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Home > Freedom of Information > Disclosure log > FOI220638: Maternity – the provision of tongue-tie services

FOI220638: Maternity – the provision of tongue-tie services

Released 7 December 2022

Request:

  1. Do Midwives use The Bristol Tongue-tie Assessment Tool?  If No please state the assessment used
  2. Please confirm which staff perform the assessment.  For example midwife or a doctor?
  3. Is it a specialist midwife or a junior doctor at the Newborn and Infant  Physical Examination (NIPE) assessment?
  4. Do you have staff designated to perform tongue tie surgery, eg please state if this is an outpatient clinic and how many staff and their job designation/band. – Yes/No
  5. If No – do staff advise parents to speak to their GP or Health visitor?
  6. What improvements have been made offering parents support on tongue tie in the past 18 months as a result of patient feedback?
  7. Please provide an example and include the source of the original feedback eg National Maternity Survey, Complaint, PALS, FFT.

Information disclosed:

Please note University Hospitals Sussex NHS Foundation Trust has been in operation since 1 April 2021, following the merger of Brighton and Sussex University Hospitals NHS Trust and Western Sussex Hospitals NHS Foundation Trust. Information about the Trust’s hospitals

Whilst we are in the process of aligning services under the merged Trust, our legacy Maternity services continue to function individually to ensure there is no disruption to these services and our response reflects this.

Our response relative to Royal Sussex County Hospital, Brighton and Princess Royal Hospital, Haywards Heath is provided below:

  1. The Bristol tool is used on the postnatal wards when considering appropriate referrals to clinic; the Hazelbaker tool is used in the tongue-tie clinics.
  2. Referrals on the wards come from midwives or nursery nurses. Referrals from the community come from midwives or maternity support workers. Midwives run the tongue tie clinics and we also have a consultant who runs clinics.
  3. Midwives and doctors
  4. Yes. We have tongue-tie clinics in the hospital for outpatient appointments. These are usually run by band 6 midwives, with one midwife per clinic.  In total we run 2 clinics per week and each clinic sees 5 babies. 
  5. Not applicable
  6. The Trust constantly monitors its performance and looks for ways to improve its service based on multiple factors, including best practice as well as feedback from staff and patients. There was a reported delay in diagnosis of tongue tie, which resulted in the creation of a webinar for staff with a Q&A and infant feeding boards with photos and descriptors of the TABBY tool which are displayed on the postnatal wards to inform staff and support them with referrals.
  7. See response to question 6 above.

Our response relative to St Richard’s Hospital, Chichester and Worthing Hospital, Worthing is provided below:

  1. The TABBY tool is generally used but other tools are used by staff as required.
  2. The service is Midwife-led.
  3. Midwives and doctors
  4. Yes. Trained practitioners perform the procedure and training is carried out in-house. We currently have 7 trained practitioners in total and are in the process of training 4 more. Procedures are usually carried out on an outpatient basis.  However, staff will perform the procedure on an ad-hoc basis if necessary.  Procedures are always carried out in the clinical environment. The clinics are run by band 6 midwives and one band 7 midwife, with one midwife per clinic, supported by a band 3 maternity care assistant.  In total we run one clinic a week at each hospital (St Richards and Worthing). 
  5. Not applicable
  6. The Trust constantly monitors its performance and looks for ways to improve its service based on multiple factors including best practice as well as feedback from staff and patients. Occasionally the Trust receives feedback via the PALS service about a lack of feeding support.  To address this, we also have an infant feeding team available to support more complex issues and we are setting up a clinic for people with tongue tie issues to receive extra support with feeding if there is a delay in getting an appointment.
  7. See response to question 6 above.

Relevant Trust-wide (at St. Richard’s, Worthing, Royal Sussex County and the Princess Royal Hospitals):

For questions 6 and 7, University Hospitals Sussex NHS Foundation Trust is currently working towards its Baby Friendly Initiative (UNICEF and WHO accreditation), which covers training around breast feeding and support for staff and clients alike.

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