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Baroness Julia Cumberlege marks the two year anniversary of the publication of Better Births by reflecting on the importance of personalisation and choice to women when using maternity services.
Following the maternity review and the publication of Better Births in 2016 one of the key findings was that personalised care, centred on the woman, her baby and her family, based around their needs and their decisions, where they have genuine choice, informed by unbiased information, was central to ensuring that women received the best care possible.
Personal care is safe care. It means listening to women, understanding what they want and what they need and putting in place a personal care plan. Ensuring maternity care is safe runs through every aspect of the maternity transformation programme, the more we centre care around each individual woman, the safer that care will be.
The NHS England choice programme is working to ensure that women are provided with reliable, consistent and objective information on which to make informed decisions, and are supported to understand their options – including the risks. This information will support and empower women to make choices that are in line with their preferences and within a clinically appropriate setting.
In 2016 seven maternity choice and personalisation pioneers were set up throughout England to test ways of improving choice for women using maternity services, including through testing Personal Maternity Care Budgets (PMCBs) as a mechanism for empowering women to take control of decisions about their care.
PMCBs are an important way of ensuring women have that better quality conversation – and that the NHS offers them that more personalised service.
We are on track to exceed the target set out in the Next Steps on the Five Year Forward View that 10,000 women would have a PMCB by end of March. An independent evaluation of PMCBs will be conducted in 18/19.
Pioneers have taken different approaches to improving choice and personalisation, and have some good learning to share with the system – including improving the information available to women, training and engagement with midwives, and working with independent providers.
Some of the pioneer highlights include the recent opening of a new free-standing midwifery unit (FMU) in Greater Manchester which will be used by five providers to give women in the area more choice in where to give birth. Women are being offered continuity of carer in Waltham Forest via collaboration between the local NHS and a social enterprise called Neighbourhood Midwives.
The pioneer in Hampshire is giving midwives motivational interview training to support them in having the choice conversation with women. They also have a single phone line ’labour line’ shared across providers with information on staffing and capacity to support women in their choices even once they are in labour. The pioneer in Cheshire and Merseyside has extended the choice offer for antenatal care in Liverpool Women’s through the addition of services such as additional breastfeeding support in their PMCB. Work is underway to expand choice across all nine providers in the LMS.
There is so much good work going on to improve care for women and their families, we will be discussing this in Manchester today to make maternity care personal and safe.