Shortlisted in the ‘Community or Primary Care Services Redesign – London and the South’ category, Neighbourhood Midwives – founded on the values of improving access and achieving positive outcomes for families – was commissioned by Waltham Forest CCG to run a pilot for women in the area that increases choice and offers continuity of care. Too often, women have a complete stranger looking after them during the birth of their baby.
“When women receive continued care from the same one or two midwives, they have significantly better outcomes, for themselves and their families,” says Neighbourhood Midwives’ Chief Executive, Annie Francis. “Our purpose is to do everything in our power to enable women to have the best possible birth experience and to make a successful transition to parenthood.”
It’s easy to imagine how continuity of care builds trust, allowing women to ask questions, voice concerns and be more open about their circumstances; and conversely, how seeing a multitude of midwives and doctors can prevent rapport from being built. In the National Maternity Review (the Better Births report, 2016), it is cited that continuity has a positive effect on user experience and outcomes as well as safety, with better coordination and risk factors more likely to be picked up.
“This is about a child having a good start. What happens during lead up to birth and in the first few hours really can make a difference. Our service also enhances a mother’s ability to bond with a baby and connect as a family.”
Women cared for by the same midwives are more likely to have a normal birth, a healthy baby, a quicker recovery and greater success with breastfeeding. Just taking the latter point, this tees up savings for the NHS due to the preventative and protective implications for both baby and mother. “Often women want to breastfeed,” says Annie. “But breastfeeding support funding is being cut, with short term savings prioritised over long-term benefits, so mothers don’t get enough support to make it happen. In these cases, the system fails them. Breastfeeding is a learnt activity and mothers need adequate time to get to grips with the skill.”
Neighbourhood Midwives have a fascinating story. With their core belief being that all women should have choice and a continuous carer through the NHS, regardless of geographic, economic and demographic factors, they always aspired to deliver the model they’re piloting in Waltham Forest. However, because the group was formed of individual midwives (in 2013), they didn’t yet have group data behind them, preventing them from going for NHS contracts.
“We had to launch a private service first to get our track record,” explains Annie. “We always wanted this level of care to be available on the NHS, and the 2-year pilot is the first step to that happening.
“Using the Buurtzog principles of self-management, we have created a scalable and streamlined model for the future. Waltham Forest CCG is evaluating it, and we want to expand into wider networks, so all women have access to greater choice within their local maternity system that offers the core things that make a considerable difference to maternity outcomes.”