Health Commissioners

Who are One to One Midwives?

One to One Midwives are an NHS accredited midwifery service providing case loading midwifery in the community. One to One provides a woman with the same midwife throughout pregnancy who will provide all the antenatal, birth (Homebirth) and postnatal midwifery services. One to One is insured by the NHS Litigation Authority who insures NHS hospitals and has also been fully assessed and assured by the NHS Care Quality Commission (CQC). The service was founded by a midwife and manages ‘all risk’ women in partnership with health and social care.

One to One midwives are currently commissioned for self or GP referral by 6 CCGs in the North West of England (Wirral, Liverpool, Warrington, Western Cheshire, South Cheshire and Vale Royal). In line with NHS England maternity guidance (Gateway 01110) One to One midwives can also accept GP referrals from other CCG areas. If a woman is referred by a GP the local CCG will fund the care we provide.

One to One midwives have safely looked after over 5000 women across the North of England over the last 4 years. The service aims not to replace the local NHS hospital midwifery service but compliment local provision by offering an alternative model of care that may meet some women’s needs better.

What do One to One Midwives offer?

One to One are not the same as traditional NHS midwifery services. One to One provides an enhanced community based case loading midwifery service with a clear focus on normality of pregnancy through a continuity of care model. This focus has already proved very successful to over 5000 women and the One to One service has the best normality outcomes in the UK. Examples of these outcomes include,

This enhanced service from One to One is provided at national maternity pbr Tarff so costs no more than hospital maternity services. Also One to One midwives do not take on paying women. One to One believes this model of care should be made available free to all women. It is the organisation vision for One to One to support such a model being available to all women everywhere.

How does the One to One service work?

The model of care is a purely woman focused model of care. Unlike traditional NHS midwifery where the woman has to fit in around the service, One to One deliver a service that is tailored to the woman herself. The model works as follows,

• A midwife with in 48hrs visits the woman at home from referral.
• The women will have the same midwife throughout pregnancy and 6 weeks postnatal.
• The midwife will undertake all aspects of care inc. bloods.
• The care will be provided at home inc. evenings and weekends.
• The woman has access to the midwife 24/7 by phone and txt.
• The midwife will link in with GP, HV & Obstetrician if required.
• Scans will be undertaken in the community.
• If the pregnancy does not go full term midwife will offer support.
• The woman can birth at home or hospital of choice. If HB the woman’s midwife (with a 2nd midwife) will do HB.
• The same midwife will visit daily as required to support breastfeeding and general health & well-being.

Our local midwives care for women in a community setting, including the woman’s home across 7 days. Our services include community scan clinics, screening tests, bloods, parent education classes, hypnobirthing and obstetric input should the need arise.

With One to One women are not required to decide on place of birth until late on in the pregnancy if they wish. Women can choose any local hospital to birth, they can birth at home or can birth in a community-based midwifery led birthing unit if available. One to One is also looking to establish community-birthing centers in all the areas they cover.

In relation to safety and quality, One to One midwives have pathways and policies assured by CQC, NHS Litigation Authority (insurers) and the Local Supervisory Authority of Midwives. The pathways have been shared with Clinical Commissioning Groups, local hospitals, community services, safeguarding services, mental health services and social care where contact with One to One midwives has been required.

How does One to One differ from traditional NHS Midwifery services?

The table below clearly demonstrates the difference between the One to One model and the typical NHS provision.

How will One to One help commissioners meet national quality standards and policy?

The One to One model already meets national standards and policy where many other NHS maternity providers do not. Below are just a few examples of how One to One can deliver now on national policy and drivers,

One to One therefore can ensure that commissioners are able to meet their legal commissioning obligations around quality as set out by the NCB.

What commissioning options are available with One to One?

One to One midwives can provide a number of options to work with commissioners to deliver this service locally. Options include,

1. Working as a choice option to current maternity services being provided through,
a. Non-contracted activity through self and/or GP referral.
b. CCG can become an associate to the main contract.
c. CCG can directly procure One to One to work in the area. 

2. In partnership providing the community and homebirth based service in the local area and allowing the current provider to manage the hospital service of the pathway.

3. Managing a specific locality in the commissioned area providing additional capacity to the local provider.

4. One to One can target the more deprived and complex women’s groups with an aim to reduce the health inequalities compared to affluent areas of a community with the primary objective of ensuring that all women, regardless of socio-demographics, have the same health outcomes.

One to One can discuss any options that the local women, trust and commissioners require.

As a commissioner do you want your local women to benefit from the best outcomes in the UK?

As the representative for your local women can you justify not offering this choice option?

Further information can be found by contacting:

E-mail -
General enquires can be made through the website and by telephone.
Telephone: 0330 330 9121

Current articles with information on One to One midwives.