transforming maternity ervices t (tst) at newham u h b · aligns with the tst vision personalised...
TRANSCRIPT
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