Here you will find frequently asked questions related to the Transforming Midwifery Care consultation. These will be continually updated.
What is Transforming Midwifery Care?
Over the last three years, Shropshire and Telford & Wrekin CCGs have been carrying out a detailed review of midwife-led services across Shropshire and Telford & Wrekin. Initially referred to as The Midwife Led Unit Review this programme is now called Transforming Midwifery Care.
The review has looked at the way that midwifery care is currently delivered for women across Shropshire and Telford & Wrekin, whether it meets the needs of families and how we could make improvements in the future. As part of this review, we have engaged with hundreds of women and families, midwives and other healthcare professionals, listening to their views and experiences and finding out what’s important to them. The review also involved looking in detail at a broad range of local and national research, evidence and best practice in providing midwifery care.
We have looked in detail at all the feedback and evidence we have gathered. We have also commissioned a travel and transport assessment and carried out a detailed financial analysis of a range of options. By bringing all this information together we have developed a proposed new model of midwifery care. We will ask for your views on this proposed new model as part of a public consultation.
How is the programme governed?
Transforming Midwifery Care is commissioned by Shropshire and Telford and Wrekin CCGs and sits under the governance structure of the Sustainability and Transformation Partnership, which brings together health and social care organisations across the county. It has a Programme Board whose members include representatives of: Shropshire and Telford and Wrekin CCGs; Shrewsbury and Telford Hospital NHS Trust; Shropshire, Telford and Wrekin Local Maternity System; Healthwatch Shropshire and Healthwatch Telford and Wrekin; Shropshire and Telford and Wrekin Councils’ public health commissioners; West Midlands Ambulance Service; Shropshire, Telford and Wrekin Maternity Voices Partnership; a patient representative and an external clinician.
The Programme Board is responsible for overseeing the progress of the Transforming Midwifery Care review and implementation of the new service model, reporting to the Shropshire CCG Clinical Commissioning Committee and the Telford and Wrekin CCG Planning, Performance and Quality Committee, and making recommendations to the governing bodies of the two CCGs.
Why do things need to change?
The safety of mothers and the 5,000 babies born each year in Shropshire, Telford and Wrekin is our number one priority when we are thinking about making any changes to midwifery care.
The way midwifery care services are designed and organised in Shropshire, Telford and Wrekin has not changed for over 30 years, but our communities and the needs of women and their families have.
- More women are being identified as having higher risks of complications during pregnancy, for example, due to rates of obesity and smoking in pregnancy
- The number of midwives and maternity support workers are not based where most women need them to be
- The services women can currently access close to home are different across the county and they aren’t always where the majority of women are or where there is most need
We want women to know that they can rely on safe, high quality care being available throughout their pregnancy, during the birth and after their baby is born wherever they live.
What are you proposing?
We are proposing to transform the way that midwifery care is delivered across Shropshire, Telford and Wrekin to provide all women with safe, high quality and personalised care throughout their pregnancy (antenatal care), during the birth and following the birth of their baby (postnatal care).
We are suggesting that we create a network of midwifery care, including:
- Antenatal and postnatal clinics and activities in the local community
- Home visits, including home births
- 24 hour access to midwives on the phone, by video link or face-to-face
- New maternity hubs open 12 hours a day, 7 days a week offering an enhanced range of services such as support for women to improve their health and the health of their babies
- Two Midwife-led Units (MLUs) where women can give birth 24 hours a day, 7 days a week
Consultant Unit services will continue to be available.
Midwives and maternity support workers (previously known as women’s support assistants) would work flexibly, providing safe, high quality, personalised care to women closer to home throughout all stages of their pregnancy, birth and beyond.
How does this proposal reflect what women want?
We have listened to women from all over Shropshire, Telford and Wrekin and taken their views into account whilst making sure our proposed model reflects national guidance and the latest evidence.
Our porposal has been developed in line with what women said is important to them which included:
- Support with early pregnancy
- Knowing the midwife delivering their care (continuity of carer)
- Getting good care after the birth (postnatal care)
- Being part of decisions about their care when things don't go to plan
- Getting to the place of birth on time
- Building a network of mum friends
Does this proposal affect the decision made following Future Fit?
In January 2019, following the Future Fit public consultation, a Joint Committee of Shropshire and Telford and Wrekin Clinical Commissioning Groups (CCGs) made the decision to reconfigure the acute hospital services provided by The Shrewsbury and Telford Hospital NHS Trust (SaTH). This means that the Royal Shrewsbury Hospital (RSH) will become an Emergency Care site and the Princess Royal Hospital (PRH) will become a Planned Care site.
- The women and children’s consultant-led unit will move to the Royal Shrewsbury Hospital in 2023/24 to be on the same site as the Emergency Department when the hospital becomes an Emergency Care site.
- There will continue to be a 24-hour midwife-led unit at both the Royal Shrewsbury Hospital in Shrewsbury and the Princess Royal Hospital in Telford where women can give birth and receive care during pregnancy (antenatal care) and following the birth (postnatal care)
- At both hospital sites there will be Antenatal Day Assessment Unit, Early Pregnancy Assessment Service (EPAS) and Maternity Outpatients and scanning.
The new proposed model of midwifery care takes into account these changes.
Will I be able to share my views on the proposed changes?
Yes. We will be launching a public consultation soon to seek people’s views on our plans to transform midwifery care across Shropshire,Telford and Wrekin.
People will be able to ask questions and have their say in a number of ways and complete a survey either online or on a paper copy. We will be holding public events, providing information stands in venues that families visit, attending meetings and sharing information online, through the media and social media.
We want to hear your views and no decision will be made until we have concluded the consultation and taken into consideration all the feedback.
Who will decide if the proposal goes ahead?
The final decision will be made by a Joint Committee of Shropshire and Telford and Wrekin CCGs.
Once the public consultation has closed, all responses will be analysed by consultation specialists, Tonic. Tonic will produce a report which will be carefully considered by the CCGs. All reports and details on the decision-making process will be available on this website.
No decision will be taken until full consideration has been given to the responses and the analysis report.
Does this mean services are being taken away from rural communities?
No. Antenatal and postnatal clinics and activities that currently take place in over 50 different places including GP practices and children’s centres across the county will continue. In fact, our proposed new model would mean more women having better access to a broader range of services closer to home through new maternity hubs.
Have service users and members of the public been involved?
Yes. Right from the very beginning we have involved service users and members of the public. They have been involved in all stages of the review including the options appraisal. Our proposed model has been designed with women and their families, the public, professionals working in and with maternity services, voluntary and community organisations and both Shropshire and Telford and Wrekin Healthwatch organisations.
How have you engaged with people with protected characteristics?
We have engaged with people with protected characteristics and within seldom heard groups in the development of the proposal and sought to understand any specific impacts or issues for these groups. This will feed into the design of services offered in the hubs and also targeted outreach where for example certain groups have particular difficulty attending clinics.
Further information can be found in our Pre-Consultation Engagement Report related to seldom heard groups and Equality Impact Assessment which are both available under our key documents page.
Have professionals been involved in shaping the proposed model?
Yes. Significant engagement has taken place with professionals to develop the proposed model. This has included midwives (including midwives from other areas), women's support assistants, obstetricians, neonatal nurses and consultants, GPs, health visitors and healthcare assistants. A broad mix of clinicians, from different parts of the county, have also been involved in a number of stakeholder meetings and workshops, including the options appraisal workshops.
GPs and secondary care clinicians have also been involved due to their membership of the different boards where the Transforming Midwifery Care proposals have been discussed, inluding GP Locality Boards, the CCG governing bodies and the Transforming Midwifery Care Programme Board.
Have other related services been taken into account, such as Health Visiting?
Yes. In developing our proposal a broad range of professionals working in and with maternity care were involved including health visitors. In addition, we looked at a range of key policy documents to ensure our proposal was in line with the direction of other related services. Our proposal is flexible to meet future changes in demand and policy.
When will the consultation take place?
The date of the consultation has not yet been confirmed but it will be widely publicised through the media, social media and distribution of printed information in public places.
How will I be able to have my say during the consultation?
You will be able to have your say through a number of different channels:
- Completing our online survey accessed via this website or the Baby Buddy App, an interactive pregnancy and parenting guide for women and their families
- Completing a paper copy of our survey and sending it to a FREEPOST address
- Attending one of our consultation events
- By email or letter
How will I find out more and ask questions during the consultation?
All the relevant documents which show why we are making this proposal will be available on this website.
The consultation document will also be available on request in printed format (including an easy read version if preferred) and also as a text file suitable for reading with a screen reader.
You will be able to find details on this website of all the events we will be holding where you can meet staff and ask questions.
We cannot answer all questions received by mail, email, telephone message or social media during the consultation but we will be regularly updating these Frequently Asked Questions.
Is this proposal just about saving money?
No. The Shropshire and Telford and Wrekin CCGs currently pay the service provider in line with a nationally set tariff and this will continue to be the case. However, through re-designing the service we can use the money in a different way to make improvements for women and their families.
Will this proposal lead to redundancies?
No. The proposed model does not need fewer staff. These changes are about having the right number and mix of staff in the right locations to deliver care that better meets the needs and preferences of women and families. The Trust have also recruited to Birthrate Plus recommended staffing levels for the wider maternity service. This has resulted in the recruitment of an additional 29 whole-time equivalent (WTF) midwives. The Trust are also increasing the number of Band 3 Maternity Support Workers (MSW).
The Trust plans to repeat the Birthrate Plus assessment this year.
What arrangement of working hours can staff expect under the proposal?
This level of detail will be developed by the provider (Shrewsbury and Telford NHS Tust) and will not be known until a later date. The ways of working under this proposal will need to be in line with the requirments of the broader maternity transformation programme in relation to providing continuity of carer.
Would community midwives be expected to travel more under the proposal?
Currently, midwives are covering clinics and visiting women all over the county and this will not change. Under our proposed model, where some of the clinics happen could change to include the activity based at the new maternity hubs.
Will community midwives be based at the maternity hubs 12 hours a day?
No. Under our proposed model, some maternity support workers would be based at the maternity hubs for 12 hours a day which will allow midwives to work flexibly across different settings so that they can be where women need them to be. Midwives would only need to be at the maternity hubs to deliver planned midwifery clinics.
Is this consultation connected with the Ockenden maternity review?
No. However, once the recommendations of the Ockenden review are known, we will need to ensure that our proposed model of care adapts accordingly if required.
How is the current care being improved?
For information about the care being provided in Shropshire, Telford and Wrekin please visit the maternity pages of the Shrewsbury and Telford NHS Trust website www.sath.nhs.net
Will the Ockenden review affect the proposed new model of care?
Until we know the findings and the recommendations of the Ockenden review, we don't know what changes may need to be made. However, we have designed the model so that it can be flexible to meet the changing needs of women. This means it can also be adapted to reflect any recommendations made by the Ockenden review.