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Qualitative service evaluation of a rural midwife-led ultrasound service: listening to women

02 May 2024
Research
02 May 2024
Volume 32 · Issue 5

Abstract

Background/Aims

Patient experience is needed to understand if a service is meeting the needs of the population it serves. In rural areas, accessing maternity services can be challenging for women. Local provision should be explored and consistently reviewed to adapt to changing social requirements and expectations. The aim of this study was to examine a rural midwifery-led ultrasound service 5 years after implementation and post COVID-19, to ascertain if the service provides a positive service user experience.

Methods

A qualitative service evaluation was carried out using semi-structured interviews with four service users. Data were analysed using content analysis.

Results

Positive aspects of the service included continuity of care, communication, time to care, financial benefits and inclusivity in care and care decisions. It was noted that the ultrasound service was in the opposite direction from their homes to the obstetric service if participants needed to be referred for consultant opinion the same day. The significant underlying theme was the positive impact on mental wellbeing and patient experience in pregnancy when attending the service.

Conclusions

There was a high level of satisfaction with the service. Engagement of a broader spectrum of women would provide deeper insight into the service and robust evidence for any service development.

In the last 10 years, there has been a drive towards evidence-based practice and patient-centred care to improve clinical effectiveness and patient safety through the inclusion of patient experience in healthcare quality improvement (Luxford et al, 2011; Doyle et al, 2013). All health boards in Wales are under scrutiny to ensure that they have high standards of maternity care, and that quality improvement is forefront in providing a safe and effective maternity service that provides equity and engagement for service users. Several health board reviews cite ‘listening to the women using the service’ as an essential element in patient care and service evaluation (Royal College of Obstetricians and Gynaecologists, 2019; Kirkup, 2022; Ockenden, 2022). On 1 April 2023, the Health and Social Care (Quality and Engagement) (Wales) Act came into force, requiring improvements in communication and engagement through a citizens advice body to ensure service user experience is used to drive forward improvement. The Act expands on the duty of quality to include not only safe and effective care, but also person-centered, timely, efficient and equitable care.

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Obstetric ultrasound
Patient experience
Rural maternity