The aim of providing Day assessment and Ultrasound Scanning services within Powys was to improve the care available to women in their rural community. While reducing costs to both the organisation and families living in Powys. The targets set out in the funding bid were:
- Reduction in un-necessary hospital admissions.
- Improved Patient Satisfaction.
- Increase in the number of women receiving scans and diagnostic tests in their own community.
- Reduced cost of commissioning.
- Improved Staff Satisfaction.
Efficiency Through Technology Welsh Government funding [ETTF] was used to provide the capital for setting up a day assessment unit within two areas of Powys, close to local communities from 2015- 2018. This involved purchase of essential equipment and adaptation of community hospital environments. Provision of specialist training for identified midwives in maternity ultrasound. Provision of specialist training in advanced midwifery diagnostic testing, cardiotocograph interpretation and medical conditions.
Evaluation methods included: collection of quantifiable activity data and comparison with project targets, table top discussion and feedback from the group, staff satisfaction surveys, client satisfaction feedback cards, client stories and a review of incidents during the project timetable.
Original proposal was reviewed- two key practice aims in the original project were: To implement NT screening. To increase availability of local apt. for women requiring further investigations/ scans but who do not need to be seen immediately by a consultant obstetrician.
We had successfully achieved both of these aims.
In addition to the original two aims we also implemented a service for all women requiring GTT's to have these in Powys enabling better compliance with detection of diabetes in pregnancy. A change in clinical best practice guidelines recommended increased number of scans for women in at risk groups. This resulted in a significant increase in number of scans required by women; the project has enabled some of these scans to be carried out in Powys ensuring that Powys was able to adopt the National programme and ensure best care for women in rural communities.
We know that prior to commencing this service almost all routine USS and diagnostic testing required women to travel to an external DGH for admission. We were unable to ascertain accurate baseline figures for admission via commissioning but were able to estimate a baseline figure based on routine care alone [Approx. 350 apt per month]. Additionally a small number [approx. 180] were able to have appointments in Powys via limited visiting commissioned services. The number currently having appointments in Powys has increased from 180 per month to 470 per month average. Therefore we are confident that the total number of external apt. will have been less than prior to the service set up.
The number of miles saved this year to Powys residents is in excess of 61,000 which can only add to the high levels of satisfaction experienced by families.