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What is Better Births?

In February 2016 the NHS England Better Births report set out a vision and approach for improving NHS maternity services in England by 2021. The report recommends that all NHS Clinical Commissioning Groups and all NHS maternity care providers work together as local maternity and neonatal systems. 

All counties have their own Local Maternity and Neonatal Systems (LMNS) delivery teams to develop and implement the local vision for improved maternity care. The Better Births report focused on the following seven key themes to improve outcomes of maternity services.

Personalised Care & Choice

The Better Births report highlighted that many women were not being offered real choice in the services available to them and were often told what to do, rather than being given information to make their own decisions. To address this, Northamptonshire Local Maternity and Neonatal Systems (LMNS) are committed to ensuring pregnant women are informed of all their local options. We want to empower Northamptonshire women and their partners to fully understand the local service options so that they are equipped to discuss their preferences with the midwife and make informed choices.

Choice Example

A pregnant woman who lives in Corby or Kettering wants to give birth in a Midwifery Led Unit (MLU). Kettering General Hospital (KGH) NHS Foundation Trust does not have a MLU at the moment, however we do have a MLU at Northampton General Hospital (NGH) NHS Trust. So, to support the pregnant woman with her choice, she is entitled to give birth at the MLU unit at NGH following discussion with her midwife.

Personalised Care

To support personalised care both KGH and NGH have developed a “Personalised Care Plan,” (PCP) which we introduced in the summer of 2019. The Personalised Care Plan will help you to explore, understand and record your individual choices for pregnancy, birth and early parenthood. Every woman is different, with individual needs, which have an influence on the choices you make and the care given. Decisions regarding care should be made in partnership with your midwife and your partner. Plans can change as your pregnancy progresses, if needed. Midwives and doctors can offer advice but this is your pregnancy and your birth and it’s important that you feel at the centre of your care and aware of all the choices available to you. The PCP provides you with an opportunity to document what is important to you and for this to be shared with the team providing your care.

Continuity of Carer

The Better Births report highlighted mums wanted to have a dedicated midwife/team throughout pregnancy and after birth. Mums said they saw different midwives throughout their pregnancy. The revised continuity of carer working model will ensure women are cared for by a primary midwife/team throughout pregnancy, birth and the early postnatal period.

To support this we are reviewing our workforce models and defining support aligned to our local needs. The NHS guidelines required each LMNS to start rolling out continuity of carer by March 2019, with an expectation that by March 2021 most women are receiving this model of care.  We have started this roll out programme at both NGH and KGH.

Safer Care

Most women who contacted the Better Births review said the safety of their baby and themselves was their main concern. The report stipulated that every woman wants and is entitled to the safest possible birth for herself and the baby.

To support safer care, maternity services across Northamptonshire are working together to develop a delivery model which offers pregnant women a rapid referrals service with access to the right care in the right place and if things do go wrong, we carry out thorough investigations with honesty and integrity and learn from the findings. The NHS Northamptonshire Clinical Commissioning Group (CCG) Quality Directorate also monitor quality and safety at local hospitals, which is reviewed by the Northamptonshire Local Maternity and Neonatal Systems (LMNS) Delivery Board.

Postnatal & Perinatal Mental Healthcare

Perinatal mental health problems affect between 10% to 20% of women during pregnancy and the first year after having a baby. The Better Births report stipulated the importance of better postnatal and perinatal mental health care and encouraged significant investment to support this service.

In June 2018 NHS Nene and Corby Clinical Commissioning Groups (CCGs), together with Northamptonshire Healthcare NHS Foundation Trust (NHFT) were successful in receiving funding to work in partnership to provide a community specialist perinatal mental health service. This was a fantastic boost for the CCGs and NHFT.

The service has been piloted across Northamptonshire by NHFT, in partnership with the CCG, local maternity service providers, community services, GPs as well as linking in with children’s services.

For further details about perinatal mental health services, please click here.

Multi Professional Working Across Boundaries

The Better Births report encourages the introduction of community hubs offering antenatal and postnatal care in children’s and community centres which support family health and social services.

To support working across boundaries, the CCG are reviewing how the maternity services work across the county with a view to aligning and unifying work practices. As part of the transformation of our local maternity and neonatal services, we will be linking antenatal and postnatal care into children’s and community centres across Northamptonshire.

The hubs will be situated in locations which support the needs of pregnant women and families. The antenatal and postnatal services will run alongside other services offered to pregnant women and their families, such as financial and employment advice support clinics; food banks; breastfeeding advice; stop smoking and healthy living support; baby weighing clinics – the models will focus on the localised needs of our service users.

We are in the process of working with public health services and Northampton County Council (NCC) to establish locations that best serve our local population.

As we start identifying suitable children’s centres, we will start rolling out the community hubs to support maternity care.

Look out for further details on this website and the KGH and NGH hospital web sites.

Payment System

This final theme relates to payments to the maternity service providers such as Kettering General Hospital (KGH) NHS Foundation Trust, Northampton General Hospital (NGH) NHS Trust and Northamptonshire Healthcare NHS Foundation Trust (NHFT). NHS Northamptonshire Clinical Commissioning Group are working with local Trusts to ensure the financial models are aligned to the revised maternity services.

The Better Births Report

To view the national maternity Better Births report in full, please click here.

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