System Transformation

The System Transformation Workstream of the LMNS

Better Births, the report of the National Maternity Review was published in February 2016 and set out a clear vision: for maternity services across England to become safer, more personalised, kinder, professional and more family-friendly; where every woman has access to information to enable her to make decisions about her care; and where she and her baby can access support that is centred on their individual needs and circumstances. It also calls for all staff to be supported to deliver care which is women centred, working in high-performing teams, in organisations which are well led and in cultures which promote innovation, continuous learning, and break down organisational and professional boundaries. 

Implementing the vision set out, Better Births will support the Secretary of State’s ambition to halve the number of stillbirths, neonatal and maternal deaths and brain injuries by 2025.  Local transformation is key to realising the Better Births vision working in tandem with ICSs and through the maternity Clinical Networks and regional boards.  


Midwifery Continuity of Carer: LMSs should ensure that all providers remain on track to offer Midwifery Continuity of Carer as the default model of care and are prioritising rollout to those most likely to experience poorer outcomes: 

a) Ensuring the building blocks for safe and sustainable transformation are in place as set out in Delivering Midwifery Continuity of Carer at full scale; 

b) By 15th June 2022, submitting a plan and quarterly trajectory for rollout of Midwifery Continuity of Carer in line with the building blocks, so it is the default model for all women; and so that 75% of women of Black, Asian and Mixed ethnicity and from the most deprived neighbourhoods are placed on pathways to timescales linked to the essential recruitment of midwives, as agreed with Regional Boards. 

c) Prioritising rollout of Midwifery Continuity of Carer teams to the most deprived neighbourhoods and those with higher numbers of Black, Asian and Mixed ethnicity women 

Personalisation and Choice: LMSs should work with providers to ensure that every woman is offered a personalised care and support plan in line with the guidance. 

Maternal Medicine Networks (MMN) should be fully embedded with: 

a) All providers operating within a commissioned service; and 

b) Maternal Medicine Centres on track to meet or exceed staffing as set out in the national service specification. 

Postnatal Improvement: As part of their deliverables for 19/20, Local Maternity Systems (LMS) have been asked to ensure that: by Feb 6th 2020, all providers and commissioners have agreed on a local improvement plan for postnatal care. NB. Some actions were unable to take place due to the covid pandemic, and are being actioned now that restrictions have been reduced. 

Key documents

Successes so far

Implementation of MCoC at the James Paget Hospital:  approximately 83% of JPUH total pregnant population are being cared for under the MCoC model. This includes approximately 96% of all pregnant people from minority ethnic backgrounds and 88% from the most socially deprived areas. 

Plans have been submitted and preparations made to begin implementation of the MCoC model at QEH and NNUH when all of the building blocks are in place. 

Personalised Care and Support Plans 

Each trust, in collaboration with the Maternity Voices Partnerships, have co-designed and implemented PCSP’s, supporting choice and personalisation throughout the maternity journey. 

Maternal Medicines Network 

MMN has been successfully launched at NNUH. 

The LMNS has approved the funding proposal and a project manager has been appointed to support with reporting and service user engagement. 

A task & Finish Group has been set up to continue to learn, improve and evaluate the new service. 


Midwifery Continuity of Carer

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Community Hubs

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Postnatal Improvement

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Maternal Medicines Network

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