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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?