Here you will find frequently asked questions related to the Transforming Midwifery Care consultation. These will be continually updated.
What is Transforming Midwifery Care?
Over the last two years, Shropshire and Telford & Wrekin CCGs have been carrying out a detailed review of midwife-led services across Shropshire and Telford & Wrekin. Initially referred to as The Midwife Led Unit Review this programme is now called Transforming Midwifery Care.
The review has looked at the way that midwifery care is currently delivered for women across Shropshire and Telford & Wrekin, whether it meets the needs of families and how we could make improvements in the future. As part of this review, we have engaged with hundreds of women and families, midwives and other healthcare professionals, listening to their views and experiences and finding out what’s important to them. The review also involved looking in detail at a broad range of local and national research, evidence and best practice in providing midwifery care.
We have looked in detail at all the feedback and evidence we have gathered. We have also commissioned a travel and transport analysis and carried out a detailed financial analysis of a range of options. By bringing all this information together we have developed a proposed new model of midwifery care. We will shortly be asking for your views on this proposed new model as part of a public consultation.
How is the programme governed?
Transforming Midwifery Care has a Programme Board whose members include representatives of: Shropshire and Telford and Wrekin CCGs; Shrewsbury and Telford Hospital NHS Trust; Shropshire, Telford and Wrekin Local Maternity System; Healthwatch Shropshire and Healthwatch Telford and Wrekin; Shropshire and Telford and Wrekin Councils’ public health commissioners; Shropshire, Telford and Wrekin Maternity Voices Partnership and a patient representative.
The Programme Board is responsible for overseeing the progress of the Transforming Midwifery Care review and implementation of the new service model, reporting to the Shropshire CCG Clinical Commissioning Committee and the Telford and Wrekin CCG Planning, Performance and Quality Committee, and making recommendations to the governing bodies of the two CCGs.
Why do things need to change – why can’t you keep services as they are?
The safety of mothers and the 5,000 babies born each year in Shropshire, Telford and Wrekin is our number one priority when we are thinking about making any changes to midwifery care.
The way we deliver midwifery care in Shropshire, Telford and Wrekin has not changed for over 30 years, but our communities and the needs of women and their families have. This means that:
- More women are being identified as having higher risks of complications during pregnancy
- The number of midwives and maternity support workers are not based where most women need them to be
- The services women can currently access close to home are different across the county and they aren’t always where the majority of women are or where there is most need
We want women to know that they can rely on safe, high quality care being available throughout their pregnancy, during the birth and after their baby is born wherever they live.
We must make sure we use the available resources well, including staff, equipment and buildings, so that women and their families get the greatest benefit possible.
What are you proposing?
We are proposing to transform the way that midwifery care is delivered across Shropshire, Telford and Wrekin to provide all women with safe, high quality and personalised care throughout their pregnancy (antenatal care), during the birth and following the birth of their baby (postnatal care).
We are suggesting that we create a network of midwifery care, including:
- Home visits, including home births
- Midwife-led Units (MLUs) open 24 hours a day, 7 days a week, where women can give birth
- Clinics in local communities
- New maternity hubs open 12 hours a day, seven days a week offering an enhanced range of services and outreach in areas where there is a need
- 24 hour access to midwives on the telephone, by video link or face to face.
Midwives and maternity support workers (previously known as women’s support assistants) would work flexibly, providing safe, high quality, personalised care to women closer to home throughout all stages of their pregnancy, birth and beyond.
How is this proposal linked to Future Fit?
In January 2019, following the Future Fit public consultation, a Joint Committee of Shropshire and Telford and Wrekin Clinical Commissioning Groups (CCGs) made the decision to reconfigure the acute hospital services provided by The Shrewsbury and Telford Hospital NHS Trust (SaTH). This means that the Royal Shrewsbury Hospital (RSH) will become an Emergency Care site and the Princess Royal Hospital (PRH) will become a Planned Care site.
- The women and children’s consultant-led unit will move to the Royal Shrewsbury Hospital in 2023/24 to be on the same site as the Emergency Department when the hospital becomes an Emergency Care site.
- There will continue to be a 24-hour midwife-led unit at both the Royal Shrewsbury Hospital in Shrewsbury and the Princess Royal Hospital in Telford where women can give birth and receive care during pregnancy (antenatal care) and following the birth (postnatal care)
- At both hospital sites there will be Antenatal Day Assessment Unit, Early Pregnancy Assessment Service (EPAS) and Maternity outpatients and scanning.
The new proposed model of midwifery care takes into account these changes.
Will I be able to share my views on the proposed changes?
Yes, we will be launching a public consultation soon to seek people’s views on our plans to transform midwife-led services across Shropshire and Telford & Wrekin.
People will be able to ask questions and have their say in a number of ways and complete a survey either online or on a paper copy. We will hold public events, provide information stands in venues that families visit, attend meetings and share information online, through the media and social media.
We want to hear the views of our population and no decision will be made until we have concluded the consultation and taken into consideration all feedback.
Who will decide if the proposal goes ahead?
The final decision will be made by NHS Shropshire and Telford and Wrekin CCGs.
Once the public consultation has closed, all responses will be analysed by consultation specialists, who will then produce a report. The CCGs will read this report and carefully consider all feedback. All reports and details on the decision-making process will be available on this website.
Please be assured that no decision will be taken until full consideration has been given to the responses and the analysis.
Is this just a way of closing rural maternity services by the back door?
No. Antenatal and postnatal clinics and activities currently take place in over 50 different places including GP practices and children’s centres across the county. This would not change. In addition, our proposed new model would mean more women having a broader range of services closer to home through new maternity hubs.
How have service users and members of the public been involved in developing the proposed model?
Over the last two years we have carried out a review of local midwifery care which involved listening to the views and experiences of hundreds of women and their families to understand how they want to be cared for and supported before, during and after having a baby. Our proposed model has been designed and checked by women and their families, the public, professionals working in and with maternity services, voluntary and community organisations and both Shropshire and Telford and Wrekin Healthwatch organisations.
How much have you listened to both the positive and negative views of mothers and the families who have used the rural MLUs?
Over the last two years we have carried out a review of local midwifery care which involved listening to views and experiences of hundreds of women and their families across the whole county. We held events in each of the rural MLU areas as well as in other locations to make sure that people from all over Shropshire, Telford and Wrekin could get involved. We have taken these views, both positive and negative, into account when deciding on the options.
We have continued to engage in the pre-consultation phase and we will provide different ways for people to feedback when we go out to consultation.
How have you made sure that you have engaged with people with protected characteristics?
We have engaged with people with protected characteristics and within seldom heard groups in the development of the proposal and sought to understand any specific impacts or issues for these groups. This will feed into the design of services offered in the hubs and also targeted outreach where for example certain groups have particular difficulty attending clinics.
Further information can be found in our Pre-Consultation Engagement Report related to seldom-heard groups and Equality Impact Assessment which are both available under our key documents page.
How are you working with other areas to ensure all the best practice is incorporated in the proposed model of care?
We have considered the relationship our patients have with other areas – for example where women from Shropshire and Telford and Wrekin currently use services provided outside of the county. Through the Local Maternity System, we are linking in with other areas to ensure service pathways are joined up where appropriate.
Our proposal takes into consideration clinical evidence, including national evidence from the Better Births report, which provides recommendations to ensure that maternity services provide the best outcomes possible for pregnant women and their babies (Better Births: Improving outcomes of maternity services in England – A Five Year Forward View for maternity care, NHSE 2016).
When will the consultation take place? How will I know when it is open and how long will it last?
The date of the consultation has not yet been confirmed but it will be widely publicised through the media, social media and distribution of printed information in public places. It will last for at least eight weeks.
How will I be able to have my say during the consultation?
You will be able to have your say through a number of different channels:
- Completing our online survey accessed via this website or the Baby Buddy App, an interactive pregnancy and parenting guide for women and their families
- Completing a paper copy of our survey and sending it to a FREEPOST address
- Attending one of our consultation events
- By email or letter
How will I find out more and ask questions during the consultation?
All the relevant documents which show why we are making this proposal will be available on this website.
The consultation document will also be available on request in printed format (including an easy read version if preferred) and also as a text file suitable for reading with a screen reader.
You will be able to find details on this website of all the events we will be holding where you can meet staff and ask questions.
We cannot answer all questions received by mail, email, telephone message or social media during the consultation but we will be regularly updating these Frequently Asked Questions.
Is this proposal just about saving money?
No. The safety of mothers and babies is our number one priority and staffing levels are an important factor in delivering a high quality and safe service. Currently the numbers of staff and their skills mix does not appropriately match the level of demand. The smaller MLUs are over-staffed for the level of activity and therefore have associated high costs. We are proposing a new way of delivering midwifery services that will make the best use of the resources we have available and enable more women across Shropshire, Telford and Wrekin to receive high quality care closer to home.
Will this proposal lead to redundancies?
No. The proposed model does not need fewer staff. These changes are about having the right number and mix of staff in the right locations to deliver care that better meets the needs and preferences of women and families.
How much have midwives been able to have their say in the proposed new model?
Midwives have been closely involved in developing the model and determining the options we are proposing. A number of midwives and women's support assistants (to be called maternity support workers under our proposal) attended the events and briefings throughout this review to inform the service proposal and being part of the options appraisal.
During the consultation anyone can have their say by completing the survey online or by post (sent to a FREEPOST address), by attending one of our events or by email or letter. We will also continue to engage with staff through a series of face to face sessions.
I work in maternity services. What kind of hours/shift/on call pattern will I be expected to work under the proposed new service model?
This level of detail will not be known until a later date. In the proposed new model midwives will have more control over how they work.
I am a community midwife, would I be expected to travel more under the proposed new service model?
Currently, midwives are already covering clinics and visiting women all over the county and this will not change. Midwives would only need to be at the maternity hubs to deliver midwifery clinics. Maternity hubs would be staffed by maternity support workers which will allow midwives to work flexibly across different settings so that they can be where women need them to be.
Will community midwives need to be based at a maternity hub for 12 hours a day under the proposed new service model?
No. Under our proposed model, some maternity support workers would be based at the maternity hubs for 12 hours a day which will allow midwives to work flexibly across different settings so that they can be where women need them to be. Midwives would only need to be at the maternity hubs to deliver midwifery clinics.