Our vision
The vision of the West Yorkshire and Harrogate Local Maternity and Neonatal System (LMNS) is based on the needs and collaboration of women, their partners and their families. We have worked with health and care staff and women from across West Yorkshire and Harrogate to create a plan for how we transform our services.
Addressing inequalities in West Yorkshire and Harrogate
West Yorkshire and Harrogate Local Maternity and Neonatal System, Equity and Equality Action Plan has been refreshed and updated.
Health inequalities are unfair and avoidable differences in health across the population, and between different groups within society. The conditions in which we are born, grow, live, work and age can impact our health and wellbeing. These are sometimes referred to as wider determinants of health (NHS England)
Our Local Maternity and Neonatal System (LMNS) works with pregnant women and birthing people, and parents, to improve the care and support provided before pregnancy, during pregnancy and beyond. This is in line with the NHS’s Long-Term Plan ambition to make sure everyone gets the best start in life. A key element of this work, and part of NHS West Yorkshire Integrated Care Board's vision, is to eliminate health inequalities and ensure that all our people have access to the services and support they need, when they need them most.
Our first Equity and Equality Action Plan was published in September 2022, and a number of actions have already been implemented over the last two years. We have chosen to update our actions because we know that our local communities are regularly growing and changing. That’s why it’s important that our services also grow and evolve to make sure we can deliver the best possible care for our communities.
View the West Yorkshire and Harrogate Equity and Equality Action Plan for 2024 - 2027
The actions we will take between now (December 2024) and 2027 and cover the following areas, to improve the outcome for women and their families at all six maternity units across West Yorkshire and Harrogate:
- Personalised Care
- Digital services and data quality
- Maternal medicine networks
- Continuity of carer
- Culturally competent genetic services
- The impact of culture, ethnicity, and language, in incidents and adverse outcomes
- Improving health and wellbeing
- Diabetes prevention programme
- Health protection and vaccinations
- Maternal mental health services
- Smoke-free pregnancy support
- Improving breast-feeding rates
- Care for pregnant women with complex social factors
- Establishing community hubs in areas of greatest need
- Addressing social determinants of health
- Workforce
Maternity shared care record
The hospital trusts in West Yorkshire and Harrogate are carrying out a project to use the Yorkshire and Humber Care Record (YCHR) technology to share maternity summary documents between each organisation.
Currently, information is stored in six different maternity systems - and potentially in none-maternity systems too. This may be because maternity patients visit several healthcare settings. The record, centred around the mother and child, will enable data sharing across several maternity systems transparently and safely.
We’ll carry out the work in phases. In this first phase we have prioritised five maternity records which we can generate as PDFs and make available through the YCHR. The priority records are:
- Booking in - for example blood group, allergies, medical history
- Delivery - for example, how the baby was delivered, GP details, weight
- Discharge - for example, feeding
- Personalised care plan - for example, birth and post-natal preferences
- Pregnancy outcome - for example, miscarriage, moved out of the area
Improved connectivity and integration will provide clinical and care staff directly involved in the mother’s care access to the most up to date information. It means they’ll be able to view real time maternity information across care providers and between different IT systems safely and securely.
Time consuming telephone calls to understand different systems and chasing up information will become a thing of the past. Access to better information means more time to spend with patients, improved decision making and planning of maternity services as well as more joined up care.
Data is pulled from secure clinical systems. All health and care records are strictly confidential and can only be seen by clinical and care staff directly involved in the patient’s care.
Developing a common infrastructure and exchanging maternity data in this way is the first step in progressing a more comprehensive Maternity Shared Care Record.
The Partnership’s Digital Programme leads the rollout of shared records across our associated health and care organisations in partnership with the central Yorkshire and Humber Care Record team.
Data
WY&H LMNS is putting data at the centre of our work.
All projects within the LMNS use data to identify opportunities and challenges to service delivery and the quality of care received by our patients. We support the LMNS-wide workforce, ATAIN, PReCePT, Continuity of carer, pre-term birth, and public health workstreams, delivering a variety of data collections, analysis, and quality improvement. Process and outcome measures are presented to the LMNS board as part of the Quality & Safety assurance paper.
WY&H LMNS maintains a maternity health inequalities dashboard which provides detailed results to health and care of women by different population groups like ethnicity and deprivation of residence. This dashboard has been made available to all maternity units, maternity commissioners, and local authorities to enable a more detailed understanding of the populations we serve. We expect data like this to be invaluable in improving our understanding of and ability to address health inequalities.
All data shared by us are anonymous aggregated totals shared safely for management purposes only.
Workforce
The WY&H LMNS recognises that our workforce is our greatest strength, enabling maternity services to deliver more personalised and safer care.
Our vision is to ensure we support our workforce to be highly skilled and knowledgeable in all elements of the maternity and neonatal pathway. We will promote a culture of learning and continuous improvement to maximise quality and outcomes.
Our ambition is for maternity and neonatal services in West Yorkshire and Harrogate to be where the maternity workforce chooses to work and wants to stay. In order to achieve this, the LMNS has developed a workforce strategy and action plan.
View the WY&H LMNS workforce strategy and action plan here.
Working in collaboration with Trusts, Yorkshire & Humber Neonatal Operational Delivery Network (Y&H Neonatal ODN) and NHS England Workforce, Training and Education Directorate, the WY&H LMNS will ensure there is sufficient staff, good wellbeing support, specific training and supervision and a diverse workforce reflective of the communities we serve. In addition, we will respond to workforce recommendations detailed in nationally and locally developed reports. This includes ensuring the LMNS workforce priorities align to the NHS Long Term Workforce Plan.
The key areas of focus for 2024-25 are;
- Implementing initiatives to attract, recruit and retain the maternity workforce
- Support Trusts to implement the Core Competency Framework v2
- Developing the Maternity Support Worker role
- Developing the Labour Ward Coordinator role
- Improving the student midwife experience
- Supporting staff wellbeing
- Support Trusts to implement Enhanced Continuity of Carer
Safety
Safety is the golden thread that runs through transformation throughout the LMNS. We are working collaboratively to learn and share across the system.
Personalised care
The West Yorkshire and Harrogate Local Maternity and Neonatal System (LMNS) was set up in 2018 to bring together maternity services in our area to help change maternity services to make them safer, more effective and more responsive to the needs of the people who use their services. The document Better Births (2016), also called the national maternity review, detailed what this transformation should look like.
In March 2023 NHS England published the Three Year Delivery Plan for Maternity & Neonatal Services (NHSE March 2023). This plan describes how to make improvements to care.
Our priority is to ensure that care is personalised, recognising that every woman, every pregnancy, every baby and every family is different. We also want to ensure that women and birthing people are enabled to make choices based on good information they receive.
We work closely with our local service users and those with lived experiences to ensure the care available to women, birthing people and their families is reflective of our local populations and is centred around individual needs.
All women and birthing people can choose which hospital they wish to provide their pregnancy, birth and after birth care. We have a booklet to help you with making choices and to explain your maternity journey, please click here.
We also have personalised care and support plans available in a variety of formats that you can use with your maternity care providers (midwives, doctors, support workers) to state your preferences and help you discuss and explore your options. A short video also shown below explains personalised care and support planning. There is also information here on the NHS England website.
The postnatal care and support information is available here . The postnatal booklet has been split into several different easy read booklets below:
Booklet 1: Postnatal care, birth registration and coronavirus
Booklet 2: Resuming sexual intercourse and contraception
Booklet 3: Maternal physical wellbeing and health concerns
Booklet 4: Emotional wellbeing and mental health
Booklet 5: Infant feeding and blood spot tests
Booklet 6: Baby care and wellbeing
Booklet 7: Coping with crying and safe sleeping
Sadly some people experience loss in pregnancy and we have a bereavement postnatal care and support booklet to help you.
Midwifery Continuity of Carer
Midwifery Continuity of Carer is care that is provided by a small team (maximum 8) of midwives to women throughout their pregnancy, birth and post birth care. Each midwife will care for their own group of women (their caseload), supported by the rest of the team when needed (for example when they are on leave or are supporting another woman giving birth).
This model of care enables better relationship building between the women and her named midwife, which has been shown to improve outcomes and experiences for mothers and babies. Some of our maternity services offer this type of care and others are working towards it.
Health and wellbeing before, during and after pregnancy
‘When women access services before and between pregnancies, opportunities should be taken to improve health behaviours and manage long-term Health conditions ’ (NHSIR 2018) . Current national legislation such as Saving Babies Lives clearly identified the need to improve women’s safety in relation to lifestyle choices and behaviour in order to reduce stillbirths, neonatal deaths, brain injuries and maternal morbidity and mortality. Read more by clicking this link.