For instance, the College of Health was invited to undertake a study of patient satisfaction in the maternity unit of a large district hospital in an inner city district in London. In-depth interviews were carried out in the women's homes six weeks after discharge. In addition discussions were held with a group of Muslim women and members of the local National Childbirth Trust.
The main findings included:
- Lack of information about the choices and services available for ante-natal care and delivery;
- An appointments system that was too inflexible for mothers with other young children;
- Lack of help and information for women who could not speak English;
- Poor continuity of care for some women during their delivery;
- Inadequate staffing levels sometimes led to women in labour being treated in an unacceptable manner;
- Women on the post-natal ward were given inadequate help with breast feeding to the extent that some switched to bottle-feeding;
- The early discharge policy was not flexible enough for women with special needs.
The College of Health's report has 32 recommendations for action or change, all of which were agreed between management and staff and approved by the Health Authority and a timetable for implementation drawn up.
It is particularly interesting to note that only five of the 35 proposals entailed new cash expenditure, the total sum being L3,100. The vast majority involved changes in practice or attitude.
As a result of this study a Consumer Audit Checklist is being developed for the providers of ante-natal and maternity services.
College of Health, St Margaret's House, 21 Old Ford Road, London E2 9PL (tel 081 983 1225; fax 081 983 1553).