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I acknowledge the Traditional Custodians and the ancestors of the land on which I tread and respect the Elders and their cultural obligations to Community and Country
I think these are good observations Mary – just to note that the continuity of carer scheme recommended is one where women see one care giver, who might have a ‘buddy’ for when that midwife is on leave or not available, and that midwives providing this kind of care work in teams of 4-6:
4.15. Therefore, the NHS should offer greater continuity of the healthcare professional
supporting the woman, her baby and the family. It should involve:
• a midwife who will normally provide continuity throughout a woman’s journey,
if that is what she and her partner want;
• the midwife will usually work in and be supported by a small team of four to
six midwives, one of whom could be a buddy and take responsibility for the
woman’s care if her midwife is not available;
• each team of midwives should have an identified obstetrician who can get to
know and understand their service and can advise on issues as appropriate;
• having a midwife the woman knows at the birth. Ideally this will be her own
midwife, but if that is not possible, a midwife from the same team of four to
six; and
• where a woman needs on-going obstetric support, this should be from a
single obstetric team and the care should be fully integrated across the
midwifery and obstetric services.
From: A forum for discussion on midwifery and reproductive health research. [mailto:[log in to unmask]] On Behalf Of Mary Sidebotham
Sent: 23 February 2016 21:49
To: [log in to unmask]
Subject: Re: Women to be offered their own £3,000 'birth budgets'
While I have not had the opportunity to read the whole report yet - I think its important that we focus on the positive aspects of the report
Promoting continuity of care is really important in light of the overwhelming evidence of benefit to women and babies - and more recently the growing evidence showing that midwives who work in caseload practice where they have a relationship with the woman and are well resourced have a lower incidence of stress depression anxiety and burnout - this is why its disappointing to see the recommendations for small teams of 4-6 I would hope that providers interpret this as a team of 3 or 2 caseload partners
Re giving the woman the choice of where to spend her allocated budget - look at New Zealand
If we flip this and look at what the report does for women - it should provide the opportunity to think about how public providers re orientate - reinvest so that the service is attractive enough for the women to chose to use that service - reminds me of the pressure GP fund holding put on services providers when first introduced years ago - it put pressure on public providers to step up
We have to provide a service women want and need - and educate and resource people to work in those models
Best wishes
Mary
Associate Professor Mary Sidebotham
Director Primary Maternity Care Programs
School of Nursing and Midwifery, Logan Campus
Griffith University
Ph 338 21378
M 0434932303
LO5 Room 3.30Member Maternity and Family Unit | Centre for Health Practice Innovation | Menzies Health Institute
Associate Editor Nurse Education in Practice
Visiting Associate Professor| Gold Coast University Hospital
Midwifery@Griffith: Leading the wayuTransforming lives
Facebook for Midwifery at Griffith available at:https://www.facebook.com/MidwiferyGriffithUniversity
I acknowledge the Traditional Custodians and the ancestors of the land on which I tread and respect the Elders and their cultural obligations to Community and Country
On Wed, Feb 24, 2016 at 3:00 AM, Macfarlane, Alison <[log in to unmask]> wrote:
That’s why I wanted to read the actual report. The press release gives personal budgets more prominence but mentions trialling them https://www.england.nhs.uk/2016/02/maternity-review-2/
So someone must have put out the story about using personal budgets for privatisation. Who? Personal budgets are the flavour of the month for dismantling the NHS, so it’s not surprising.
Alison
From: Soo Downe [mailto:[log in to unmask]]
Sent: 23 February 2016 16:47
To: [log in to unmask]
Subject: Re: Women to be offered their own £3,000 'birth budgets'
Importance: High
I was involved in one of the workstreams, and I think it is a shame that this aspect, which is presented in the report as something to be tested in a small number of sites to see if it works, with no obligation to then roll it out, has outweighed the really important aspects of the report, that are calling for continuity of midwifery care for all women, authentic choice for women in care and in place of birth, and seamless joined up, kind, respectful interpersonal services. Please all read the report: it is an opportunity, and if we oppose it for the sake of this aspect, I fear we will miss out on something very important.
All the best
Soo
From: A forum for discussion on midwifery and reproductive health research. [mailto:[log in to unmask]] On Behalf Of Mary Edmondson
Sent: 23 February 2016 16:27
To: [log in to unmask]
Subject: Re: Women to be offered their own £3,000 'birth budgets'
https://www.england.nhs.uk/ourwork/futurenhs/mat-review/
I wasn’t involved, but does this help.
Mary
On 23 Feb 2016, at 16:11, Macfarlane, Alison <[log in to unmask]> wrote:
Can someone who was involved in the Maternity Services Review in England please provide a link to the actual report. The way it is being reported suggests that women who are at low risk will be given £3,000 personal budgets to spend on paying independent midwives or companies like Neighbourhood Midwives or One-to-one Midwifery for private midwifery care at home or in private midwifery units. If so, what is the evidence? The findings of Birthplace related not midwifery care by salaries NHS staff.
If the reporting is wrong, is something being done to put it right? See below
Alison
From: Scott-Samuel, Alex [mailto:[log in to unmask]]
Sent: 23 February 2016 15:29
To: [log in to unmask]
Subject: [POHG] Fwd: Women to be offered their own £3,000 'birth budgets'
Begin forwarded message:From: OurNHS openDemocracy <[log in to unmask]>
Date: 23 February 2016 15:17:39 GMT
To: John Lister <[log in to unmask]>
Cc: "Scott-Samuel, Alex" <[log in to unmask]>, "<[log in to unmask]>" <[log in to unmask]>, "[log in to unmask]" <[log in to unmask]>, "fph inequalities group" <[log in to unmask]>, Keep Our NHS Public Merseyside <[log in to unmask]>, KONP SG <[log in to unmask]>, "[log in to unmask]" <[log in to unmask]>, "[log in to unmask]" <[log in to unmask]>, NHS Momentum <[log in to unmask]>
Subject: Re: Women to be offered their own £3,000 'birth budgets'With his kind permission, John's excellent reaction is published more or less unedited, here:
please do share widely. let's put some pressure on!
and if others want to offer other pieces in reaction, I'd still be keen to publish more.
thanks all
c
On 23 February 2016 at 13:39, John Lister <[log in to unmask]> wrote:
The so-called “independent” review of maternity services chaired by Tory peer Baroness Cumberlege has predictably shown itself to be nothing more than a pretext for privatisation.
Its proposals would fragment an already over-stretched midwifery workforce, take vital funding away from mainstream maternity services, and potentially force more NHS maternity services to close or centralise, bringing more anguish to women who would have to travel further to give birth.
The proposal to fragment maternity services by giving pregnant women a £3,000 ‘personal budget’ to spend as they wish is indeed a formula for chaos and destabilising core maternity services. The obvious danger is that as women are given funding to spend as they wish on “one-to-one midwifery”, more and more midwives will be encouraged opt out of high-pressure work on busy maternity wards, and opt instead to offer services privately.
It’s no surprise that Baroness Cumberlege, who runs a company that promotes and profits from privatisation and the chaotic ‘reforms’ forced through under Tory Health Secretary Andrew Lansley, should advocate a policy that would encourage small scale private provision of services for women with uncomplicated pregnancies, at the expense of the NHS provision for those with more complex needs.
It is bizarre to see the Royal College of Midwives, which only four months ago was complaining that overstretched and under-staffed maternity units across the country were closing their doors for lack of staff, has for some reason welcomed these latest proposals, which in the current climate of frozen and inadequate NHS funding can only make matters worse.
RCM chief Executive Cathy Warwick said she was ‘delighted’ with the plans, but went on to warn that more midwives would be needed – despite the fact that there would be no extra money in the pot to pay for any additional staff.
The proposal has all the disadvantages of other “personal budget” and “NHS voucher” schemes – in that it opens the way to individual “top-up” payments, widespread full-scale charging for health care, and private health insurance.
Like personal budgets it would take money from core budgets for services, without evidence or systems to ensure it will be spent appropriately – and leaving an under-resourced service to deal with all the more demanding cases – and those that develop later complications.
The NHS England statement explicitly says that any woman needing urgent care because of complications would get it regardless of whether their personal budget had been spent.
This policy is as illogical and unrealistic as the government claims that an NHS that is already billions in deficit, and facing cuts to balance the books, can implement 7-day working with no extra staff or funding.
In this case the main beneficiary is likely to be a newly created private sector midwifery service, run by NHS-trained midwives who might otherwise be delivering NHS care in NHS units or in the community, free of charge at point of use.
On 23/02/2016 13:34, Scott-Samuel, Alex wrote:fyi
From: "Scott-Samuel, Alex" <[log in to unmask]>
Date: 23 February 2016 13:28:24 GMT
To: "[log in to unmask]" <[log in to unmask]>
Subject: Delivering the Forward View: the CCG Improvement and Assessment FrameworkThe number of personal health budgets taken up should not be a performance criterion for CCGs. There is no evidence that personal health budgets benefit the health of users. When the Department's evaluation of personal health budgets was independently evaluated in a peer-reviewed publication from Kings College London, its optimistic conclusions regarding the benefits of PHBs were shown to be false.
This publication adds further peer-reviewed evidence:
yours sincerely, Alex Scott-Samuel (Dr)
On 23 Feb 2016, at 11:51, "Gaynor Lloyd" <[log in to unmask]> wrote:couldn't agree more. It seems to be a thing with ex Health Minister Baronesses, like the NHS Direct likely stitched up by Bottomley's Odgers, fresh from the fee they got for recruiting Simon Stevens.
And CCG's to be "marked" higher for number of personal health budgets they achievehttps://www.england.nhs.uk/commissioning/wp-content/uploads/sites/12/2016/02/CCG-IAF-engagement-document.pdf page 8
From: [log in to unmask][mailto:[log in to unmask]] On Behalf Of Raymond Tallis
Sent: 23 February 2016 11:36
To: 'Alan Taman'; 'Scott-Samuel, Alex'
Cc:[log in to unmask]; 'fph inequalities group'; 'Keep Our NHS Public Merseyside'; 'KONP SG'; [log in to unmask];[log in to unmask]; 'NHS Momentum'
Subject: RE: Women to be offered their own £3,000 'birth budgets'
Dear All, The conclusion of the report is not the slightest bit surprising given the key role of snout-in-trough Baroness Cumberlege. It is a boon for the privateers. Best wishes Ray
From: [log in to unmask][mailto:[log in to unmask]] On Behalf Of Alan Taman
Sent: 23 February 2016 11:30
To: Scott-Samuel, Alex <[log in to unmask]>
Cc:[log in to unmask]; fph inequalities group <[log in to unmask]>; Keep Our NHS Public Merseyside <[log in to unmask]>; KONP SG <[log in to unmask]>;[log in to unmask];[log in to unmask]; NHS Momentum <[log in to unmask]>
Subject: Re: Women to be offered their own £3,000 'birth budgets'
What concerns me, as a PR professional, is the need 'competing' services will now have to address in enticing women to use them: marketing costs money. Lots of it, on this scale. Where does that come out of? Also the need to out-bid one another to secure the service in the first place. What a splendid mis-appopriation of public funds that could have gone into making maternity services safer, instead of more 'appealing'.
On Tue, Feb 23, 2016 at 11:24 AM, Scott-Samuel, Alex <[log in to unmask]> wrote:
Alex Scott-Samuel (@buzhna)
Don't be fooled: personal health budgets are all about preparing the NHS for co-payments, insurance & privatisation
bbc.co.uk/news/health-35…
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