maternity strategy where are we now……and where do we want to get to????

Maternity Strategy

Where are we now……and where do we want to get to????

Changing face of NI maternity population

• Older• Fatter• Greater ethnic diversity• More unmarried mothers• More long term conditions (e.g. diabetes)• More multiple pregnancies

Desired Outcomes Give every baby and family the best start in life Effective communication and high quality

maternity care Healthier women at the start of pregnancy Effective, locally accessible, antenatal care and

a positive experiences for mothers and babies Appropriate advice, and support for parents and

baby after birth.

Give every baby and family the best start in life

A culture of normalisation of pregnancy

Parents should be considered as partners in maternity care and given all relevant information to help make informed choices

Now 1 in 60 pregnancies is a twin pregnancy – and one in 30

babies born is a twin!

Effective communication andhigh quality maternity care

Effective clinical leadership and communications pathways

A skilled workforce which understands specific roles and responsibilities

A sustainable configuration of service provision A focus on improving clinical outcomes Appropriate ICT support

Effective communication andhigh quality maternity care

• Maternity services must show good clinical leadership and communication, including in the use of maternity hand held record, Labour ward Forum and other multi disciplinary groups.

Inquiry Common Themes• Often prompted by public/media concern rather than professional

assurance

• Lack of awareness of level of harm

• Lack of collective responsibility

• Lack of sensitivity to day to day operations

• Lack of learning from errors

Healthier women at the start ofpregnancy

Emphasis on preconceptual advice and support – Planning for pregnancy

Pathways to support those with long term conditions

Obesity in Pregnancy

Effective, locally accessible, antenatal care and a positive

experiences for mothers and babiesMidwife is first contact: Women to be facilitated to make early contact

with a midwife. For women with straight forward pregnancies

antenatal care will be provided primarily by the midwife in the local community

Appropriate advice, and support baby after birth.

Postnatal care, provided by the maternity team in the community will offer a woman-centred visiting schedule – not less than 10 days

Implementing change• Assess organisational readiness

• Create shared purpose

• Search for unintended consequences

• Adapt and survive

Ingredients

Practice•Evidence based•Care Pathways•Consistent processes•Education & training

People •Person Centred Service•Safety Forum •Support and challenge •Education and training

What does this mean for midwives?

• Midwives are expert practitioners in the provision of care to women with straightforward pregnancies.

What help do we have??Maternity Strategy for Northern IrelandMaternity Quality improvement group-multidisciplinary, regional , evidence basedSAIs: regional learningEMBRACE: confidential enquiry recommendations; stillbirth reductionService: appropriate staffing levels & training, configuration of maternity unitsLegal Claims and complaints: potentially a mine of useful information but how to access?NIMATsPublic involvement - MSLCs and user surveys

What help do we have?

Consultant Midwives Regional midwives

Practice, education, research , leadership Commissioning, public health, government

Each other

What about the community?

Public Health Agency and NIPEC

Community maternity care project

Objective 10 When a woman becomes pregnant she will be facilitated to make early direct contact with a midwife

Objective 12 For women with straightforward pregnancies antenatal care will be provided primarily by the midwife in the local community.

Aim

Describe and assess, current models of community maternity care with the purpose of

proposing a regional model and skills requirement of the workforce.

SCOPE OF THE PROJECT

SCOPE OF THE PROJECT

SCOPE OF THE PROJECT

ALWAYS

Ensure that the urgent doesn’t crowd out the important

Questions?