Our vision
The vision of the West Yorkshire and Harrogate Local Maternity System (LMS) is based on the needs and collaboration of women, their partners and their families. We have worked with health and care staff and women from across West Yorkshire and Harrogate to create a plan for how we transform our services. You can download our live plan here.
The plan was co-produced in collaboration with all our partners, scoping our services and undertaking a health needs assessment of our communities. View video here.
Maternity shared care record
The hospital trusts in West Yorkshire and Harrogate are carrying out a project to use the Yorkshire and Humber Care Record (YCHR) technology to share maternity summary documents between each organisation.
Currently, information is stored in six different maternity systems - and potentially in none-maternity systems too. This may be because maternity patients visit several healthcare settings. The record, centred around the mother and child, will enable data sharing across several maternity systems transparently and safely.
We’ll carry out the work in phases. In this first phase we have prioritised five maternity records which we can generate as PDFs and make available through the YCHR. The priority records are:
- Booking in - for example blood group, allergies, medical history
- Delivery - for example, how the baby was delivered, GP details, weight
- Discharge - for example, feeding
- Personalised care plan - for example, birth and post-natal preferences
- Pregnancy outcome - for example, miscarriage, moved out of the area
Improved connectivity and integration will provide clinical and care staff directly involved in the mother’s care access to the most up to date information. It means they’ll be able to view real time maternity information across care providers and between different IT systems safely and securely.
Time consuming telephone calls to understand different systems and chasing up information will become a thing of the past. Access to better information means more time to spend with patients, improved decision making and planning of maternity services as well as more joined up care.
Data is pulled from secure clinical systems. All health and care records are strictly confidential and can only be seen by clinical and care staff directly involved in the patient’s care.
Developing a common infrastructure and exchanging maternity data in this way is the first step in progressing a more comprehensive Maternity Shared Care Record.
The Partnership’s Digital Programme leads the rollout of shared records across our associated health and care organisations in partnership with the central Yorkshire and Humber Care Record team.
Data
WY&H LMS is putting data at the centre of our work. Health data are those bits of information that all our maternity services put into their information systems. This data helps us understand the numbers of women giving birth in WY&H, their distribution across the region, the care they receive and their health outcomes. We produce an LMS dashboard that tracks high level Quality and Safety across a wide range of areas that is accessible to all our workstreams.
All our LMS projects use data to support the identification of challenges to service delivery and quality of care received by our patients. We support the LMS-wide ATAIN, PReCePT, Continuity of carer, pre-term birth group, SI review panel and public health workstreams, delivering a variety of data collections, analysis, and quality improvement.
We are also working towards better understanding potential health inequalities by breaking down quality and safety measures by women’s ethnicity and the deprivation of residence and their intersectionality. This will be the most detailed view of health inequalities we have ever produced. All data used by us is anonymous and shared safely for management purposes only.
Saftey
Safety is the golden thread that runs through transformation throughout the LMS. This includes working together to implement the Ockenden recommendations for safety and quality. We are working collaboratively to learn and share our learning across the system.
The LMS has introduced processes to ensure that Ockenden recommendations are implemented. The LMS Serious Incident Peer Review Panel is formed of Obstetricians, Anaesthetists, Neonatologists, Senior midwives and representation from the Yorkshire Ambulance Service. The panel meetings are chaired by Dr Nada Sabir, a Consultant Obstetrician. Case submissions are discussed and the panel considers whether an external peer review would be beneficial. Learning is shared at the meetings, taken back to trusts and also fed into the system wide Safety Forum. Working together to share good practice is key to all West Yorkshire and Harrogate LMS activity.
Personalisation and choice
Better Births (2016), the national maternity review, recognised that every woman, every pregnancy, every baby and every family is different. Better Births provides the blueprint for maternity transformation, which is driven locally by the Local Maternity System. We are transforming maternity services to enable every woman to have access to information to enable her to make decisions about her care, and where she and her baby can access support that is centred around their individual needs and circumstances.
All women are able to choose the provider of their antenatal, intrapartum and postnatal care, and should be able to make decisions about their care during pregnancy, during birth and after their baby’s birth, through an ongoing dialogue with professionals that empowers them. Read more by clicking here
By working together with midwives and women the Local Maternity System (LMS) has co-produced two new transformational resources for use across the partnership. These include a: postnatal care and support booklet and a bereavement postnatal care and support booklet.
The postnatal care and support information is now available in easy read format that has been split into several different booklets:
Booklet 1: Postnatal care, birth registration and coronavirus
Booklet 2: Resuming sexual intercourse and contraception
Booklet 3: Maternal physical wellbeing and health concerns
Booklet 4: Emotional wellbeing and mental health
Booklet 5: Infant feeding and blood spot tests
Booklet 6: Baby care and wellbeing
Booklet 7: Coping with crying and safe sleeping
Midwifery Continuity of Carer
Midwifery Continuity of Carer describes care that is provided by a small team (maximum 8) of midwives who each have a small caseload of women for whom they provide antenatal, intrapartum (labour) and postnatal care. This evidence based model of care improves outcomes for mothers and babies, and satisfaction for mothers and midwives (Sandal et al 2016). Across the LMS we are co-producing midwifery continuity of carer teams with the ambition that this model of care will be offered to most women by March 2023. Despite the impact that the pandemic has had on the maternity workforce and services, our maternity services are concentrating their new models of care with communities whom we know will benefit the most, including deprived and Black & Asian communities.
Personalised Care and Support Planning in Maternity Services
This short animation explains what Personalised Care and Support planning is in maternity services and what women and families can expect. Care should meet your individual needs, circumstances and choices; your views will be listened to and valued; you should feel safe and support with your decisions. For more information visit this NHS England webpage.
Health and wellbeing before, during and after pregnancy
‘When women access services before and between pregnancies, opportunities should be taken to improve health behaviours and manage long-term Health conditions ’ (NHSIR 2018) . Current national legislation such as Saving Babies Lives clearly identified the need to improve women’s safety in relation to lifestyle choices and behaviour in order to reduce stillbirths, neonatal deaths, brain injuries and maternal morbidity and mortality. Read more by clicking this link.