Improved Model Outlined for the Midwifery Led Services Review

1 December 2017 10:29am

An improved model for midwifery led care to provide a wider and more accessible service for local mums and their families is being proposed by Shropshire and Telford & Wrekin CCGs following a major review.

The review has included the Midwife-Led Units that provide antenatal, birth and postnatal care in Shrewsbury, Ludlow, Oswestry, Bridgnorth and Telford. The proposals have been developed following a detailed review and engagement process. 

This looked at existing data as well as gathering new information through interviews with staff and service users. An essential part of developing the proposal was the feedback and ideas from a series of co-design workshops. These engagement events brought commissioners, women and staff together to look at what staff and women accessing the services wanted and needed. 

Taking on board the findings and feedback from the review, the CCGs have developed a proposal for an improved model of midwifery led care to better meet the needs of women and their families across the county as well as improvements for staff working in, and with, maternity services. Also factored into the model design are the key themes in the national guidance document, ‘Better Births: Improving outcomes of maternity services in England. A five year forward view for maternity care’.

The proposed model includes a number of maternity hubs that would ensure women across the county have equal access to a wide range of related maternity services close to home.  Each hub would have the same services so that all women could fairly access them, regardless of where they live. The plan is these services would not only cover pregnancy, but also offer support after the baby is born.  This would also help women build relationships with other women accessing the services throughout pregnancy and beyond – something that women told the CCGs was really important to them when they took part in the engagement workshops. 

It is proposed there would be at least one maternity hub in at least each one of the following areas including Bridgnorth, Ludlow, Oswestry, Shrewsbury and Telford. Each hub would offer a broad range of services. These would include antenatal and postnatal care from a midwife, scanning, fetal monitoring and day assessment. There would also be support with emotional wellbeing and mental health related to pregnancy and early parenthood as well as healthy lifestyle services.

In the proposed model, women would be able to give birth at the Consultant-led unit at the Princess Royal Hospital (PRH) and at the alongside Midwife Led Unit, which is also on the hospital site, as well as a freestanding Midwife Led Unit in Shrewsbury and at home. For women who choose maternity services over the border there are proposals to improve pathways to make access easier.

Excellent community postnatal care would also be available consistently across the county through the maternity hubs.  The maternity hubs would provide advice, care and support that women and their families told the CCGs were most important for them. This would include a space for women and their families to reflect on the birth experience as well as support with emotional wellbeing and mental health. 

There would also be advice with feeding as well as support with confidence building and bonding.  In addition to the maternity hubs, there would be a team of community midwives and women’s support assistants who would be available 24/7 to offer advice and support for women during pregnancy and after the baby is born.
Dr Jess Sokolov, Shropshire CCG’s Clinical Lead for the midwifery led services review, speaking on behalf of both CCGs, said: “This proposed new model improves services for women and staff by making the best use of resources in line with what women and their families want and need.  

“We’ve listened to what local mums, staff and others with an interest in midwife led units think about the current midwifery led services and have directly used their ideas raised during the co-design workshops in pulling the proposed new service model together.

“One of the things mums told us is that having a baby was not just about a trip to a delivery room to give birth, but a whole journey that starts before getting pregnant and goes on long after the baby is born. The new model really responds to this by bringing together a whole range of services throughout pregnancy and beyond, which are flexible and accessible, regardless of where mums live in the county.

“This model also has an increased focus in ensuring that it cares for both the physical and emotional wellbeing of becoming a mum - something that women said wasn’t good enough in existing services.”

Sarah Jamieson, Head of Midwifery at The Shrewsbury and Telford Hospital NHS Trust (SaTH), said: “I’m delighted the proposals from this review are now available to us. Over the last few months we have worked closely with our CCGs to enable a robust and complete review of our service as it stands today. 

“We know that the needs and wishes of our population have changed over the years. This review has been responsive to those changes and presents us with some real and exciting opportunities. At SaTH, we are eager to begin to look at how these proposals can be connected with the work of our Local Maternity System (LMS).

“We are encouraged to see that mums’ thoughts about their experience as a whole journey, and not just a trip to a delivery room, have been taken in to account. We already know that most of our women (97.3%) give birth at either the Consultant-led unit at the Princess Royal Hospital (PRH), the alongside Midwife Led Unit, the a standalone Midwife Led Unit in Shrewsbury or at home. The new model proposed maintains a full range of choices for our women, whilst protecting their antenatal care and postnatal care closer to their home. 

“The proposal to bring together a multitude of services in the communities, rather than limiting them to one or two central units, is very much in line with the recommendations of Better Births (2016) and enables the services that matter most to our mums to be broadened and enhanced, which would provide a safe and kind maternity service with access to services closer to home.” 

The proposed model is being unveiled to mums, staff and others who took part in the engagement work to help shape the service at a special presentation on Thursday, 30 November.

It will then be presented to Shropshire CCG’s Governing Body to review and comment on in December, before going to Telford CCG’s Governing Body in January. Once the two Governing Bodies have considered the proposal it is intended that it will be subject to consultation.

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