TRANSFORMING MATERNITY SERVICES

TOGETHER (TST)

AT NEWHAM UNIVERSITY HOSPITAL,

BARTS HEALTH

Cathy Falvey- Browne, Consultant Midwife Low Risk

Caterina Raniolo, Maternity Project Manager

BACKGROUND &RATIONALE FOR CHANGE

Part of Barts Health NHS Trust

Diverse, transient and socially

deprived population.

High activity and acuity- 6600 births/

year.

Projected birth rate increase across

North East London with Newham

being one of the highest.

CONTINUED

Women did not have a named

midwife.

No clear definition of continuity of care

Inconsistent provision of continuity of care.

Service not equitable for all women.

Most women giving birth in an obstetric unit with care led by doctors rather than midwives.

High level of interventions and emergency section rate.

OUR VISION

AMBITIOUS ASPIRATIONS

Number of births by unit type, 2012. Women’s preferences from survey of 5500

women by NFWI in 2013. Better Births,2016.

OUR STRATEGY

TST journey began in January 2015

Benchmark our services to identify

gaps

Agreed strategy in June 2015

to promote normal birth

women to have a named midwife

prepare for the increase in births

to increase choice of birth place for

women

To ensure all women have no more 3

midwives (antenatal and postnatal)

despite their risk factors.

Scope models of intrapartum

continuity of care for other groups

including vulnerable women.

Promote the Home Birth Team/Group

Practise/BCBC.

Final TST strategy is on the NUH

Agenda

CONTINUED

Vision Agree

Team Identify

stakeholders

Project

Plan Regular

meetings

Continuous engagement

Continuous feedback and update to staff

PLANNING, DEVELOPMENT AND

IMPLEMENTATION

TST is coming to town

NATIONAL MATERNITY REVIEW (2016)

ALIGNS WITH THE TST VISION Personalised Care

Our CCG have been selected to be one of the

maternity choices and personalisation pioneers sites.

Continuity of carer:

No more than 2 to 3 midwives.

Group practice model will provide optimum, personalised care

and continuity of care for women of all risks.

Multi-professional working and safer care

Midwives in the group practice will be attached to a GP practice,

working closely with GPs, obstetricians and other professionals.

HOW WE DID IT?

What does Great Look Like?

TST workshops

ACHIEVEMENTS TO DATE

Increased births out of OU from 22.7% (2016) to 24.9% - ambition to reach over 25% by March 2017.

Group Practice model started in November 2016.

Working towards continuity for all risk women ensuring women with complexities have a named midwife and input for key appointment with that midwife.

Increase in Parent Education provision from 20% to 37%- ambition to reach 40% by March 2017.

Barking Birth Centre - Scored 1st across the sites for “I want great care feedback”.

WHAT OUR WOMEN SAY “I had my first appointment where my birth place choices were discussed. I chose BCBC as it was close to my home and the midwives have been really attentive throughout my antenatal care. I really felt like I developed a relationship with them, particularly in labour too – they were very motivated and this helped me with my labour. I would certainly recommend giving birth at BCBC and will come back here if I am blessed to get pregnant again.”

“My midwife in the community recommended BCBC as I had previously had a poor hospital birth experience and did not want that for this birth. I have had so much better an experience this time at BCBC, I would definitely return if I was to have another baby and would very much recommend to friends.”

WHAT OUR MIDWIVES SAY

“Working in the Homebirth Team feels like being a

‘proper Midwife’.

I get to see my ladies and their families navigate their journey of

pregnancy and birth together. I build a bond and develop a trusting

relationship with them.

They feel safe when they have a problem or a worry, they know I know

their story already.

If she’s worried I’ll reassure her, if she’s happy we’ll laugh together.

I choose to do this because I enjoy seeing the journey from the start

and seeing the difference it makes getting to know the whole family.

I love being a midwife and, in all areas I have worked, in this is the

most rewarding.

It’s a privilege that these women allow us to care for them and welcome

us into their homes and lives.

I feel proud to work in this type of Midwifery Team which caters for

all.”

WHAT OUR WOMEN SAY

“I had a good experience in the birth centre, the

midwife and student that delivered my baby

were calm and compassionate. They

encouraged me and reassured me every step

of the way”.

“Being cared for by Newham Homebirth

Team we felt listened to, well cared

for and in control. Our midwife

helped us make informed decisions

and supported our choices. We’ll

definitely plan homebirth for all future

births.”

“I received exceptional care, a positive experience

throughout, everything was outstanding about the

care the home birth team provided me and my

family. We feel so lucky to be looked after by such

a fantastic team.”

THANK YOU- ANY QUESTIONS?

REFERENCES

Better Births,(2016) Improving outcomes of

maternity services in England-A Five Year Forward

View for maternity care

National Institute for Health and Clinical Excellence

190: Intrapartum care for healthy women and

babies. NICE,2014 London

The birthplace in England study, NPEU 2007