Areas of InnovationEileen O Meara

One size does not fit all

Services for women and children in the context of

The Five Year Forward View

Hilary Cass – President RCPCHDavid Richmond – President RCOG

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

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

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

Paediatrician

Obs/Gynae

Obs/Gynae or FSRH etc

GP

GPChildren’s

community nurse

HV

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

Paediatrician

Obs/Gynae

Obs/Gynae or FSRH

GP

GPChildren’s

community nurse

HV

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