Clinical Commissioning Groups:
Who are One to One Midwives?
One to One Midwives are an NHS accredited midwifery service providing caseloading and team midwifery in the community. One to One provides a woman with a dedicated midwife throughout pregnancy who will provide all the antenatal, birth (if a homebirth is chosen) and postnatal midwifery services. One to One Midwives 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 services.
One to One midwives are currently commissioned for self-referral by 9 Clinical Commissioning Groups including, Liverpool, Northeast Essex, South Cheshire, South Sefton, Southport and Formby, Vale Royal, Warrington, West Cheshire and Wirral.
One to One Midwives have safely looked after over 10,000 women across the North of England and Essex over the last 7 years. The service aims not to replace the local NHS hospital midwifery service but compliment local provision by offering an alternative model of care.
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 caseloading and team 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 10,000 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.
The One to One Quality Account 2015 – 2016 can be downloaded from the website homepage which gives more detail regarding One to One outcomes.
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 will contact the woman within 48 hours of the referral being received to arrange a booking appointment. This is done at any stage during the pregnancy.
The women will have a dedicated midwife throughout pregnancy, the birth (if a homebirth is chosen) and 6 weeks postnatal.
The midwife will undertake all aspects of care including the taking of bloods and arranging scan appointments at locations within the community.
- The care will be provided at home including evenings and weekends.
- The woman has access to a midwife 24/7 by email, phone and text.
- The midwife will link in with GP, Health Visitor and Obstetrician if required.
- If the pregnancy does not go full term midwife will offer support.
- The woman can birth at home or hospital of choice. If a homebirth is chosen the woman’s midwife (with a second midwife) will do the homebirth.
- The same midwife will visit daily as required to support breastfeeding and general health and wellbeing.
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. One to One have also opened three Pregnancy Advice Centres across the Northwest and information on the services provided at the Advice Centres can be viewed here: http://www.onetoonemidwives.org/pregnancy-advice-centres
With One to One women are not required to decide on place of birth until late on in the pregnancy. 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.
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.
Working with Personal Maternity Care Budgets (PMCB)
The PMCB (Personal Maternity Care Budget) is one of the first steps to fulfilling one of the recommendations for the transformation of maternity services in the Better Births Report 2016.
Better Births recommends that all women should have personalised care, centred on the woman, her baby and her family, based around their needs and their decisions, where they have genuine choice. Better Births also set out a vision that women should be able to choose the provider of their antenatal, birth and postnatal care and be in control of exercising those choices through their own NHS Personal Maternity Care Budget. One to One have been working to the above specifications since 2010 and have ensured that all women are given informed choice about the care they can receive at every stage during their pregnancy and beyond.
Evidence shows that the choice women have regarding maternity providers across the country varies and NHS England want CCG’s to widen the choice offered across CCG boundaries and deepen the choice offered to women and their families.
One to One are working alongside the Clinical Commissioning Groups in Northeast Essex and the Northwest of England to ensure the PMCB is a tool used to support the choices that a woman makes amongst providers and services offered by the local CCG and will continue to ensure that all women receive informed choice.
What commissioning options are available with One to One Midwives?
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 GP and/or self –referral processes.
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.
For further information:
Make an enquiry via our website at: http://www.onetoonemidwives.org/enquiries
Telephone: 0330 3309 121