AIMS Campaigns Update: Better Births 5 Years On

By the AIMS Campaigns Team

Last month - on February 22 to be precise - AIMS marked the fifth anniversary of the publication of Better Births. Judging from the muted coverage of the anniversary, it seems that we may have been alone! But next week, one month later, we are pleased to see that this anniversary is being marked nationally, including at the national online event organised by NHS-England.

The Better Births report (2016) was the culmination of the work of the National Maternity Review for England, a group made up of a wide group of experts and stakeholders and chaired by Baroness Julia Cumberlege (supported by Professor Sir Cyril Chantler as vice-chair). Better Births established a new vision for a transformed maternity service in England and made 28 specific recommendations. The report still makes for a very good and relevant read. The Review members had listened to many first-hand accounts of the maternity services during the review, and at the heart of their report was a call for England’s maternity services to become ‘personalised and safe’, underpinned by a fundamental and transformational shift to a relational model of maternity care (also known as Continuity of Carer). AIMS has been campaigning for decades for such a relational model of NHS maternity care, and we remain keen to see this, alongside other crucial and inter-locking elements of the Better Births vision, implemented speedily, effectively, and sustainably. Women and their families have been waiting long enough.

To oversee and lead the national implementation of Better Births, NHS-England established a national Maternity Transformation Board, led by the CEO of Birmingham Women and Children’s Hospital, Sarah-Jane Marsh. In addition, a Stakeholder Council was formed, led again by Julia Cumberlege (chair) and Cyril Chantler (vice-chair) - this represents welcome continuity and AIMS is pleased to be part of that Council. We use our place on the Council to encourage a sharp focus on implementation. AIMS is all too aware of how often the UK has prided itself on excellent national maternity policy, whilst we fall short on implementation: we now need to see our latest excellent policy framework - Better Births - implemented across the country.

AIMS notes that there have been many positive developments in the maternity services since the publication of Better Births, even if these have been overshadowed in the last year by the coronavirus pandemic (which - as in so many other areas – has shone a light on both the existing strengths and weaknesses in our public services). National maternity leadership has developed tremendously, Local Maternity Systems are now in place to lead local implementation, the ‘service user voice’ is now a usual feature in the maternity policy arena, rather than an exception, and – so important for AIMS - the rollout of the flagship #ContinuityofCarer model of care, underpinned by firm commitments made in the NHS Long Term Plan, is happening at pace.

Nevertheless, and as repeated coverage of poor maternity experiences and outcomes attest, there is still much to be done to achieve the Better Births vision across England, in a way which is driven by a focus on equity and ‘leaving no-one behind’. Much of the progress is at an early stage, not yet benefitting from a transformed service that will ‘hold it well’, leaving some excellent progress vulnerable and fragile and at risk of being undone. AIMS is clear that access to excellent maternity care across England should not be on the basis of a postcode lottery, nor dependent on one’s demographic characteristics, but available to everyone, individualised to ensure that the maternity services address, rather than contribute to, existing inequalities. There is much that needs to be done to ‘level up’, so that everyone has access to a maternity service that is as good as the best.

Going forward, AIMS repeats our call for increased transparency around the implementation of the Maternity Transformation Programme. We call for a rigorous review of progress, including against the original 28 Better births recommendations, national workstream-by-workstream, and by local area, so that we can learn lessons from the implementation progress to date and refocus together on continuing to build a transformed maternity service that is fit for purpose. A maternity service, in each and every local community across England, in which the Better Births vision is a reality for all.