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IN-DEPTH: MATERNITY CARE “I BETTER BIRTHS


n 2016, we audited 120 sets of patient notes drawn from across north west London to understand where we were starting in terms of continuity of care,” says Helen Maric, one of the implementation leads for the north west London maternity transformation programme and former Trust midwife. “Of those 120 patients, only one had met the midwife who delivered her baby prior to her labour.” NHS England’s Better Births programme, launched in 2016,  including north west London – to jump- start maternity care improvements. Helen’s project management team used funding from NHS England to co-ordinate north west London’s six maternity units – Queen Charlotte’s & Chelsea, St Mary’s, Chelsea and Westminster, Hillingdon, Northwick Park and West Middlesex hospitals – to plan changes in response to patient feedback. Clear themes emerged:


Jenifer Percy D’Costa with her daughter Sara and her new baby at the birth centre at St Mary’s Hospital


A new person-centred approach means continuity of care for more mums-to-be in north west London.


better continuity of care, closer relationships with midwives and high- quality, consistent information.


CONTINUITY OF CARE


Each unit was given a broad framework for improving continuity of care but was free to determine the approach that worked best for their service. Our teams at Queen Charlotte’s & Chelsea and St Mary’s have rolled out a ‘caseloading’ approach in which six to eight midwives collaborate to care for women with  team shares responsibility for – and relationships with – their patients. This means each patient will see a midwife from her caseloading team at every appointment.


“As well as being what patients wanted, we knew providing continuity of care


reduces risk and provides better outcomes. We were already using a caseloading approach successfully for women with severe mental health issues and social complexities,” says Scott Johnston, head of midwifery. “So, we selected additional pathways that we believed had the most potential to  we could implement easily.” Additional caseloading teams were put in place for: women planning home births; women with previous pregnancy losses; women with medical


8 /Trust


www.imperial.nhs.uk


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