnatal stay for normal delivery	2 (Days)	1.4 (Days)		1.5 (Days)	5.0 (Days)
Average length of stay for normal delivery -primip	1.5 (Days)	4.6 (Days)		1 (Days)	5 (Days)
Average length of stay for normal delivery - multip	2.2 (Days)	2.3 (Days)		2 (Days)	5.0 (Days)
Average length of postnatal stay for vaginal with intervention delivery	2 (Days)	2.3 (Days)		2 (Days)
Average length of stay for vaginal with intervention delivery - primip	1 (Days)	2.6 (Days)		1 (Days)
Average length of stay for vaginal with intervention delivery - multip	4 (Days)	4.4 (Days)		4 (Days)
Average length of postnatal stay for caesarean delivery	4.4 (Days)	3.4 (Days)		4.4 (Days)
Average length of stay for caesarean delivery - primip	6 (Days)	4.1 (Days)		6 (Days)
Average length of stay for caesarean delivery - multip	4 (Days)	4.2 (Days)		4 (Days)
% women who were given sufficient food	76.6%	77.3%

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Postnatal care at home	Trust Average	English Average
% women who were visited at home	97.4%	98.0%
Average age of baby at last midwife contact	12 (Days)	14.6 (Days)
% of women who would have liked more contact with midwife	17.6%	22.2%
Quality of transfer process to health visitor (score out of 5)	5 (Score out of 5)	4.4 (Score out of 5)
Quality of support in caring for the baby after discharge	68.2%	66.1%
Average number of contacts with midwife after going home	5	4.4
Planned postnatal contacts	6	5.5
% planned postnatal contacts by midwife	83.3%	83.4%
% planned postnatal contacts at home	83.3%	80.7%
Hours of availability of drop-in-clinics	35 (Hours per week)	21.1 (Hours per week)

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Health checks	Trust Average	English Average
% babies having statutory examination of newborn	99.7%	98.5%
% babies with baby check completed prior to discharge	87.0%	95.1%
% women receiving a postnatal check up of their own health (survey)	87.0%	88.1%
Women re-admitted within 2 weeks of discharge	2 (Number per 1000)	5.4 (Number per 1000)

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Infant feeding	Trust Average	English Average	Clacton Midwife Led Unit	Colchester General Hospital	Harwich Midwife Led Unit
% women who put their baby to their breast (survey)	79.2%	80.1%
% women who initiated breastfeeding	77.0%	67.4%	73.0%	77.3%	73.0%
% women who breastfed (at least in part) in the first few days	74.7%	76.0%
% of women who reported good advice, help and support on infant feeding	61.4%	58.0%
% women who discussed breastfeeding with midwife during pregnancy	91.9%	77.4%

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Neonatal care	Trust Average	English Average	Clacton Midwife Led Unit	Colchester General Hospital	Harwich Midwife Led Unit
Admissions to neonatal unit per 1000 babies born	173	102		187
% babies admitted to neonatal unit from survey	15.9%	10.4%
Tube feeding	Yes	60% Yes - 40%No	No	Yes	No
Phototherapy	Yes	99% Yes - 1%No	No	Yes	No
Intravenous antibiotics	Yes	57% Yes - 43%No	No	Yes	No
Other intravenous medicines	Yes	28% Yes - 72%No	No	Yes	No