NHS maternity services must set personal care budgets

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NHS maternity services must set personal care budgets

Pregnant women should receive personal care budgets of up to £3,000 to have more control over maternity care, a review commissioned by NHS England has recommended.

Maternity care should offer "genuine choice informed by unbiased information" centred on the decisions of the woman, her baby and her family, the report said.

Baroness Julia Cumberlege, chair of the Maternity Review said: "To be among the best in the world, we need to put women, babies and their families at the centre of their care."

Every woman should develop a personalised care plan, with their midwife and other health professionals, which sets out her decision about her care reflecting her wider health needs.

The report recommended trialling the NHS Personal Maternity Care Budget which would give women more control over their care, whether it is through an existing NHS trust or a fully accredited midwifery practice in the community

NHS England commissioned the National Maternity Review, which set recommendations for how services should change over the next five years.

The review found that despite the increases in the number of births and the increasing complexity of cases, the quality and outcomes of maternity services have improved significantly over the last decade.

The stillbirth and neonatal mortality rate in England fell by over 20% in the ten years from 2003 to 2013 (HSCIC Indicator Portal NHS Outcomes Framework Indicator 1c).

Maternal mortality in the UK has reduced from 14 deaths per 100,000 maternities in 2003/05 to 9 deaths per 100,000 maternities in 2011/13 9 (MBRRACE-UK Confidential Enquiry into Maternal Death 2015. Figures exclude coincidental maternal deaths). 

However, the review also found meaningful differences across the country, and further opportunities to improve the safety of care and reduce still births.

The report urged for continuity of care: every woman should have a midwife, who is part of a small team of four to six midwives, based in the community who knows the women and family, and can provide continuity throughout the pregnancy, birth and postnatally.

Community hubs should enable women and families to access care close to home, in the community from their midwife and from a range of other services, particularly for antenatal and postnatal care.

Postnatal care must also be "resourced appropriately". Women should have access to their midwife (and where appropriate obstetrician) as they require after having had their baby.

The report also endorsed the recommendation of the Mental Health Taskforce published last week for a step change in the provision of perinatal mental health care across England

Simon Stevens, the chief executive of NHS England, said: "The independent review finds that quality and safety of NHS maternity services has improved substantially over the past decade, and most new mums tell us they are looked after well.

"But it rightly argues that the NHS could and should raise its game on personalised support for parents and their babies, better team working, better use of technology, and more joined up maternity and mental health services."

Further reading

Beware of expat maternity costs- Jelf International
 

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