Position Statement: One to One Midwives in Yorkshire


It is with great sadness and disappointment that One to One Midwives can no longer continue to provide our service to the women in Yorkshire. One to One have been providing our community caseloading midwifery service across the Yorkshire region as a choice option for women who have requested it since 2013. During this time we have made numerous attempts to communicate and engage with the Clinical Commissioning Groups (CCGs) as we believed that as an accredited NHS provider of maternity services we could accept women into our care under our NHS contract as non contracted activity and receive payment under the Payment by Results maternity tariff system. Unfortunately the CCGs did not believe this to be the case and we have struggled to reach an agreement on this issue, with the CCGs citing safety and quality concerns as a reason for non engagement and to support their decisions in declining women’s requests.

These concerns have never been validated and One to One remain a registered CQC provider of maternity services and are commissioned by a number of CCGs in the North West. One to One continue to achieve some of the best outcomes in the UK and our safety record is better than, or comparable, to any other NHS provider.

Had the CCGs engaged with One to One, we could have become part of a local formal regulatory framework and the CCGs would use this framework to monitor performance and quality assure the service, just like they do with all their commissioned providers, but they have chosen not to do so.

In January NHS England provided some clarity on this issue and their interpretation of the current guidance is that One to One can only accept women onto our service with the approval of the CCG. This means that even if a GP makes a referral the CCG still has to approve the referral and unfortunately in the Yorkshire region, where we are providing our service, all the CCGs have formally instructed us not to accept any women onto our service.

The reality of this decision is that women now no longer have the ability to exercise choice and One to One have had to make the very difficult decision of closing our service in the Yorkshire and Humber region.

The Yorkshire One to One midwives who are currently providing care for women have remained passionate and committed to continuing to do so and as an organization we will support them to do this and we remain committed to completing the full care of all of our existing women. Unfortunately we are no longer able to accept new referrals into our service and this makes the service unsustainable and unviable. The service will be completely closed by September/October 2015.

We welcome the news that NHS England has now publicized their commitment to undertake a full maternity review of existing national maternity policy and One to One hope to be a part of this review and present our experiences and the challenges of providing women with choice in the current NHS landscape.

In the meantime One to One will continue to try and engage with the Yorkshire CCGs with the ultimate aim of being a provider in Yorkshire and once again being able to open our service as a choice option in this region.

To confirm – One to One will continue to provide and complete care for all women who are currently booked onto our service but we are unable to accept new referrals from the Yorkshire and Humber region.

Please note: This decision does NOT apply to our commissioned or approved areas and One to One continue to accept women onto our service in these areas, including Wirral, Liverpool, West Cheshire, Warrington, South Cheshire and Vale Royal, North East Essex and Mid Essex and some regions across the Greater Manchester area.