Project outline

Local Maternity and Neonatal Systems (LMNS) have been asked to ensure that all providers and commissioners have agreed a local improvement plan for postnatal care to include:

• How women will be provided with personalised, kind care in the postnatal period, including how the postnatal ward experience will be monitored and improved.
• Plans to support effective transfer of care when women return home, and that women receive appropriate, high quality information, with clear information on who to contact at all times.
• How women will be supported in their return to physical health, including follow-up of pregnancy complications and clear pathways for referral when women encounter issues, such as with pelvic health.
• How women will be supported to successfully feed their babies, including a tailored breastfeeding strategy across the LMS.
• How mental health assessment, identification, and access to emotional and mental health support will be improved, including for bereavement and neonatal care.
• How women will receive seamless care between maternity, health visiting, and general practice, including how handover from midwifery to health visiting services and General Practice can be supported, to ensure informational continuity.

Why is this project needed?

Better Births (NHS England, 2016) sets out the vision for maternity services in England. It describes safer, more personalised and kinder care, which is co-designed with service users, placing the needs of women, babies and families at the center. It describes a vision where every woman can access information to enable her to make decisions about her care; and where she and her baby can access support centered around their individual needs and circumstances; with staff who are supported to deliver high quality care which is improving continuously. 

Better Births also highlights that care in the postnatal period is ‘equally important as during pregnancy and birth’ and makes it clear that postnatal care needs to be improved ‘to give women and their babies the best start in family life’. 

In November 2019 NHS England published draft guidance, “Implementing Better Births Postnatal Care” and as part of the Maternity Transformation Programme the LMS are developing their response to this.

In addition, the LMS Postnatal Improvement Plan will be informed by the results from the more recent CQC Maternity Surveys and local feedback from women and their families via Family and Friends Tests, Maternity Voice Partnerships, engagement (Whose shoes). The Maternity Survey (CQC, 2019) demonstrates in line with previous years, results still indicate poorer experience of care for many women postnatally compared to antenatal care and care during labour and birth.

Expected outcomes

Improvements in:

• Personalised, kind care in the postnatal period, including how the postnatal ward experience will be monitored and improved.
• Effective transfer of care when women return home, and that women receive appropriate, high quality information, with clear information on who to contact at all times.
• How women are supported in their return to physical health, including follow-up of pregnancy complications and clear pathways for referral when women encounter issues, such as with pelvic health.
• How women are supported to successfully feed their babies, including a tailored breastfeeding strategy across the LMS.
• How mental health assessment, identification, and access to emotional and mental health support will be improved, including for bereavement and neonatal care.
• Seamless care between maternity, health visiting, and general practice, including how handover from midwifery to health visiting services and General Practice can be supported, to ensure informational continuity.

Project successes so far

An action plan was developed, informed by the system wide gap analysis and accepted by the national team in NHS England. Most actions are complete, however 4 were outstanding due to the impact and restriction of the covid 19 pandemic – such as the ‘partners staying overnight’ system wide policy. The outstanding actions are currently being refreshed and reviewed at a postnatal improvement task and finish group which includes LMNS Better Births lead midwife for Transformation, postnatal ward managers from each trust and Maternity Voice Partnership.