Implementing Continuity of Carer in England: What can local Birth Activists do now?

In many parts of the country, there is now momentum building in favour of the implementation of a relational model of maternity care. This is something that AIMS has been campaigning for, alongside others, for decades. Will you help us bring this campaigning objective one step closer to reality, where a continuity of carer model of care is the standard model of care offered to all women and families? If so, please read on ...

In the June 2020 AIMS Journal, we briefed birth activists on the welcome news that the national policy of Continuity of Carer in England had been embedded in the NHS Resolution’s Maternity Incentive Scheme for Trusts. Put simply, this offers birth activists a new framework for monitoring local activity around the implementation of this key Better Births initiative. As with so many other programmes, the Scheme was put on hold earlier this year during the pandemic, but it has since been relaunched with a revised section on Continuity of Carer.

AIMS very much welcomes the relaunch of this Scheme and calls on all local birth activists to act now to help ensure that local implementation plans are of a good standard, and aligned

with the national ambition. If not, the team at NHS-England are keen to offer further support: together, we can help make this happen.

According NHS Resolution, “the action plan should reflect how the Trust will continue or resume continuity of carer models so that at least 35% of women booking for maternity care are being placed onto continuity of carer pathways. In light of the increased risk facing women from Black, Asian and minority ethnic backgrounds and from the most deprived areas of poor outcomes, local systems should consider bring[ing] forward enhanced continuity of carer models primarily targeting these groups.”

It may be that you are part of your local MVP, where such plans are shared and reviewed regularly. If so, you may already have a view on the adequacy of your local plan and may be engaged in a constructive conversation.

Even if you are not part of your local MVP, you might be able to obtain a copy of your latest local plan from your local MVP chair, or maybe it is included in the papers for your Trust Board meetings: it is worth checking your local Trust website to see if you can find them there. If not, you may want to use the template letter below to get hold of your local implementation plan.

Once you’ve seen the plan, you will be in a better position to assess whether it seems to you to be adequate. If you’d like some assistance with assessing your local plan, please feel welcome to contact the AIMS campaigns team at campaigns@aims.org.uk, and we’ll be pleased to support you.

Dear [BOARD LEVEL SAFETY CHAMPION - You should be able to find out who this is from your Trust Board Secretary; it is also worthwhile copying in your Trust Board secretary into this correspondence]

For some years now, as a [describe your role here: eg local service user/ national Volunteer for AIMS/ lay member of the local MSLC/MVP/ local doula/ local NCT practitioner], I have been keen to understand and support local efforts to implement the national policy of continuity of carer. [Add any other specific interest here. ]

It is now nearly five years since the publication of the report of the National Maternity Review, Better Births, which clearly outlined the direction of travel in this area, yet my impression is that [adapt to local circumstances: eg “we have not yet managed to prioritise this area of maternity service improvement locally”]. Looking forward, I very much hope that we can work together, via the MVP, to ensure that local service users increasingly benefit from this transformational way of delivering maternity services, as service users are already doing in other parts of the country.

By February 28, 2020, according to the NHS Resolution maternity incentive scheme, I understand that you - as our Board level safety champion- were to have reviewed our local Continuity of Carer action plan. [If this is the case: This is not a plan that has ever been shared with the MVP.] Are you willing to share with me that pre-pandemic plan, please?

More recently, I understand that you should have reviewed the continuity of carer action plan in the light of COVID-19, taking into account the increased risk facing women from Black, Asian and minority ethnic backgrounds and from the most deprived local areas. I also understand that our revised action plan must describe how the maternity service will resume or continue working towards a minimum of 35% of women being placed onto a continuity of carer pathway, prioritising women from the most vulnerable groups they serve, and that you should have personally reviewed this plan by 30/11/2020 and monthly thereafter. I very much look forward to reading the latest version of that plan, understanding that it is likely a dynamic document, and I would ask that you share it with me.

I apologise for troubling you with this matter during the current difficult times, and offer you and all staff at the Trust my thanks for your continued dedication to public service during the pandemic and beyond.

Kind regards,
{Name}