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Our proposed model

Posted in Our consultations

We are proposing that we create a network of midwifery care services, including Midwife-led Units (MLUs) where women can give birth; new maternity hubs open 12 hours a day, seven days a week offering an enhanced range of services; clinics in the local community; home visits; and 24/7 access to midwives on the phone, by video or face to face. 

The new model of care will include:

24 hour access to midwives by telephone, video link or face-to-face

Women will continue to be able to contact midwives any time of the day or night by telephone.  As now, a midwife will be able to provide advice over the phone or may advise the woman to see a midwife in person.  This could be at one of the MLUs or the Consultant Unit. Under our new model, once the technology and safeguards are in place, midwives will also have access to video link which will let women have a face-to-face conversation with midwives by phone or computer.   

Clinics in local communities and home visits

Routine antenatal and postnatal clinics and appointments with midwives will continue to take place in community locations across the county, including GP practices and children’s centres, as well as visits made to women’s homes. 

Maternity Hubs

Will be open 12 hours a day, 7 days a week. Maternity hubs will offer a range of services such as care from a midwife or maternity support worker, planned appointments with an obstetrician, scans, perinatal mental health services and healthy lifestyle services. The opening hours of each hub and how often each service would be available could adapt over time to meet the needs of women in each community. Women and their partners will be able to meet other families at the hubs to share experiences, through schemes such as drop in ‘cafes’ and online networks. Each of the maternity hubs will provide outreach into communities where there is a need.

Birth options

Women will continue to be able to choose from the current range of places to give birth: Home birth; Freestanding MLU at the RSH; Alongside MLU at the PRH; and the Consultant Unit at the PRH. When the changes to the local acute hospitals, which were agreed following the Future Fit consultation in 2019, are put in place, the women and children’s Consultant Unit at the PRH will move to the RSH to be on the same site as the Emergency Department when the hospital becomes an Emergency Care site. Both hospital sites will still have a MLU operating 24 hours a day, 7 days a week where women can give birth and receive their antenatal and postnatal care.

Home Birth

Women will continue to be able to give birth at home should they wish provided they haven't agreed with their consultant or midwife that they need a higher level of care available at the Consultant Unit. Home births have the same level of care and back-up as a Freestanding MLU. Women requiring a higher level of care during labour are transferred to the Consultant Unit by ambulance.

The Freestanding MLU at the RSH

The Freestanding MLU at the RSH will continue to be open 24 hours a day, 7 days a week. Women will continue to be able to give birth at the Freestanding MLU provided they haven't agreed with their consultant or midwife that need a higher level of care available at the Consultant Unit. This is suitable for women with uncomplicated pregnancies who wish to give birth in a non-medical environment. Births at a Freestanding MLU have the same level of care and back-up available as a home-birth. They don’t have consultant care on the same site and women are transferred by ambulance to the Consultant Unit should they need a higher level of care during labour.

The Alongside MLU at the PRH

The Alongside MLU at the PRH will continue to be open 24 hours a day, 7 days a week. Women will continue to be able to give birth at the Alongside MLU provided they haven't agreed with their consultant or midwife that they need a higher level of care available at the Consultant Unit. Alongside MLUs are suitable for women with uncomplicated pregnancies who wish to give birth in a non-medical environment but have access to consultant care on the same site if needed.

A Consultant Unit

A Consultant Unit is staffed by a team including midwives, maternity support workers, obstetricians, anaesthetists (see glossary) and support staff. Care for women giving birth is often provided by midwives but doctors are involved if needed. Women and their babies who may be at higher risk will always give birth at the Consultant Unit. The Consultant Unit at PRH will continue to be available for births 24 hours a day, 7 days a week.

Postnatal care

Following the birth, women will receive the postnatal care they need closer to home, through their midwife or maternity support worker visiting them at home or by attending a clinic in their local community. In addition they will be able to get a range of postnatal care, advice and support at their local maternity hub. Women giving birth in a MLU will be able to stay for up to 6 hours before returning home unless they or their baby need extra care available at the Consultant Unit.

Continuity of carer

As recommended in Better Births, the NHS’ vision for maternity services, by 2021 most women will receive their care from the same team of midwives and maternity support workers throughout their pregnancy, birth and postnatal care. In the proposed new model, all women who give birth in a MLU or at home will receive continuity of carer throughout antenatal care, birth and postnatal care. All women, regardless of where they give birth, will receive continuity of carer across antenatal and postnatal care.