Have maternity services at the Royal Free Hampstead improved?

(98 Posts)
umf Fri 10-Jul-09 09:09:49

This thread is a spin-off from this discussion about north London maternity hospitals.

A lot of mumsnetters have been critical of the Royal Free. I don't think the RF's problems are unique or the worst in London. But it has had a bad reputation for several years and women report the same repeated concerns.

Personally I had a ghastly experience of antenatal and postnatal 'care' there in 2006. It was comforting to me to discover on mumsnet that I wasn't the only person who felt so miserable about the place.

A RF consultant (SympatheticConsultant) contributed to the old thread, saying that staffing levels and organisation had lately improved, and hoping that positive comments would start appearing.

Perhaps the RF now has a user feedback mechanism so that they take on board the comments of the women who birth there. But just in case they don't (!) how about we do it here?

What do recent and current users think? Is the RF getting better?

What improvements do you feel most urgently need to be made? What's going well there?

nwthree Sat 19-Sep-09 19:01:17

Thanks Ema - I'm definitely going to look into it x x x

SympatheticConsultant Sun 20-Sep-09 15:39:07

Dear nwthree & sassmonkey,
I am delighted you are both considering giving our services a chance! I will happily agree to oversee you pregnancies and act as your named NHS Consultant.
Please drop me an email(sajjad.ali@royalfree.nhs.uk) so I can get your respective details and i will arrange the necessary appointments for my antenatal clinic so we can at least meet and take things from there.

Best wishes

SC smile

LondonDove Fri 25-Sep-09 10:27:49

Dear Sympathetic Consultant,

I have talked to you on another thread and came back here to let you know that I have reluctantly decided to leave RF. My first priority is the safety of my mono-di ID twins and don't think I can count on that at RF. I know you tried to reassure me in the past but the reality of my RF experience has let your optimism down.

I wanted to ask you to ensure the doctors on Mr E's team who scan multiples and then give parents consultations about the pregnancy read the RCOG Dec 08 guidelines before they make the gaffe of saying that mono-di twins are not at risk of TTTS again. They then made the decision to see us after a 5 week interval. Hence changing hospital. I want someone who knows what they're talking about monitoring me.

On a positive note, I also wanted you to pass on my appreciation to the wonderful specialist midwife AnneMarie. She gave me time and I want to thank her for listening to me.

LondonDove

mellow123 Sat 26-Sep-09 21:56:40

I just thought I’d add something about my recent experience at the RF, as I found this thread helpful myself when deciding to go back to the RF to have baby no 2.

I had my daughter at the RF in late 2006 – although the medical care when we needed ventouse delivery was good, everything else was a bit grim; all the usual complaints – post natal ward dirty and hectic, some staff curt and unkind, and no help with breastfeeding (in fact I was advised to bottle feed by several midwives). All in all, I was rather dreading going back to the RF (I live around the corner so it seemed silly to trek to UCH etc, although I did seriously consider it). However, I just had my son at the RF a couple of weeks ago, and I have to say that things were much, much better. Some positive changes:

Ante–natal care: The community midwives are very busy, but all those I saw were kind and helpful (thanks, Green Team!) Reception staff and others in the Antenatal Clinic and Day Assessment Unit were much more helpful and friendly.

Labour Ward – care was excellent, all the midwives I saw were thoughtful and kind, kept us informed about progress, and just generally seemed to care much more than they did last time I was there. I ended up with an emergency c-section and doctors and other staff were just brilliant. ‘Skin to skin’ contact with your newborn now seems to be really encouraged – we had a good long time, despite the c-section; last time, my baby was whisked away despite me asking for skin to skin time.

Post natal: The ward is still a busy and very noisy place – don’t expect to get much sleep while you are there. But the midwives were much friendlier and much more professional – they introduced themselves, told you what they were doing, and each of the 4-bedded rooms had a ‘named midwife’ for the day which made it seem more personal and also made it much easier to know who to ask if there were problems. Wards and bathrooms now seemed extremely clean. There is a nice little breastfeeding room open day and night, with comfy chairs. There is even a team of 'alternative therapy' volunteers who come in and give foot massages from time to time (yes, really!)

Breastfeeding support on the postnatal ward – this had changed beyond all recognition; this time, no one told me to bottle feed despite me having similar problems breastfeeding baby number two; several midwives tried to help me, and I was put in touch with the ‘Camden Peer Support’ volunteers who come in every weekday (trained mums who pop in to help and advise)

Despite the huge improvements, there were still some negatives -
- I agree it can be very hard to get hold of the community midwives – I called and called over several days (leaving messages in various places) to follow up a blood test. It took 4 days to get hold of anyone – and I ended up having to go in immediately for an induction once a doctor saw the results; it was a little unsettling as the midwives had been happy to have left things another week til my next midwife appointment (I had obstetric cholestasis.)
- My baby had terrible trouble breastfeeding – turns out he had a complete ‘tongue tie’ – this was not mentioned by any of the paediatricians or midwives – and was only spotted some days later back at home when I asked a mw to check in the baby’s mouth for problems. The RF has a weekly clinic for tongue tie but a week is a long time to be unable to feed your baby! I ended sorting this out privately. (Could checking for tongue tie be added to the list of newborn baby checks? It would have made a huge difference to our first few days if this had been picked up earlier…)
- Regarding induction – I was induced on the labour ward because of complications; however, most people who need induction are induced on the postnatal ward, I think, and this looked like a grim option, as partners etc have to leave at 8pm, so you are on your own from then til 10am the next morning. One night on the post-natal ward a woman was induced in the room I was in – she went into labour and was there much of the night labouring alone; she was told to stay in bed, and none of the midwives had time to give her any support. I felt so sorry for her and would have helped her if I could! As soon as you get to some milestone (eg x cm dilated) you can go to thelabour ward and be with your partner, but for many women I know it can be many tough hours to even get to being ‘officially’ in active labour (been there!). Very hard to go through that all alone, on a bed, being monitored. Yuck. So much else at the RF has improved – I wonder if there is anything that can be done to help women in this position eg setting aside a place for them to labour that’s not surrounded by crying babies and sleeping women, or even perhaps getting trainee doulas to sit with them, for example?

- A couple of things that I wasn't prepared for the first time round, but it helps if you know about them: your partner can't stay on the postnatal ward with you after 8pm, so if your baby is born at night, they will have to leave you quite soon - which can be hard. Also - be prepared, when you are ready to go home, 'checking out' can take a day or more – you may need to wait (and wait) for the paediatrician and various others to sign you out, and for all the paperwork to be completed. I found this less stressful the second time around as I was prepared for the wait (it can be hard to end up staying an extra night when you are desperate to get home!)

Finally- with breastfeeding support, although things seem to have vastly improved at the RF, I would go prepared in case you have problems. Get the list of Camden baby clinics to take in with you (go to one when pregnant if you can), and if you’re having ANY problems while in the RF, ask to see one of the fantastic Peer Supporters – ask the mw to put you on the daily list to see them when they come in (I think this is weekdays only?).

Sorry for the long post, but I hope this helps. Many, many thanks to Sympathetic Consultant and others like you, for taking the time to post on this board – and for all the positive changes that you’ve clearly been making at the RF.

sassmonkey Wed 30-Sep-09 11:30:28

Dear mellow123 - thank you so much for bothering to post about your experience. It was very useful to hear an up to date experience - and one that was largely positive! I'm sure all of us who are contemplating the Royal Free appreciated a balanced view of your experience there.

Labouring alone in the post-natal ward does NOT sound appealing.

SympatheticConsultant, can you shed any light on whether or not this is a common practice and if it's possible to get around it?

Mellow, did you catch a glimpse of or have any involvement with the birth centre? Just wondering what that is like.

Thanks again for your post,
sassmonkey

nwthree Wed 30-Sep-09 19:50:35

Sassmonkey,

If you're interested in the Birth Centre, you might want to consider taking the tour of the maternity unit (2pm on Sundays). I went last week and was impressed. It was incredibly clean and seems to have been put together with care. You certainly feel that you are in hospital, but they have tried to keep all the medical stuff hidden. You can't book in advance - when you turn up in labour, they will assess you and if you are low risk and there is space, you will have the option of going to the BC. Fair enough, given that none of us know when we will be turning up there!

sassmonkey Thu 01-Oct-09 10:54:41

Hi nwthree,

Good idea and one I had been thinking about for this weekend. Glad to hear you were impressed. Are you doing to stick with the RF then?

Did you get a tour of the labour ward as well? I guess that could be the other place we end up on that as-yet-unknown day...smile

mellow123 Fri 02-Oct-09 20:00:53

Hi Sass Monkey

Unfortunately, I never made it to the Birth Centre, as I had some complications with both labours. However, it looks very nice! And it is literally next door to the Labour Ward - just seperated by a door, really - so there is quick access to the Labour Ward if needed. If you do the tour, I think they show you both the Labour Ward and the Birth Centre.

(From my other post - Just to say, I think you'd probably only be in labour on the postnatal ward if you were induced; otherwise, I think the norm if you go in to the RF already in labour is to go the 'triage' area in the Labour Ward and then be sent to either the Birth Centre or a room in Labour Ward, depending on your risk level and preferences. Hope that makes sense!)

Good luck to all, hope your births go well!

mellow123 Fri 02-Oct-09 20:04:55

Hi Sass Monkey

Unfortunately, I never made it to the Birth Centre, as I had some complications with both labours. However, it looks very nice! And it is literally next door to the Labour Ward - just seperated by a door, really - so there is quick access to the Labour Ward if needed. If you do the tour, I think they show you both the Labour Ward and the Birth Centre.

(From my other post - Just to say, I think you'd probably only be in labour on the postnatal ward if you were induced; otherwise, I think the norm if you go in to the RF already in labour is to go the 'triage' area in the Labour Ward and then be sent to either the Birth Centre or a room in Labour Ward, depending on your risk level and preferences. Hope that makes sense!)

Good luck to all, hope your births go well!

nwthree Sat 03-Oct-09 10:57:11

Hi again,

Yes, I've decided to stick with the Royal Free and am feeling happy about it. Unfortunately the labour ward was full when I was on the tour so we didn't see any of the rooms but I think there may be pictures on the RF website. The midwives all seemed really nice and it was a friendly atmosphere.

nwthree

sassmonkey Fri 09-Oct-09 14:10:49

Well, we had our tour of the birth centre last weekend. Like nwthree, we didn't get to see a labour room, which was too bad. The midwife seemed nice but I did ask a couple of tricky questions - e.g. is it true that if you are induced and in early labour at night, no visitors are allowed so you labour alone?? She said yes and some of the others in the group looked a bit shocked!

I also asked how the midwives ensure a consistency of style and approaches between shift changes, so that women in labour aren't receiving conflicting advice. She kind of laughed and indicated that was a tough one. She did say that they are doing more to ensure one-to-one care at the RF in the next few months. Anyone know anything about what that means to us?

Good luck to you too, mellow!

againagain Sun 11-Oct-09 22:01:12

I gave birth to my DS2 at the royal free in September 2008.
The care I experienced was patchy and I think if this had been first time around I'd have been truly unnerved.
I arrived well into active labour (5cm according to triage) but still had to stand at the desk until one of the (many) disinterested MW said - 'yes?'. It was approaching 6pm (is this shift-change?) and no one seemed to want to deal with me! I saw a very kind midwife in triage then was put in a labour room (birth centre unavailable due to lack of midwife). Another midwife came in and told me she'd be my midwife until 8.30 only. Other midwives brandishing paperwork kept coming in while I was contracted - was I sure this was the right name of my GP etc. No worries - he'd popped out by 7pm, but seriously in the half hour after birth I had midwives coming in to borrow equipment, row more about the paperwork and even one while I was being stitched who had a row with my midwife about needing to borrow something. i got the impression that only 1 or 2 of them actually wanted to be there and they had no respect that I was in labour. As I said if this was first time round I'd have been horrified!

Wilsybear Sun 01-Nov-09 14:36:03

Hi I was really interested to read this thread as I am due to give birth at the RF next week!

As a first timer, and having only lived here a short time, I have to admit to being a bit confused about maternity care generally in London. My GP was utterly useless about advising me on even which hospital catchment area I fell under. Searching on the internet it appeared that all the maternity units have good and bad reviews, so I chose the RF based mainly on the appeal of the birth centre.

My experience so far has been reasonably positive, there have been times when I have had to wait, which is obviously a health service wide problem not specific to this dept or hospital. I have never seen the same midwife twice, but again I believe this to be a London wide issue.

The staff I have seen are generally friendly (the people who take your blood can be a bit hit and miss), and I found the midwives who did the hospital tour and waterbirth workshops to be really friendly and informative.

The only specific problem I have had is on my last check up. Having been waiting for a while (and on realising that people who arrived after me were being seen) I went to the desk to be told that I had already been marked off as been seen! The receptionist and midwife I eventually saw were very apologetic, and the midwife I saw was the best I have seen so far, in that she explained everything she was doing and why, and again made time to answer my queries.

My main concern about the RF has always been the things I have heard about post natal support, but I guess I will find out very shortly about that aspect of the care!

nwthree Mon 02-Nov-09 08:18:16

Good luck Wilsybear! Let us know how it goes.

sassmonkey Wed 25-Nov-09 10:54:39

Any updates on this thread from anyone?

nwthree, when are you due?

allaboutme Wed 25-Nov-09 11:21:17

I'm so pleased things are changing at RF it seems.
I wish I had researched it a bit more before having DC1 there in late 2005.
I'm still a bit bitter at the fact that a trainee MW broke DC's arm when delivering him.

I had DC2 at a completely different hospital and it was so so different, they were fantastic.
The level of care you get does make such a huge difference and so I am very pleased that RF is pulling its socks up finally.
Well done sympathetic consultant on your good work.

Ana11 Wed 25-Nov-09 23:03:17

I am due to give birth in 3 weeks time and have found this thread extremelly interesting as I have heard so many mix reviews about the RF in the last couple of years. I had my first baby at the RF in July 07 and my experience was very much in line with most of the comments here. Whilst medical staff and midwives were excellent the post natal care and ward was sub-standard. I won't go into it in detail as it all has been said on previous posts.
My experience this time round has been better so far in that I have seen the same midwife throughout the pregnancy and she has been fantastic. I never had to wait too long for the scans and the sonographers were always very kind and attentative. Only problem was when I received a letter informing me I had missed my scan appointment which as a matter of fact I had already had a week or so before the letter was printed so I guess there was some sort of mix up there!
I have made my decision to have my second baby at the RF given the efforts that are being put in in improving the experience and as such I will be letting you all know what my experience is like as soon as I am home.... I just hope that SympatheticConsultant is at hand if needed and that all the efforts made to improve the Unit are a reality!

Lastly, I agree with mellow123 that it would be nice to be able to have my husband with me whilst I am in labour...he was sent home last time and I had to endure most of it on my own

KERALA1 Wed 25-Nov-09 23:15:36

Surely it can only get better. I cannot imagine it would be possible to be any worse than when I gave birth there in summer 2006. People had warned me it was bad but I thought they were being precious/demanding. Ha how wrong I was.DH and I both ended up with mild PTSD because of what happened there. We did make a formal complaint.

We moved out of London and last year had a second baby at a hospital in the South West. The experience was so so different it is hard to comprehend that both hospitals are part of the same NHS system. Even if we hadnt moved I would never never have gone back <shudder>.

sassmonkey Thu 26-Nov-09 11:15:54

I have had two appointments (just the general checkups) with SympatheticConsultant because I wasn't happy with the midwife at my local surgery (she is from the RF but does a day a week at the surgery). SC has been great - very thorough and approachable. And in fact, the other people I have seen in those visits were good as well - everything happened relatively on time, even the things that weren't booked (i.e. blood tests). They seem to not be able to find my hospital notes last visit - I'm hoping that will be rectified for next visit!

I'm due on Monday (30th Nov), so having made the decision to stay, I hope the Birth Centre, Labour Ward and post-natal are putting in as much effort to provide good service as SympatheticConsultant is!

I'll let you all know...

And sorry to hear about your past bad experiences Kerala1. I'm glad your most recent birth was much better.

nwthree Sun 29-Nov-09 09:50:16

Hi all,

Like Sassmonkey, I've been seeing Sympathetic Consultant at the RF. I agree that he is approachable and clearly really making an effort to improve things. He has answered a lot of questions that my midwife was unable to address. We have had a couple more scans as well. The bedside manner of some of the junior doctors at the scans could still be improved, I'm afraid, but I have faith that this will be addressed.

I'm due on 19 December, so I'll be very interested to hear Sassmonkey's experience. I'm also hoping to use the birth centre, space permitting. I'll report back on how I get on.

As an aside, I've heard that UCH is suffering from its popularity at the moment. It's so busy that women are not getting midwife appointments. This is something I've had no problem with at the RF, so anyone deciding between the two might want to consider this.

Good luck Sassmonkey! Hope it all goes smoothly.

pecanpie Mon 30-Nov-09 07:16:45

I am on Miss Tuck's team at Royal Free. Her registrars are a great reflection on her teaching abilities. I really believe that I am getting the best advice even from the less confident members of the team. The only problem with Royal Free is the awful community midwife care. I chose to see my GP and consultant's team rather than the blue team of midwives which to say the least is poorly managed. The team leader was over an hour late for my first appointment which was in the hospital and a friend has experienced the same. She's also heard her arguing with other staff members in public which is pretty unprofessional. If this woman was on duty in the hospital on the day I deliver, I would not want her anywhere near me or my baby.

sassmonkey Mon 30-Nov-09 11:36:42

I wasn't that impressed with a certain member of the yellow team as well, and am much happier in the care of the consultant's team. That said, I've had contact with a few midwives who were very helpful, so I guess we can't write off everyone. Nor should we want to, we will be in their hands! I agree though, Sympathetic Consultant's registrar was very good as well.

Damn, nwthree, I thought perhaps you were going first and could report back! Allright then, I'll go first, scope out the territory and report back. grin

Wilsybear Wed 02-Dec-09 17:01:44

Hi there I finally gave birth to my DD last week and was released from the RF yesterday following a slightly prolonged stay of 5 nights due to needing a induction and then the baby having a few issues. Anyway I just thought that I would report back on my experiences. Basically they are pretty much in line with what people have previously reported and I would end up writing War & Peace if i go into every detail. So in summary:

Antenatal - I have previously posted about this.
Induction - I spend 2 nights at the RF being induced before having my baby. My initial induction was cancelled as last week was particularly busy and there were no beds. I was not bothered by this as I was still keen to go into spontaneous labour anyway. I agree with another post that it is awful when you are in early labour and your partner is not allowed to be there to support you. I am not sure really what can be done about this, as I can see that they need to control people coming in and out at night time, but I did find it very difficult and quite stressful not to have my DH there.
Labour Ward - sheer bliss after being on the Postnatal ward for 2 nights! I cannot fault it, the staff are fantastic and when I needed an assisted delivery they made us feel really in safe hands. Ana, Ola and Donna all great.
Postnatal - As people have commented it is good to have a named midwife in charge of your room, they are however hugely busy. This said I didn't have any negative experiences with the midwifery team on this ward. My only comment is that whilst the ward is clean, they do not appear to even check if your sheets need changing. I was in for 3 nights after my birth and as you can imagine they were in a pretty bad way by the end of the stay.
Discharging - This is my major problem! After 5 nights I was climbing the walls to get home and it took us 8 hours to get discharged, and only then happened when I threatened to discharge myself and threw a fit. When I think that they were cancelling inductions the week before due to lack of beds, I can now see why! The doctor responsible for discharging had gone AWOL and to be fair to the midwifery team they were all pretty annoyed at not being able to find her, as I think they had a number of women waiting for discharge.

All in all it was not a bad experience and whilst it was not the birth I would have wanted this is not the fault of the hospital. The staff are good, if a little over stretched. As someone else has mentioned the junior doctors do seem to have a more impersonal approach. The doctor who ended up delivering my baby for instance, I had seen on a couple of occasions and I still have no idea who he was because he didn't introduce himself hmm We very much felt we were treated simply as another one to tick off his list. As an aside I would also like to say that the anaesthesiology team are fantastic and the lady anaesthetist who was at my delivery was brilliant (can't remember her name)throughout, letting us know exactly what was going on and why.

Sorry this has turned into a really long post. If you have managed to get to the end of it, I hope it is of some use smile

nwthree Fri 04-Dec-09 15:02:08

Hi Wilsybear,

Congrats on the birth of your baby. I'm pleased that your experience wasn't all bad - thanks so much for the feedback. It sounds as though there are still improvements to be made, and hopefully SC is still monitoring this thread. I'm seeing him next week and will mention it. I think the junior doctors leave a lot to be desired. Very odd that they have a complete inability to introduce themselves (I've experienced the same problem a few times and it really riles me), especially when you are so vulnerable and don't know what's going on.

Hope you have time to relax and recuperate.

sassmonkey Fri 04-Dec-09 20:34:35

I agree, congrats Wilsybear and thank you for your posting. It gives me reassurance that you had a relatively good experience. SCs registrars seem to have some social skills, but I haven't encountered any others. Based on your experience, I'm hoping to get booked for an induction ASAP as if I leave it to next week after my sweep, I might have to leave it longer than I want to.

Thanks again for feeding back, hope you are enjoying your wee one!

Sass

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