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Keeping Childbirth Natural and Dynamic (KCND) Scottish Government Health Directorates.

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Presentation on theme: "Keeping Childbirth Natural and Dynamic (KCND) Scottish Government Health Directorates."— Presentation transcript:

1 Keeping Childbirth Natural and Dynamic (KCND) Scottish Government Health Directorates

2 Scottish Government policy context Framework for maternity services / EGAMS Reports – Endorse pregnancy & childbirth as normal life events – Recommend care packages based on need Community based, midwife led care for healthy women Obstetric led, maternity team care for complex cases Ongoing medical care by GP – Significant progress made in implementing Variance across NHS Scotland – Key aspects still to be achieved in some areas

3 KCND Purpose – Support implementation of policy at Board level – Promote multidisciplinary working & care tailored to need Multiprofessional programme of work Aims – Maximise opportunities for women to have as natural birth experience as possible through Evidence based care, reducing unnecessary intervention, ensuring informed choice Introducing multiprofessional antenatal, intrapartum and postnatal care pathways

4 Objectives Implement national referral criteria and care pathways – Green Midwife lead professional – Amber Further assessment required – Red Obstetric team care recommended – Flow between care streams as risk alters

5 Objectives Implement lead professional by risk – Maternity team roles Midwifery lead, healthy women Obstetric lead, complex cases Neonatology lead, sick baby Named on SWHMR, ISD – Primary care team roles GP ongoing responsibility for medical care of mother & baby Health visitor ongoing care of well mother & baby – Women’s choice

6 Objectives Implement normal birth pathways – For healthy women – Regardless of setting – 1 st, 2 nd 3 rd stage labour Evidence based – No admission CTG – Guidance for monitoring and care – Flow between midwifery and obstetric team care as risk alters

7 Objectives Implement midwife 1 st point professional contact – Initial risk assessment Against national criteria Social circumstances Health promotion – Stream woman to midwifery or obstetric team care to book Prior to 12 weeks GP opinion on stream – Additional relevant history?

8 Workstreams Led by Scottish Government Health Directorates – National steering group, stakeholders engaged Reports to MSAG NHS Boards – Funding allocations Consultant Midwives to support local implementation Chief Scientist NMAHP Research Unit – Literature review to support programme – Evaluation lead – partnership working Multi-strand approach – quantitative and qualitative

9 Workstreams NHS Education Scotland – Leadership and change management support Leadership programme for new Consultant Midwives Multiprofessional work 2008 – Challenges for implementation, strategies for change NHS Health Scotland – Support change management Literature for women, publications NHS Quality Improvement Scotland – Antenatal, intrapartum, postnatal criteria and pathways 1st drafts for consultation May, launch Dec 08

10 Wider context Rising birthrate trend – Economic and social migration Increased case complexity – Rising maternal age, improvements in the management of longterm medical conditions Career framework changes - MMC, GMS, EWTD – Pregnancy & childbirth normal for many but – Need to ensure specialist services readily available as required Need to direct resources appropriately – Right professional, right women, right place, right time

11 Summary Focus on implementing current policy – Nothing new Robust foundations – Wider maternity team works GP well established role for ongoing medical care Evidence on efficacy of midwifery led care Enough work to go round Stakeholder engagement – All Royal Colleges, users Outcome efficient and effective services – Appropriate care packages for women based on need

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