3 January 2018

Better Births – The story so far

by Logan Van Lessen

UCLPartners are coordinating trusts across North Central London who will form part of an early adopter site, rolling out a change model for maternity services, as described in ‘Better Births’.

Here, Consultant Midwife and Clinical Lead for North Central London Community Hubs, Logan Van Lessen, describes the work to date. This is the first in a series of blogs which will feature various workstream leads providing updates on the ‘Better Births’ work.

Better Births, the national review of maternity services was launched in 2016, and we, in the North Central London sector (NCL) of trusts, are part of an early adopter site. What does this mean? Well, it means that we:

  • Are piloting models of care, which is part of our ambition to achieve continuity of care/carer, and
  • Personalising care and working across boundaries along with other aims.

For those of you who are not familiar with Better Births, take a look at the National Maternity Review report which outlines a five year forward view for maternity care. This document will increasingly influence the way we work in maternity.

What has happened so far?

The Local Maternity System (LMS) has now been set up and it has representatives from commissioning, managers, service users, obstetricians and maternity leads from the NCL Trusts (UCLH, Royal Free/Barnet, Whittington, and North Middlesex). They are overseeing the development of the Better Births early adopter work and have appointed a project lead and project support team who will help the clinical leads, supported by the lead commissioner for maternity for each of the Better Births work stream.

The LMS has to report to NHS England on the work we are doing so far and give regular updates on progress.

Who’s in the team?

Project Lead: Charlotte McClymont (UCLPartners)

Workstream Leads:

  • Community Hubs – Logan Van Lessen (Consultant Midwife – Whittington)
  • Collaborative Working – Angela Velinor (Professional Development – UCLH)
  • Choice and Personalisation – Gillian DeLaMotte (Band 7/Birth centre – UCLH)
  • Safety and Quality – Ruwan Wilmasundera (Consultant Obstetrician – UCLH)
  • Single Point of Access – Julie Juliff (Maternity Commissioner NCL)

The role of community hubs

In July 2017, I held an initial workshop to discuss what community hubs will look like and what we can offer from them. Community hubs can be physical or virtual spaces and will accommodate midwives, health visitors and other services to provide a seamless service to women and families.  Further group discussions and meetings have been held and we have now narrowed our choice of hubs to one in Camden (Harmood Children’s Centre) and one in Haringey (Park Lane Children’s Centre) which will be our pilot sites to test our proposed models of care.

Bearing in mind we need to demonstrate that we are providing continuity of care and carer, the Camden hub will involve midwives from UCLH and Royal Free working together to provide antenatal and postnatal continuity for women concentrated around the NW5 area, while Whittington and North Middlesex midwives will provide a caseload model of care for more vulnerable women in the Northumberland park area of Haringey (to include intra-partum care). We need to demonstrate that we are making a difference to care and outcomes with these models, therefore we are working out all the detail that is required to provide care in this way. Some of you may already be providing more continuity ante and postnatally, however in Camden it has been a different picture with many women not living where they book to have their baby. Once these hub models are implemented an evaluation will take place against agreed outcomes.

What’s next?

It has been exciting though quite challenging to get started and we have made some good progress but have a way to go before we can implement the models. The timeline is to launch during February 2018, but more details are to be considered and agreed before we can get the pilot sites going.

I will keep you updated of our progress and if any of you are interested or would like further information please do not hesitate to contact me at logan.vanlessen@nhs.net.

It is also important that frontline staff are engaged and involved in this process and I am very happy to take any suggestions you may have on board. To all those who have contributed to the work so far….. a big thank you!

Thank you for your time in reading this…. do give me feedback as to whether you find this useful.