Do you live in Birmingham or Solihull? Q&A with Dr Andrew Coward about NHS services in Birmingham and Solihull - ANSWERS BACK

[EmmaMumsnet]

If you live in Birmingham or Solihull we're inviting you to join a Q&A over the next couple of weeks with eminent Birminghmam GP Dr Andrew Coward about the services the NHS offer in Birmingham and Solihull. Dr Andrew Coward is Chair of Birmingham South Central (BSC) CCG. He is a grassroots GP in Kings Norton with 23 years experience on the front line of primary care

Do you have a question about vaccinations for your child? What services are on offer specifically for young children and babies in your area? Are you unsure about when you should take your child to hospital rather than wait for the doctors? Post your questions to Dr Coward before end of Friday 21 December and we'll post up his answers the first week in January.

Hi there. I live in Sutton, and have had both my children at Good Hope. I cannot fault the midwives and doctors both there and at my surgery. What does confuse me though is the vaccinations. I have always had them vaccinated as soon as I am able, as personally I think it very important. However, I still receive reminders to vaccinate from the NHS. I received one last week when my 18month old had all her relevant vaccinations at 12 months and will not be due anymore until preschool.

Why is this? Are the systems with my GP not linked to some central vaccination point? It is a matter of concern because it is not always clear which vaccination your child has had if they have had a "bundle" altogether and so potentially you may have a parent present for the same injection twice.

This just seems a waste of time and resource.

I live in Solihull by about a footstep

My doctors surgery is awful. You can ring for a same day appointment from 8.30am. You can't get through until at least 9.30am - and all the appointments are long gone by then. Or, you can queue up at the surgery - and get a same day appointment (hopefully) but have to drag yourself and your poorly child to the surgery and back twice in one day - not fun when you are heavily pregnant and don't drive.

Or to book an appointment in advance (which they don't like to do) you are looking at a two week wait, or sometimes told to call back in a weeks time to try and book an appointment for two weeks after that.

So, everytime one of my children is ill I go to the walk in service at Solihull hospital (where they are brilliant) as you will be seen pretty quickly and you don't have to pre book or mess about with waiting for hours on the phone. But, by doing this I am probably using up valuable resources and not using the service for its intended use, but I can't see an alternative. It's getting harder and harder to access basic health care in my area.

I am also under the care of a pretty awful midwife via my GP surgery. I asked about changing midwives but was told that they (the midwives) only rented a room at the surgery and she was the only one available. As antenatal care is split site I am shunted between Heartlands and Solihull hospitals who seem incapable of communicating between themselves. After having a urine test at Solihull at 12 weeks pregnant it took a further 6 weeks or so for the results (that I had a uti) to filter through, by which point I was in hospital with a kidney infection... If I ever have to phone for advice I am passed from pillar post never getting anywhere. It is so frustrating.

Although, when my third child was born (at heartlands) 18 months ago the care I received from individuals was excellent. Things beyond their control (such as waiting hours for pain relief) I can't fault them for as they are obviously stretched to the limit.

I just wanted to commend the NHS in Birmingham and Solihull. I have a young son who has visited the GP more times than I would have wanted as well as a couple of visits to the Badger Clinic (out of hours of clinic) at Solihull Hospital, one of those visits resulted in a direct referral to Bham Children's Hospital and an operation within 24 hrs. Apart from the waiting times at the GP surgery, I have felt massively supported by the NHS and think that you do a great job.

You could answer one question for me though (am not sure you will be able to). I was induced at 38weeks in my first pregnancy due to obstetric cholestasis, labour was difficult and I ended up with a ventouse and forceps delivery. I had a second degree tear with separate rectal tearing and don't feel the same as I used to, although I suppose most women don't. I would like to know what my chances are of being able to elect for a c section next time

WasWallis - I agree the walk in/out of hours at Solihull is really good. A few times my ds3 has been transferred to Heartlands from there and they always seem really on the ball and I was particularly impressed last time I took ds3 (two weeks ago) with yet another chest infection, the doctor was very good and seemed to check him for everything as well as the obvious. I've never come away from there feeling like we've been rushed in and out or like we've wasted anyone's time.

We're in Cotteridge and have samples the delight of the Walk In Centre on Katy Rd more times that I care to mention. But the care has always been excellent and re same goes for my GP surgery - Riverbrook.

My question is about the maternity services in South Birmingham. I have birth at the Women's Hospital and ended up with an EMCS after 3 days in the hospital in labour. My care was patchy throughout, with some archaic advice given by midwives and health visitors. However, my antenatal care was excellent. How can we make the whole of the system here excellent? It felt like two different services.

Yes, i love locally in Boldmere and the GP's surgery is diabolical for getting in.

Why did my GP's surgery send out a written letter as a referral to City Hospital to refer me to neurology, though? They sent it on 7 Dec, and it got lost in the post... As of 14 Dec, still nothing had been received in the post.

Disgusting practice, and wasting valuable time :(

Im in Four Oaks- It has taken me 3 days to get an apt with a female gp at my local surgery ( I didn't request a female gp- I was told I had to see one as I needed some contraception advice??? Don't male GP's give out this type of advice?? thats ludicrous in itself)

So after sitting hitting redial for 3 mornings, only to be told all apts have gone- I FINALLy get a slot yesterday morning at 1030am. I arrive at 1020 and I'm still sat waiting until 1110- I only get seen at that point because I complain.

The GP then prints off a fact sheet off the internet for me. Im sure a male GP could have done this.

( I suppose that this isn't a question more of a moan!!)

I have some concern regarding mental health services in solihull. Im a MH professional and I believe that you plan to decommission Inpatient services for Solihull. How will this work? where will your acutely unwell population with MH issues go??

Hello. One of the maternity wards at Good Hope Hospital has recently closed for good. Why was this done, when there were plenty of times when both maternity wards were so full, that they had to close to new admissions ??

I'm assuming that most people in Sutton and the surrounding areas will still be refered to Good Hope for their maternity care, but will then face being turned away at the time of delivery ? Where will they go then ??

Also, I have a 15yr old daughter with Scoliosis. She was first referred over 2 years ago, when I noticed a curve in her spine. We then waited over 6mths for an initial consultation, and each time I rang to chase it up, we were told that there wasn't enough clinics to cover patients ad that they basically didn't know when she'd be seen. I ended up having to involve my MP, and we were then seen within 2 weeks.

The whole service there though seems so unorganised and patchy. My daughter is now on the list for surgery. Originally we were told 10mth wait, and then when we rang up after ten months we were told it was more like 12.
I fully expect to ring after xmas and be told that it is now 16 mths or similar.
I understand that they are busy, but my daughter is in pain, with no end in sight and the hospital do very little to answer questions about clinics and appointments helpfully, and often sound like they are reading from a script, written by someone higher up.
Last time I spoke to someone there, they said they were going to send us an appointment for a nerve test at the QE. That was in October, and we still haven't had it.

However, whilst I am posting, I must sing the praises of the orthodontic staff at Good Hope Hospital. My 13yr old, has been having treatment there since she was 11, and the whole department have been fabulous, and nothing is ever too much trouble. Other departments should take note.

I think I'm quite lucky with my GP - I can get appointments same day if I need, and don't have to phone at 8.30 to get one.

Also, I was lucky to be able to use the Birthing Centre at the Women's hospital, and when things didn't go to plan, get wheeled up a corridor to some very good natal care. Birmingham Women's is, rightly, a flagship hospital for pregnancy and birth, with the best of both worlds - midwife led care for those who are able to have a straightforward birth, and the best delivery suites in the UK for those who need a bit of extra help.

It's once baby has arrived it starts going downhill. I spent my first night with my daughter alone in a ward with 3 other new mums, all of whom had babies who were crying and who were not being given the support that they needed to have a stress free first night. Overnight auxillary care was pretty abysmal and I didn't get a lot of rest because of the constant crying of the other babies, which, combined with pregnancy hormones was not a good start.

The breastfeeding support was "oh she's latched and had a feed so you're okay". The breastfeeding support worker I requested to speak to never turned up and I ended up with thrush, shredded nipples and extreme pain.

To get good breastfeeding support I had to drive to the Kings Heath Breastfeeding support clinic which takes place on a Friday. Thankfully a community midwife mentioned it at my day 12 check up. Bea and Helena deserve to be given so much more funding and support as they were struggling with sheer numbers when I attended, just because they are the only decent breastfeeding support clinic in the area and mothers travel from all over Birmingham to get advice from them. We need more clinics like theirs - it should be held up as some sort of gold standard. Not all mums have the support needed to get to Kings Heath so there need to be more clinics like that throughout Birmingham.

Would you also be able to tell me whether I would be able to opt to give birth at Birmingham Women's Hospital rather than Heartlands even though I live in Solihull. BWH is preferable to me for a variety of reasons. I am not even pregnant with my second yet but I plan to be next year. I was living in Birmingham when I was pregnant with my first.

WasWallis - I'm 33 weeks pregnant and was told my only options were Solihull or Heartlands (I live in Solihull) so I'd be interested in the answer to your question too as I'd rather not go to Heartlands (even though the individual midwives were lovely last time)

Which makes me think of another question for the Doctor:

I'm currently classed as a 'High Risk' pregnancy and don't understand why. I have asked but was told its due to "a number of factors" - having this label is preventing me from choosing Solihull hospital so its quite important to me that I understand why.

Factors are:

4th baby
Previous 3 were problem free labours (not even so much as a stitch needed, home after 6 hours) using gas and air. 4 hour labours at most.
Healthy babies with Apgar scores of 9 each time.
Reasonable weights - 7lb 3, 7lb 4 and 6lb 14 (but have been classified as small for dates and I'm having to have growth scans - this pregnancy my baby is following the 9th percentile same as my others)

I'm 29, healthy, maybe 7lb over weight pre pregnancy, problem free pregnancy.

I've had choliostasis in my second pregnancy, not in any of the others. It caused no problems and he was born at 40 weeks.

So I don't understand how I'm classed as high risk and get no joy out of asking my midwife. Can you shed any light?

Dinosaurs and was wallis....I don't think you have been given correct information. I live in birmingham and was told that the women's hospital was full when I had my booking in appointment so had to be booked at solihull and heartlands. I thought it didn't matter as I wanted a home birth again, but when I asked my community MW what would happen if I needed to be transferred to hospital during the home birth....I live closer to the women's and was concerned I would be transferred to heartlands, I was told that as I was booked at heartlands, it would be heartlands that I was transferred to. I was not happy with this (transfer to the women's would have taken 10 minutes, to heartlands 25 plus), so my community MW wrote to the supervisor of midwives at BWH and my care was transferred over.
On the day I attended for a booking in appointment they seemed to be running a special clinic for those people who were transferring care. Just write to the SOM and ask to transfer! Also I think NHS codices would mean you can choose any hospital for any appointment....

As it was I had high bp and a growth scan showed possible IUGR, so was induced at the women's the very next day. Received fantastic care on the induction ward, on the delivery suite and patchy care on post natal.

Dinosaurs, thanks for that. I think I will end up as consultant led if I get pregnant again (due to cholestasis in previous pregnancy) hence it rules out Solihull for me too. Heartlands wouldn't be a disaster just very inconvenient.

I had heard loads of horror stories about Heartlands so was worried about going there (plus its further away from Solihull hospital) but it wasn't to bad. They are very busy though. I went in when my waters had broken and was having the odd contraction. I was in the waiting room for a couple of hours (not in established labour but contractions every 4/5 minutes) which wasn't fun as there were other people waiting, a few children and around etc. Then moved to the assessment ward - 6 beds all full and I was in proper labour by then and in gas and air. I think I forgot that I had an audience and I'm not sure how noisy I was etc

But, when I was finally moved at 8-9cm I had a lovely room in the birthing centre upstairs, there was a birth pool, one-two-one midwife, twinkly lights in the ceiling, comfy chairs and ensuite, CD player etc. Lovely midwife and very relaxed atmosphere. I didn't have time for them to fill the pool as I gave birth 20 minutes later. I was bought tea and toast and given lots of time with my baby, had a shower - it was a lovely experience.

Postnatal ward wasn't as good - again very busy midwives. I asked for painkillers a few times but after waiting hours for paracetamol I sent exp out to buy me some and started taking my own. I was lucky as it was my third baby and I knew what I was doing, but some other poor ladies were struggling and the midwives just didn't have time to help them. The toilets very filthy, I would take rubber soles slippers with me.

Food wasn't to bad though, and there was a bowl if crackers with cheese spreads available all day. Took a good while to be discharged as the paper work took hours to be completed.

I wouldn't complain about any of it as every individual person I saw was lovely, it was just a case of not enough pairs of hands or hours on the day. I'm not to worried about going there again if I knew I would get the birthing centre again although my friend would rather give birth in the street than set foot in heartlands again but I won't scare you with that

Brumworld I've also heard good things about the Kings Norton BF Clinic - Helena taught my NCT class and I was the only one not to succeed at BF (although I did express for 3 months).

Agree that the aftercare at BWH was terrible. I had my EMCS at 5:45pm, was transferred to the ward at 8pm and DP was forced to leave me at the door to the ward as visiting hours were over. I hadn't slept in 4 days as had been in labour, had surgery and needed to look after DD. IMO the set up is archaic and I have never felt so alone.

Thanks for your questions so far. We've sent these over to Dr Coward, but because everyone's busy over Christmas, we're going to keep the thread up until January 14 so that more people can join in. Keep 'em coming?

Hello Waswallis - another OC sufferer here. I had it in both pregnancies and have fantastic consultant led care at Birmingham Womens. Have to say the aftercare with my 5 month old was awful though and couldn't wait to get out of the place. The poor midwives seem to do a stupid amount of paperwork now I'm sure my discharge papers were 10 times the quantitiy I had with DD now 7. Midwiives should ahve their paperwork substansially cut IMHO

My question for Dr. Coward is - why can I not have my children immunised for TB? I tried to get it done and was told we did not qualify as we live in wrong part of Birmingham and do not have the right family history (family from Asia?) In my job and DPs we are constantly mixing with different communities from across the city and DD meets children from across different communites at school and during activities like Brownies and swimming. DS at only 3 months was picked up and cuddled at a party by a woman I later discovered to be recovering from TB. I have grave concerns we are unable to have our children immunised. Can you advise how we can have this done or put my mind at rest please?

Thanks for all your questions. Dr Coward now has all of them and he'll be posting answers very soon.

Hello all,
Sorry for the delay in getting these answers to you. We now have the answers back from Dr Coward and also a couple of answers from Dr Patrick Brooke. Dr Brooke is a GP and Chief Officer of Solihull Clinical Commissioning Group. Dr Brooke has responded to questions specifically about health services in Solihull as Solihull CCG will take on responsibility for buying and monitoring healthcare for the people of Solihull from 1st April this year. We'll now post up their answers.

@BillyBollyBrum

Hi there. I live in Sutton, and have had both my children at Good Hope. I cannot fault the midwives and doctors both there and at my surgery. What does confuse me though is the vaccinations. I have always had them vaccinated as soon as I am able, as personally I think it very important. However, I still receive reminders to vaccinate from the NHS. I received one last week when my 18month old had all her relevant vaccinations at 12 months and will not be due anymore until preschool.

Why is this? Are the systems with my GP not linked to some central vaccination point? It is a matter of concern because it is not always clear which vaccination your child has had if they have had a "bundle" altogether and so potentially you may have a parent present for the same injection twice.

This just seems a waste of time and resource.

Thanks for the question. I know it sounds like madness, but what I think is happening here is that the two systems are not updating each other as quickly as they should.
The central system which records child vaccinations is held by Birmingham Community Health Care?s childrens? services. When a child has their vaccinations it is recorded by your GP practice and then it is sent to the central system. However, as is sometimes the case, records can sometimes go amiss and the information is the central system is not as up to date as we would like. It is worth remembering that your GP practice holds the most accurate information, so if you are in doubt always check there first.

@WasWallis

I just wanted to commend the NHS in Birmingham and Solihull. I have a young son who has visited the GP more times than I would have wanted as well as a couple of visits to the Badger Clinic (out of hours of clinic) at Solihull Hospital, one of those visits resulted in a direct referral to Bham Children's Hospital and an operation within 24 hrs. Apart from the waiting times at the GP surgery, I have felt massively supported by the NHS and think that you do a great job.

You could answer one question for me though (am not sure you will be able to). I was induced at 38weeks in my first pregnancy due to obstetric cholestasis, labour was difficult and I ended up with a ventouse and forceps delivery. I had a second degree tear with separate rectal tearing and don't feel the same as I used to, although I suppose most women don't. I would like to know what my chances are of being able to elect for a c section next time

Clearly you had a difficult first birth, and it is only natural to want to explore your options now.
I would suggest that you talk to your midwife about being transferred to consultant led care, and then talk with the consultant about the options you have around the possibility of having a c section.
There are pros and cons to this approach, but the consultant will be able to give you the best advice on your options and the best way forward with your pregnancy for you.

@Dinosaurs

WasWallis - I agree the walk in/out of hours at Solihull is really good. A few times my ds3 has been transferred to Heartlands from there and they always seem really on the ball and I was particularly impressed last time I took ds3 (two weeks ago) with yet another chest infection, the doctor was very good and seemed to check him for everything as well as the obvious. I've never come away from there feeling like we've been rushed in and out or like we've wasted anyone's time.

I am very pleased to hear that you had a good experience at Heartlands. The NHS often gets knocked for one reason or another, but I believe that it is the best healthcare system in the world and something I am very proud to be a part of.

@PrincessPurple

We're in Cotteridge and have samples the delight of the Walk In Centre on Katy Rd more times that I care to mention. But the care has always been excellent and re same goes for my GP surgery - Riverbrook.

My question is about the maternity services in South Birmingham. I have birth at the Women's Hospital and ended up with an EMCS after 3 days in the hospital in labour. My care was patchy throughout, with some archaic advice given by midwives and health visitors. However, my antenatal care was excellent. How can we make the whole of the system here excellent? It felt like two different services.

I am delighted to hear that you had a good experience with the Walk-in Centre and at your GP Practice.

However, I am sorry to hear that you did not feel that you got the same level of care from the Health Visitors and Midwives. I agree that all care should be of the same high level and it should not feel like two separate services.
From what you have described it seems that your GP is most probably a member of the same Clinical Commissioning Group (CCG) that I am the Chair of, Birmingham South Central CCG. In all of our member practices we run a ?Yellow Card? feedback scheme, which is a way for us to gather views to make the whole care system better. Perhaps talk to your GP about your experience and they could record it on one of the Yellow Cards?

@Innocet

Yes, i love locally in Boldmere and the GP's surgery is diabolical for getting in.

Why did my GP's surgery send out a written letter as a referral to City Hospital to refer me to neurology, though? They sent it on 7 Dec, and it got lost in the post... As of 14 Dec, still nothing had been received in the post.

Disgusting practice, and wasting valuable time :(

I?m sorry to hear that your experiences with your GP practice have been so poor. If you feel that you are not getting a good enough service I would suggest seeking a new practice with the view of moving to a new GP.

In terms of your referral, the ?Choose and Book? system is an electronic system and is normally done directly with the hospital/clinic whilst you are at your surgery ? this is the prefered option for most GPs. The second, and more traditional way is to write a letter to the consultant at the hospital (and send a copy to you), an appointment is then sent to you as a result. I suspect that the second approach is what has happened in your case. You could ask your GP to use the Choose and Book system in future to help speed up the process.

@Nutcracker78

Hello. One of the maternity wards at Good Hope Hospital has recently closed for good. Why was this done, when there were plenty of times when both maternity wards were so full, that they had to close to new admissions ??

I'm assuming that most people in Sutton and the surrounding areas will still be refered to Good Hope for their maternity care, but will then face being turned away at the time of delivery ? Where will they go then ??

Also, I have a 15yr old daughter with Scoliosis. She was first referred over 2 years ago, when I noticed a curve in her spine. We then waited over 6mths for an initial consultation, and each time I rang to chase it up, we were told that there wasn't enough clinics to cover patients ad that they basically didn't know when she'd be seen. I ended up having to involve my MP, and we were then seen within 2 weeks.

The whole service there though seems so unorganised and patchy. My daughter is now on the list for surgery. Originally we were told 10mth wait, and then when we rang up after ten months we were told it was more like 12.
I fully expect to ring after xmas and be told that it is now 16 mths or similar.
I understand that they are busy, but my daughter is in pain, with no end in sight and the hospital do very little to answer questions about clinics and appointments helpfully, and often sound like they are reading from a script, written by someone higher up.
Last time I spoke to someone there, they said they were going to send us an appointment for a nerve test at the QE. That was in October, and we still haven't had it.

However, whilst I am posting, I must sing the praises of the orthodontic staff at Good Hope Hospital. My 13yr old, has been having treatment there since she was 11, and the whole department have been fabulous, and nothing is ever too much trouble. Other departments should take note.

What you have experienced is a problem that we see all too often at present. From what I understand, there is currently a national shortage of spinal surgeons.

If your GP has agreed to refer you, and if you haven?t heard anything within 3 months, then I would suggest that you go back to your GP to try to take things further.

The NHS has an 18 week waiting list limit in its constitution, but unfortunately spinal surgery cases seem to be taking longer than this at present.