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Green Templeton College | Oxford

October 2015: Maternity Care

The inaugural research seminar was curated by Lesley Page, President of the Royal College of Midwives and Visiting Professor of Midwifery at the Florence Nightingale School of Nursing and Midwifery, Kings College London. An invited group of lay and professional experts in pregnancy and maternity care met at Green Templeton College for two days of presentations and intensive discussion of the evidence around continuity in midwifery-led care. Among the participants was Baroness Julia Cumberlege, chair of the National Maternity Review.

Maternity Care

The final report of the research seminar was published jointly by Green Templeton College and King's College London in April 2016 entitled, 

Relationships: the pathway to safe, high-quality maternity care .  

Click to read the full report.

It provides a comprehensive review of the current evidence of the benefits  of continuity of midwife care to women, their families and the National Health Service.

February 2016: Female Genital Mutilation

This event provided an opportunity to share findings from research on a small GTC grant led by Sharon Dixon, Lisa Hinton and GTC research fellow Louise Locock, and supported by Brenda Kelly, lead clinician for the Oxford Rose clinic. The aim was to share experience and progress in this field and to develop an agenda for further research .

Participants included members of community groups, people working in clinical services, multi-agency team workers (police, social services and community outreach workers), legal experts, members of charitable organisations, and academics.  The seminar included a dance and song performance by Diasporan Hands, a group of Sierra Leoneans living in the UK working to empowering women and girls through awareness raising, advocacy, and direct support.

The meeting took place at Green Templeton College, Oxford on 27.2.2016 entitled:

FGM: where have we got to? And what comes next?

For more on the seminar please see the final report.

FGM 1FGM 2

 

 

February 2017: Communicating to children about life threatening illness: critical to children’s health and resilience

The Kitzinger meeting was a unique opportunity to bring together colleagues with a diverse range of academic and clinical experience from both high income and low income countries, with the aim of developing evidence based guidelines for communicating with children about life limiting illness in either themselves or their parent. The workshop was convened by Professor Alan Stein, Professor of Child and Adolescent Psychiatry, Oxford.

The meeting included presentations on a range of topics, including children’s developmental understanding of illness and death, the use of story books to promote adaptive coping for parents and children following illness or death in countries with low levels of literacy, interventions to support parents to disclose their HIV status to their children and current practice in end of life care for children and parents. In addition to these formal presentations and subsequent discussion, participants also worked in small groups to consider the particular experiences and challenges for parents and children of different ages and in different healthcare settings at the time of diagnosis of life limiting illness. These hypothetical scenarios then formed the basis for a session focused on generating principles for communicating with children. The next key challenge was to consider how these principles could be delivered in very different healthcare contexts, e.g. from a Western Specialist Oncology Unit to a rural clinic in sub Saharan Africa. The group also spent time considering the specific barriers to communication for children, parents and healthcare professionals.

The work conducted over the course of the meeting has been summarised in a series of slides, circulated to all participants, culminating in the some suggested principles of communication for children of different ages and circumstances. These outputs form a key component of two review articles, planned for submission to the Lancet. These papers detail the empirical evidence about communicating with children in the case of child illness (paper 1) and parental illness (paper 2), before giving practical recommendations about communication.

In addition to the written workshop outputs and review papers, the participants of the workshop have forged important international links between themselves and are all committed to taking this work forward in the future. Ideas include regular meetings to develop research projects to address the current gaps in knowledge and plans to generate specific teaching and training resources available for healthcare professionals working across the globe.

 

April 2017:  End of Life Decision Making for Patients in Prolonged Disorders of Consciousness: Human rights, ethics, law, medicine, science and society

A two-day international seminar curated by Professor Celia Kitzinger (York) and Professor Jenny Kitzinger (Cardiff) of the Coma and Disorders of Consciousness Research Centre (cdoc.org.uk).

Modern medical technologies and current legal practices are such that patients in prolonged disorders of consciousness (vegetative or minimally conscious states) are often maintained for years – or decades – after their families believe they would have wanted treatment withdrawn.  Our aim is to bring together a small group of international experts (plus some early career researchers for capacity-building) to share experiences, to learn from the ways systems work in different countries, to identify the problems in diverse systems and to work towards solutions.

Contributions will be published as a collection in either an edited book or a special issue of a journal.    

 

 

October 2017: Transforming Consent in Maternity Care

 11Oct2017

On 11th October Birthrights gathered a small group of maternity leaders, policy makers, service users, academics and legal experts for a seminar on “Transforming Consent in Maternity Care”. The event was hosted by Green Templeton College Oxford, as part of the Sheila Kitzinger Programme and we are grateful to the College, the Kitzinger family and Programme team for their enthusiasm, support and funding.

The day started with an exploration of the key facts of the judgment of the Supreme Court made in the Montgomery v. Lanarkshire case. In this case Mrs Montgomery, a pregnant diabetic woman with a large baby, was not informed by her obstetrician of the chance of shoulder dystocia - which she went on to experience with profound consequences for her and her son. Although Mrs Montgomery had repeatedly expressed concerns about giving birth vaginally, the obstetrician said that she routinely chose not to explain the risk of shoulder dystocia to diabetic women because the risk of serious injury to the baby was very small and that if she did explain it, ‘then everyone would ask for a caesarean section’.

Seminar participants agreed that, while there had been concern that the Montgomery judgement offered a radically different interpretation of consent, in reality it simply brought the law in to line with GMC guidance, recognising standard best practice as well as what women say they want and need. The court highlighted a need for two-way dialogue between a woman and caregiver (presented in a way that the woman can understand) and insisted that any material risks and benefits should be presented to her and that those discussions should be personalised to her circumstances. It deprecated the use of consent forms and, in synchronicity with the recommendations of the Better Births report, solidified the need for relationship-based care, that flexes around the needs of individual women in order to ensure that women and babies are safe.

After wrestling with the philosophical and personal impact of autonomy the group turned to the challenges of achieving the training, structures, systems and cultures that facilitate care that enables lawful consent to be given, paying particular attention to how this could be achieved through the Maternity Transformation Programme and other existing initiatives, alongside the difficulties faced by clinicians in the dynamic birth room environment.

There were a number of recommendations from the seminar group. Birthrights are currently consulting with the participants and other key national bodies and service user groups to develop these.


October 2017: What does it mean to be an adolescent in the 21st century? Implications for health and healthcare.

Young people (10-24) represent one fifth of the UK population. However, there is evidence that the specific needs of young people are often neglected by secondary and primary care.

Adolescence is a time of physical and emotional transition and growth. Concepts of self, attitudes to risk; peer influence; and the ability to understand the ‘other’s’ perspective all undergo major change. Many health problems present specific challenges in this age group, including those that may first present in adolescence (such as sexual or mental health problems) and those where clinical management may need to evolve alongside the development and priorities of the adolescent (such as in chronic problems including diabetes and eczema). Additionally behaviours that influence health throughout the lifecourse may be first experienced or established at this time (for example smoking and diet).

The world is also constantly changing with rapid technological advances, social media, communication platforms and political changes. With the support of the Sheila Kitzinger Programme, we are holding a one-day workshop involving advocates, adolescents, experts and relevant health professionals to consult on what it means to be an adolescent in the 21st century, and the implications of this for health service development and provision. Through sharing experiences of service design and delivery, we will consider how to support and nurture autonomy in adolescents as they develop skills in managing their health, and how services can evolve and develop to be acceptable and responsive to the needs of young people as they transition to adulthood.