More women in Jersey are now seeing their midwife in the community to make antenatal appointments more convenient for mums-to-be, and ensure continuity of care throughout their pregnancy.
The Health and Social Services Department (HSSD) is working with GP surgeries in Jersey to enhance the practice of community midwifery, so that expectant mums can be seen in the familiar and comfortable surroundings of their GP surgery, with their pregnancy monitored by community midwives.
The move means that 80 per cent of women are now seen for their initial appointments (called the “booking in” appointment) in the community, compared to a previous figure of 50 to 60 per cent of initial “booking in” appointments being held at the Hospital’s antenatal clinic.
In the first three months of 2014, 230 first antenatal appointments were in the community, compared to 47 in the Hospital.
The Jersey Community Midwifery Service has been developed as part of ongoing work which HSSD is undertaking to redesign health services for Islanders, as outlined in the department’s 2012 White Paper ‘Caring for Each Other, Caring for Ourselves.’
Funding from the White Paper to develop the community midwifery service means that:
- A further two (full-time equivalent) midwives have been employed to work in the community
- Antenatal clinics have been established in nine GP practices (involving 85 GPs) – the latest one was set up in September 2013
- Each practice now offers a package of antenatal care at a fixed cost
The benefits to the pregnant women are:
- Familiar Face: Women have continuity from a named midwife from the antenatal booking appointment until postnatal discharge to the Health Visitor
- Better Care Planning: Improved multi-disciplinary communication between hospital and community services
- Consistency of Care: Women maintain contact with their GPs during pregnancy, usually seeing them for 2 antenatal appointments during the pregnancy
The benefits to practitioners delivering the service are:
- Safe Sustainable Services: GPs have one midwife (two in the larger practices) for communication and liaison about the women registered at their practice
- Right place, Right Person, Right Time: Women with low risk pregnancies are seen in the community – relieving hospital obstetric services for women with complicated pregnancies
- Personalised Care: Midwives carry a caseload of women who they get to know during the pregnancy and afterwards
- As more bookings are being done in GP surgeries, the proportion of community follow-up appointments is rising
- Robust antenatal referral pathways are being developed to ensure women get effective evidence-based care, wherever it is delivered
Lister Surgery GP, Dr Kate Wilson said: “Having midwives in the GP surgeries is a great move. It’s something we’ve been doing at Lister Surgery for many years and we are so glad it’s been rolled out across the Island. It enables us, GPs and midwives, to get to know and thus better care for our expectant mums and young families. It is so much easier to touch base with a midwife about a case when they are across the corridor rather than spending time writing letters or phoning the Hospital trying to track someone down.
“Most pregnancies are medically straightforward and do not require specialist medical care from the Hospital. However pregnancy, birth and having a young family are big life events that have their challenges socially, psychologically and emotionally. We, as GPs, are grateful to be able to support the community midwives in what they do so fantastically – the holistic care of expectant mums and new families. The other bonus is that women have a timed appointment with the midwife at the surgery and can plan it into their day.”
Elaine Torrance, Head of Midwifery for HSSD said: “We are pleased that the community midwifery project has been so successful, and really appreciate the partnership working with GPs. We have had good feedback from women that they enjoy being seen by midwives at their GP surgery. They can build up a good relationship with the midwife as they go through their pregnancy.
“The move also allows the hospital antenatal team more flexibility to concentrate on pregnancies which might be complex, and means that for women where this is a concern, resources are on hand, and those patients will continue to be seen in the Hospital.”