Better Births and Local Maternity Systems

In February 2016, Better Births set out the Five Year Forward View for NHS maternity services in England. Better Births recognised that its vision could only be delivered through transformation that is locally led, with support at national and regional levels.

Providers and commissioners were asked to operate as Local Maternity Systems, with the aim of ensuring that women, babies and families are able to access the services they need and choose, in the community, as close to home as possible.

There are three Local Maternity Systems in the North East and North Cumbria:  Darlington, Tees, Hambleton and Richmondshire and Whitby (DTHRW); Northumberland, Tyne and Wear and Durham (NTWD) and West, North and East Cumbria (WNEC).

The Northern England Maternity Clinical Network works in close partnership with Local Maternity Systems and is an important source of support by:

  • Providing ongoing clinical input and expertise;
  • Supporting Local Maternity Systems to implement their local maternity transformation plans;
  • Helping Local Maternity Systems understand and interpret national policy for local implementation;
  • Supporting benchmarking of the quality of services and spreading good practice;
  • Supporting strategic joint working and aiding service improvement;
  • Continuing to advise upon and encourage implementation of Saving Babies Lives.

The Better Births Vision

The vision for maternity services across England is for them 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 around their individual needs and circumstances.

And 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.

Local maternity systems are responsible for:

  • Developing a local vision for improved maternity services and outcomes which ensures that there is access to services for women and their babies, regardless of where they live;
  • Helping to develop the maternity elements of the local Sustainability and Transformation Partnerships (STP) / Integrated Care Systems (ICS);
  • Including all providers involved in the delivery of maternity and neonatal care, as well as relevant senior clinicians, commissioners, operational managers and primary care;
  • Ensuring that they co-design services with service users and local communities;
  • Putting in place the infrastructure that is needed to support services to work together effectively, including interfacing with other services that have a role to play in supporting woman and families before, during and after birth.

The LMS priorities are:

  • To implement the national maternity services review “Better Births”
  • To focus on reduction of health inequalities and variations in standards of care;
  • To encourage collaboration between providers to provide the best care, in the most appropriate setting, closer to home wherever possible;
  • To determine optimal service models based on multiple considerations including quality of care, financial stability and workforce sustainability;
  • To change the focus from hospital-based services to community hubs – building services around the family.

The LMS plans are co-produced with service users and staff to ensure they are fully informed of their choices for care, including seamless and transparent transfer of care to specialist services across the area when required.

Information and Resources

Implementing Better Births: A resource pack for Local Maternity Systems is designed to help LMSs lead and manage that local transformation.  It provides guidance on implementing the recommendations of Better Births that require local action, and describes national policy that will support implementation through the Maternity Transformation Programme.

Transforming Maternity Services across Northern England Event Resources

The most recent Local Maternity Systems (LMS) event, Transforming Maternity Services across Northern England, took place on 2 October 2018 at Newcastle Racecourse.  A copy of the presentations from the event can be found here

Local Maternity System (LMS) Boards

Durham, Darlington, Tees, Hambleton, Richmondshire and Whitby (DTHRW)  

Chair:  Julie Lane, LMS Senior Responsible Officer and Nurse Director, North Tees and Hartlepool NHS FT

The role of the DTHRW LMS Board is to develop and implement a local vision for transforming maternity services by 2020/21, based on the principles of the National Maternity Transformation Programme (Better Births 2016).

This Board is the mechanism through which the Sustainability and Transformation Plans (STPs) will collaboratively transform maternity services, with a focus of delivering high quality, safe and sustainable maternity services and improved outcomes and experience for woman and their families.

Northumberland, Tyne & Wear and North Durham (NTWD)

Chair: Dr Andrew Beeby, LMS Senior Responsible Officer and Medical Director, Gateshead Health NHS FT

The aim of the NTWD LMS Board is to develop and implement a local vision for transforming maternity services by 2020/21, based on the principles of the National Maternity Transformation Programme (Better Births 2016).

The Board is the mechanism through which the Sustainability and Transformation Plans (STPs) will collaboratively transform maternity services, with a focus of delivering high quality, safe and sustainable maternity services and improved outcomes and experience for woman and their families.

The Transformation Plan for the DTHRW and NTWD LMS Boards can be found here and supporting information here

West, North and East Cumbria (WNEC)

Chair: Eleanor Hodgson, LMS Senior Responsible and Programme Director: Children and Families

The aim of the WNEC Board is to develop and implement a local vision for transforming maternity services by 2020/21, based on the principles of the National Maternity Transformation Programme (Better Births 2016).

The Board is the mechanism through which the Sustainability and Transformation Plans (STPs) will collaboratively transform maternity services, with a focus of delivering high quality, safe and sustainable maternity services and improved outcomes and experience for woman and their families.

The WNEC Better Births (LMS) plan can be found via the following link

LMS Workstreams

Personalised care centred on the woman, her baby and her family, based around their needs and their decisions and their decisions, where they have genuine choice, informed by unbiased information

Continuity of carer to ensure safe care based on a relationship of mutual trust and respect in line with the woman’s decision.  The NHS England Continuity of Carer guidance can be found here

Safer care with professionals working together across boundaries to ensure rapid referral, and access to the right care in the right place: leadership for a safety culture within and across organisations (link back to maternity patient safety learning network)

Postnatal care should be led by the woman’s own midwife, who should help her to develop the element of her personalised care plan, and provide care alongside others

Perinatal mental health care: The mental wellbeing of women and their families is as important as the physical wellbeing of the women and developing baby – the NHS needs to consider this in an integrated way. (link back to perinatal mental health)

Prevention: Maternity services have a unique role in supporting parents of all backgrounds to maximise their own mental and physical health whilst also equipping parents with the skills, information and confidence to maximise their child’s emotional, physical and cognitive development.

The role of Local Maternity Systems is to implement strategies and services to improve women’s health before, during and after pregnancy, give every child the best start in life, and reduce health inequalities.

Neonatal care: Maternity services cannot be considered in isolation and are inextricably linked to neonatal services, which are key in delivering optimal outcomes for babies. The Maternity Clinical Network works closely alongside the Northern Neonatal Network, a link to their website can be found here

To contact the Clinical Network team about any aspect of Local Maternity Systems, please send an email to our generic account – england.northernmaternity@nhs.net  We will respond as soon as possible to any questions you may have.