Launch of Local Maternity Systems across Northern England

Transcription

1 Launch of Local Maternity Systems across Northern England Monday, 13 March 2017 Newcastle Racecourse 9.30 am pm #LMSnorthern

2 Welcome Chair: Roy McLachlan, Associate Director, Northern England Clinical Networks

3 Purpose of the Day Alan Foster Chief Executive/Sustainability & Transformation Plan Lead (STP) for Durham, Darlington, Teesside, Hambleton, Richmondshire and Whitby

4 Purpose of the day Begin journey across the 3 Local Maternity System (LMS) areas which are aligned to the Sustainability and Transformation Plans (STP) footprints To start conversations on how we will develop safe, effective, high quality services which underpin choice and personalisation Provide you with an opportunity to influence and shape local maternity services in your area and to engage in the work streams to support delivering the vision

5 Transforming Maternity Care Sandra Guise Maternity Services Liaison Committee Chair West Cumbria

6 West Cumbria Maternity Voices (MSLC) Why? How? Involving women/service users in Shaping Maternity Care Sandra Guise, Chair - West Cumbria Maternity Voices Lesley Heelbeck, Head Of Midwifery - Gateshead NHS

7 Involving women/service users in shaping Maternity Care Why? It means women have a voice in how they are being looked after. It means their experiences can be shared and women and families listened to good and bad so that lessons can be learned about what goes well and what could be done better. A woman s perspective is often going to be very different from a clinicians. The drivers behind clinicians/ business managers can also be different from service users Involvement increases understanding of needs, provides sources of ideas for how they can be met, & provides evidence to inform service developments Engagement and Involvement necessary to deliver responsive services wrap services round women and families and for personalised care. Having a Voice Choice and Control should improve outcomes

8 Maternity Services Liaison Committee MSLC meetings, multi disciplinary 1/3 service uesrs/ reps; minutes, action plan & work Plan Maternity Dashboards How MSLC s Reaching service users Postnatal Reunion feedback sessions, output themed, trends & quantified = MSLC Data Walking the Patch /CCG Quality & Safety Visits Friends and Family & 2 Min s of your time Report MSLC Labour ward Forum Rep MSLC Reps Feedback from Service Users Foot soldiers going out to the groups where service users are. +Network outreach. Cascade out. Take active part in system engagement and Consultations getting involvement. MSLC Twitter * MSLC Web Page coming soon! Invited presentations areas of interest/ concern MSLC Facebook Open, Plus MSLC Close Discussion Board excellent instant access for concerns/interests response to topics. Reports from MSLC Sub groups Reps Leaflets! Briefings Posters Workshops CAKE! Report on complaints analysis Commissioner and Provider input Grassroot networking, linking and growing involvement. Fits in with people s lives Local Media/ Stakeholders promote awareness MSLC Chair report on LMS meetings Work in Partnership Local groups, Local businesses, Local Healthwatch

9 Involving women/service users in shaping Maternity Care Local Examples: Durham, & Darlington MSLC s known by name BABI Birth & Baby Information Groups. West Cumbria Maternity Voices Postnatal reunion groups feedback themed over year, & themes quantified, informs MSLC agenda/ work plan. Put s Spotlight on areas that are important to service users, evidence for praise and improvements! Women s stories use for training with permission x User led task groups set up for more in depth involvement SCBU Support group delegate areas of interests develops Service Users into Service User Reps. Need to share out work as volunteers. 25 MSLC s NHS England North, and that includes 5 known MSLC groups across Northern Network area

10 Working as a MSLC in our Local Maternity System Better Births Awareness of National Maternity Review and Better Births giving parents context for maternity developments helps Fab Better Birth Poster Sheffield MSLC Community Hubs Using MSLC meetings/ Facebook page/ Facebook Closed Discussion Board. Poster as a discussion point. Plans soon to go out with Community midwives to Parentcraft, Local Bumps and Babies, Postnatal reunion groups to talk to Mum s & partners, birth supporters. Getting ideas back take to our LMS Better Births Implementation Group. Personalisation and Choice Not as far forward with this part. Women interested in knowing what choices there are locally. Need much clearer information on that. Apps are being reviewed by midwives, but need a consumer view feedback too. Note: Not all women want to make birth plans in case it doesn t work out and I end up disappointed. Important to address about how personalisation will be measured from Service user perspective.

11 Local Maternity Systems Building up engagement and involvement Not possible to involve every service user in every decision about service design (although you can get much closer to that when it comes to personalised care / birth plan), but you can create multiple opportunities for feedback and involvement, and build relationships and structures for involvement to develop. May be best to think of a pyramid instead of ladder of involvement across LMS s degree of trust people believe that they will be involved where it is appropriate, rests on grassroots MPV s and MVP s that operate across at all levels. Start with mapping out what user groups, maternity interest groups/ resources there are already in your local patch.

12 Mapping out local area Tips for Success Doula s, Peer Supporters; Map your existing links/ outreach Gaps? Build upon Bumps & Babes, Children s centres; Soft play; Sling meets; Buggy walks;.. Aquanatal; Nurseries; Library groups; Hypnobirthing; Gateshead Café/Geordie Mums National Groups with local branches SANDS; NCT; LaLeche League; AIMS;. WI Well being groups, BEM groups; Refugee; Harder to reach groups Parentcraft Classes; Identify those who are naturals/ believe in real involvement of women use them to lead outreach - Nurture formal structures for involvement (MSLC/MVP) New Guidance- March 2017 Go out to places where Services Users are-take Cake! Look for those with a commitment to maternity services you need them to take the involvement agenda and form Maternity voices groups do enable a supportive structure, encourage them, they can do some of the leg work! See involvement for what it is an opportunity, not a risk, you need it, it offers a huge resource, and also a source of enthusiasm and inspiration! The common ambition is to progress maternity services. Think service user involvement convenience,

13 Involving women/service users in shaping Maternity Care Local Maternity Systems On the ladder of engagement you can t jump up several rungs from Friends and Family all the way to Co production, takes time to build look at what you are doing already Build on that with some of the tips given. There are more ways to reach out to service users to get more involvement. Local is key to get grass root involvement, their convenience, tea & cake helps! to shape community hubs, personalisation care; choice use drop in s and focus groups, and in tandem be building the relationships to form involvement structures local MSLC s /MPV s; but also ensuring these structures reach all parts and levels of the LMS.

14

15 The creation of our Local Maternity Systems

16 Why do we need to change? We are the best in the country, but outcomes for mothers and babies in UK are among the worst in the developed world The findings of the Kirkup report Large variations in outcomes Frequent quality of care issues in women who experience stillbirths / pregnancy losses Poor / inconsistent data collection Perceived discordance between what women want, and what we provide

17 The North East & North Cumbria System-wide, demographic and workforce issues Smoking at delivery National ~10% NE: 12-22% Obesity Reluctance to access services

18 Cumbria and the North East area From an NHS England perspective there are three STP areas relative to our local office: Northumberland, Tyne and Wear (includes North Durham) West, North and East Cumbria Durham, Darlington and Tees including Hambleton, Richmondshire and Whitby

19 Local Maternity Systems Implement the national maternity services review, Better Births through Local Maternity Systems Statement from Better Births 4.93 On a more local level, providers and commissioners should operate as Local Maternity Systems, with the aim of ensuring that women, babies and families are able to access the services they need and choose, in the community, as close to home as possible.

20 Better Births Improving Outcomes 1. Personalised care genuine choice, unbiased information +/- personal maternity care budget and digital maternity tools (inter-operability) 2. Continuity of carer through case-loading, with an identified obstetrician 3. Safer care professional working across boundaries, with rapid referral / access + leadership for a safety culture within organisations and rigorous / standardised investigations / NF redress when things go wrong 4. Better postnatal and perinatal mental healthcare and to address the historic underfunding and provision in these vital areas 5. Multi-professional working training together, and sharing of information, + metrics agreed with CCGs 6. Working across boundaries from community hubs, in Local Maternity Systems, and networks of care 7. Revised payments system

21 The ask of Local Maternity Systems Establish your Local Maternity System to design and deliver maternity services across boundaries: by March 2017 create an LMS coterminous with the STP Footprint and involving all commissioners and providers of maternity services by October 2017 establish a shared vision and plan to implement Better Births by the end of 2020/21 The implementation of Better Births will be a key component of the overall STP for Maternity and Neonatal services in our area

22 Creating our plans for each LMS You are a major part of developing our plan Acknowledges and building upon work already done Structured and facilitated conversations Personalised Care, Continuity of Carer, Safer Care, Postnatal / Perinatal Mental Health Care, Working across boundaries, System design Outputs from these conversations will be included in the plan Followed this afternoon by discussion about practicalities of taking this work forward, including governance

23 Working with Maternity Clinical Network Maternity Clinical Network Provision of targeted improvement support and clinical advice. Support to establish LMSs, draw up & implement local maternity transformation plans. Facilitating links with specialised services. Broader Membership of the Local Maternity System Leadership at all levels in implementing Better Births. Task and finish Groups focused on implementing the local maternity transformation plan. Strategic Partnership Board of the Local Maternity System Develop, implement and review a local maternity transformation plan. Collaborative approach to commissioning. System oversight of implementation of Better Births locally.

24 Enabled nationally, delivered locally LOCAL TRANSFORMATION. Local Maternity Systems Investigating and learning when things go wrong Community Hubs Continuity of carer Shared clinical governance, protocols and data Leadership for change digital records and info sharing Multi-disciplinary team working & training. ENABLED NATIONALLY Pricing and payment reform; local variations Digital infrastructure Guidance and resources Selecting & supporting early adopters National indicator set and dashboard National quality improvement programme Providing funding to enable change Workforce analysis and supply

25 Community hubs

26 What we have heard many of you Providers, Service Users & Commissioners meeting on a regular basis Shared guidelines and working practices Common Documentation and IT want from an LMS Shared governance / risk management / review of cases Feedback from Conversations Co-produced overarching strategy Cross site working Collaboration overcomes competition Shared Learning and Development Opportunities LMS contracts for staff in the area

27 What concerns have we heard about LMSs We ve been here before! Jobs and roles There s a hidden agenda Feedback from Conversations Hurried decisions being taken remote from those providing the service There ll be winners and losers Collaboration overcomes competition

28 Better Births Outcomes CCG Improvement and Assessment Framework: Maternal smoking at delivery Neonatal mortality and stillbirths Women s experience of maternity services Choices in maternity services There will be new indicators introduced over the next year 2017/18: Maternal flu vaccinations - maternity services to administer; LMS progress - based on specific questions asked to regional maternity board

29 Conduct of the conversations Completely centred around the needs of the pregnant woman and her newborn baby and family Leave aside our affiliations to host organisations Respectful of each other s roles and contributions Think of ourselves as one system Consideration for anxieties of colleagues Doubters welcome

30 The Creation of LMSs in the North East & North Cumbria

31 Breakout sessions Your badge indicates where you are sitting for all 6 conversations (before and after refreshment break). Red Dot 1-6 (North) stay in Gosforth Park Suite Green Dot (South) Gosforth Park Suite extension Yellow Dot (South) Charles Brandling Suite After Lunch please ALL come back to Gosforth Park Suite Facilitators - both refreshments & lunch in Annual Members Room

32 Feedback from breakout sessions Robin Mitchell, Network Clinical Director Suzanne Thompson, Network Manager

33 Questions? Personalised Care: Lesley Heelbeck and Jo Crawford Continuity of Carer: Janice McNichol and Louise De Luen Safer Care: Karen Hooper and Helen Simpson Postnatal Care: Derek Curry and Stephen Wild Perinatal Mental Health Care: Jan Rigby and Andrew Cairns Multi professional working/ Working across boundaries: Aarti Ullal and Elaine Gouk Co-production of Maternity and Neonatal System Design: Stephen Sturgiss, Julie Lane and Anne Holt

34 How do we co-produce a sustainable LMS aligned to the overall STP? Red dot stay in the Gosforth Park Suite (Northumberland, Tyne and Wear and North Durham LMS AND West, North and East Cumbria LMS) Green and Yellow dots - move to the Charles Brandling Suite (Durham, Darlington, Teesside, Hambleton, Richmondshire and Whitby LMS)

35 Next Steps Stephen Sturgiss, Christina Cuncarr and Anne Holt

36 Closing Remarks Roy McLachlan Thank you and don t forget to fill in evaluation forms