Swansea Bay University Health Board

Context and approach

Swansea Bay University Health Board (SBUHB) is one of the largest health boards in Wales, serving the area of Swansea and Neath Port Talbot with a combined population of 390,000 people and over 14,000 staff. Differing from English ICBs, Local Health Boards (LHBs) are the primary body for delivering health and social care in Wales, ranging from primary and second care to specialist services. This integrated model makes Swansea Bay and the other LHBs unique in the National Health Service, with three major hospitals under its direction: Singleton, Morriston, and Port Talbot.

The Health Board contacted Niche in May 2024 to commission a review to examine the safety and quality of their maternity and neonatal services between 2019 and 2024, following concerns raised by families, stakeholders and through outcome data. For 12 months, our review had five clear interrelated components: to listen to the voices of families, to assess clinical services, to review the governance processes of the health board, to review staffing and to examine the extensive data which we mined.

What we found

While the review contained a significant retrospective element, we recognised our work had to uncover and provide information which instilled patient confidence today and in future delivery. Through our assessment of MBRRACE-UK data (Mothers and Babies – Reducing Risk through audits and enquiries across the UK) and other review frameworks, and extensive analysis of data and evidence relating to demographic risk, activity, acuity, staffing and outcomes, we were able to pinpoint 10 priority recommendations.

We wouldn’t have been able to conduct this review without the input and support of the various affected families who chose to take part. We unreservedly thank them for sharing their stories, which often meant having to relive difficult and traumatic experiences to the review team.

Their input allowed our team to develop a broad and deep understanding of patient experiences and the themes that emerged. As a result, we were able to link the experience of service users to the processes behind clinical delivery as well as governance and the role of staff, for the betterment of our review.

Our recommendations were submitted in full and have been accepted by both the Health Board in Swansea and the Welsh Government.

The Swansea Bay Independent Maternity and Neonatal Review is available to view on the Swansea Bay University Health Board website.