Child and Maternal Health
In Focus: A Shared Vision
The Royal College of Midwives (RCM) are delighted to be involved in this Review and contribute to how the future of maternity and neonatal services will look over the next five to ten years. The RCM welcomes that the Review will build on the evidence base and recommendations of the Expert Group on Acute Maternity Services report, published in January 2003. The review will also be considered in the context of the Refreshed Framework for Maternity Care, published in 2011 and the Neonatal Care in Scotland: A Quality Framework published in 2013. Having been involved in all of these reviews previously we believe we are well placed to input in to this process.
Scotland is particularly unusual in the context of UK with the service we need to provide because of the issues around remoteness and rurality and the fact that we have a number of island communities which bring their own challenges.
We already have air ambulance services, which deal with emergencies, for mum or for baby. In particular the neonatal retrieval team is well established. However we do need to look to the future and ensure that this service is indeed future proofed.
It is important that maternity and neonatal services are linked and of course communication is fundamental to how this will happen. A number of high profile reports highlighted a break down in communications and multi disciplinary team working affecting the care of women and babies and we need to make sure we do all that we can in Scotland to prevent this happening here. The RCM and Royal College of Obstetricians and Gynaecologists (RCOG) have been doing a lot of work across the UK around tackling poor workplace behaviours and I will ensure that this is considered as part of the Review.
It is crucial that women and their partners are involved in the Review because their input is critical and we have designed engagement in to the Review from the beginning so their voices are heard. We know a child does not just belong to a woman but to a couple, a family and a wider community. We know that in the NHSScotland women’s satisfaction survey almost a third of women were not happy with their care in the postnatal period and that is something we must look at. I think if we looked to see how we could accommodate partners staying in overnight for that support it would help mum but also their own attachment to their newborn. Although this is starting to happen in a number of places, I would like to see it become the norm.
The RCM will bring two key pieces of work that they are engaged in to the Review. The Better Births Initiative was formed in 2014 as part of the work within the RCM’s goal in facilitating high quality maternity care. The initiative works across the UK with an emphasis on the continuum of care through from antenatal, labour and childbirth, and postnatal care. There are three themes guiding the activities, including increasing access to continuity of carer, facilitating normal births and normality, and addressing health inequalities. The other piece of work is a robust and useable model for maternity services, titled ‘Stepping up to Public Health’, which focuses on the public health role of the midwife. I think both of these pieces of work can add to the debate around the best model of maternity care for Scotland in the future.