1. Areas of Innovation Eileen O Meara

2. One size does not fit all Services for women and children in the context of The Five Year Forward View Hilary Cass – President RCPCH David Richmond – President RCOG

3. CURRENT PROBLEMS CHILDREN’S SERVICES Worst mortality in W. Europe Deficits in long term condition management – e.g. only 16% reach HbA1C targets Reactive, hospital-centric model Major mental health service shortfalls Highest obesity levels in Europe Variations in outcomes WOMEN’S SERVICES Good antenatal care BUT Poor pre-conception care Poor medical postnatal care Missed “pregnancy” opportunities Perinatal mental health Longer term deficits in care of older women Variations in outcomes

4. PROPOSAL: WOMEN’S & CHILDREN’S HUBS Hospital(s) Women’s and Children’s Healthcare Hubs Group Practice A Group Practice B Group Practice C CHILDREN’S SERVICES Urgent care – evenings, weekend days when surgeries closed Health promotion, feeding advice, pre-school support Long-term condition management including children with disabilities, diabetes, eczema etc. Other routine outpatients not needing hospital support WOMEN’S SERVICES Antenatal classes Well women services Mental health services Out of hospital gynaecology services Parenting classes Rooms for NCT meetings, other family support groups

5. STAFFING AND TRAINING Hospital Women’s and Children’s Healthcare Hub Group Practice A Group Practice B Group Practice C STAFFING GPwSI Paediatricians Obstetricians/Gynaecologists Midwives / HVs Children’s nurses Mental health staff Family planning staff AHPs Youth workers etc. etc TRAINING Joint training initiatives Scope for new hybrid role development Shared competency frameworks Extended education for parents / young people / teachers / community leaders Paediatrician Obs/Gynae Obs/Gynae or FSRH etc GP Children’s community nurse HV

6. CULTURE, COMMUNITY AND OWNERSHIP Hospital Women’s and Children’s Healthcare Hub Group Practice A Group Practice B Group Practice C ‘OWNERSHIP’ COMMUNITY Community engagement in development Other community resources on site – health library, tumbletots etc ‘Happening’ place to be rather than hospital ‘Place to come’ rather than A&E for advice and support ‘OWNERSHIP’ NHS Essential to be seen a part of community / primary care network Supporting not competing with general practice Provision of MDT support to GPs as needed Joint staffing primary / secondary care Paediatrician Obs/Gynae Obs/Gynae or FSRH GP Children’s community nurse HV

7. NEXT STEPS Pilot sites specifically focused on women & children – Workforce modelling – Activity modelling – Financial modelling – Governance / IT considerations Capacity / capability to scale up successful models at speed