Better Births – Implementing Community Hubs and considering models of care

We face an exciting year ahead for Better Births in 2018. We have made some significant progress in agreeing how we are going to implement community hubs and what models of care we can provide that will ensure continuity of care and carer wherever we can.

Discussions and meetings have been held with frontline managers and staff and we are now putting together standard operating documents (these spell out how we are going to function) for the Park Lane and Harmood Children’s Centre hubs.

Harmood Children’s Centre Hub

At this hub, which will be based in Camden, midwives from University College London Hospital (UCLH) and Royal Free London NHS Foundation Trust will be providing continuity of care antenatally and postnatally. This will be an improvement from current care provision, especially for women at UCLH, who receive their antenatal care at the hospital rather than the community and their postnatal care is fragmented due to postcode boundaries. There is an agreement now that women who have booked at either trust will continue to receive postnatal care across existing boundaries in the NW1 and NW5 area, from their known midwives. There will be a midwife available at Harmood Children’s Centre hub from Monday to Friday as midwives from both trusts will be located there on separate days of the week.

There are still operational issues and staffing levels to negotiate in order to care for 100 women (for the pilot). The project team is working hard to support and engage with the right people in ironing out these important issues.

Park Lane Children’s Centre Hub

At Park Lane Children’s Centre hub (in Haringey) we have agreed that we will be testing a caseload model of care for about 100 vulnerable women. These are women who will be in the moderate to low category of vulnerability. Midwives from the Whittington and North Middlesex will provide total care either in a team or as buddies. Women will be cared for throughout pregnancy, labour and postnatally by a midwife known to them. For this model, we are negotiating numbers of midwives required and also working out ‘on call’ arrangements that are more family friendly e.g. we are considering shifts patterns to cover the work 24/7. This model offers midwives an opportunity to manage their own caseload and exercise their autonomy as midwives.

What happens now?

This month we will be inviting midwives keen to be involved in these pilots for their expressions of interest. For those midwives who wish to develop their skills and broaden experiences as well as pioneering Better Births, this is a great opportunity. It is time limited and something midwives may wish to consider in the short term. Both pilots will be completed by the end of 2018 as we need to evaluate the impact of these models of care on women and the professionals caring for them. Midwives will be supported throughout the pilot by the project team with regular reviews, clinical supervision and with any ongoing issues to ensure both midwives and women feel secure.

Information

If you need to discuss in detail on any of these proposals or are interested in trying out the case loading model, please contact me at Logan.VanLessen@nhs.net or the project lead for NCL, Charlotte McClymont at UCLPartners Charlotte.McClymont@uclpartners.com.

A big thank you to midwifery colleagues, partners and women who have engaged and helped us so far in planning these proposed models or Better Births.