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‘Neighbourhood Midwives: The model that boosted continuity of care by 500%’ – Annie Francis

Learn about the Buurtzorg-inspired model of care enabling self-managing teams of midwives to deliver continuity of care on their own terms.

22 Apr 2020
13:00 – 14:00


Watch the recording from the webinar with Annie Francis, Midwife and CEO of Neighbourhood Midwives (NM), exploring the NM model of community care.

Annie discussed why her team believe the model is the most effective way to provide a safe, high quality service for women and their families, increase job satisfaction for midwives, improve outcomes and reduce the bureaucracy and hierarchy that generally stifles the growth of continuity models.

Watch the webinar

Download Annie’s slides

More information and resources from the webinar

A key recommendation of the 2015 National Maternity Review, now embraced by the NHS Longterm plan, is to implement continuity of care across the maternity services so that, by March 2021, ‘most women’ receive continuity of the person caring for them during pregnancy, during birth and postnatally.

Implementing continuity models of care however is not straightforward and the maternity services has been struggling to do so since the last maternity review – the 1993 Changing Childbirth report – recommended the same thing. The current ‘command and control’ system makes it very difficult to create the conditions needed to nurture these models (a culture of trust and a willingness to hand over power and control).

Neighbourhood Midwives (NM) was set-up as a midwifery social enterprise to enable self-managing teams of midwives to deliver continuity of care on their own terms. And it worked; the NM model was able to achieve 81% of women having a known midwife at their birth compared to approx 17% at the moment in the NHS. We were commissioned, as part of the maternity transformation programme, to provide a caseload community midwifery service in a two year pilot in North east London. Our self-managing model focused on developing 3 key elements:

  1. Psychological safety
  2. Clear purpose and values
  3. Devolved decision making

Although the NHS two year pilot was independently assessed as being hugely successful and loved by the women who accessed the care, NM were unable to continue beyond the pilot because the complexities of the NHS commissioning and funding structures proved neither agile or flexible enough to accommodate and adapt to the needs of a small independent provider. As in all examples of ‘failure’ however, there is a rich seam of learning to be shared from our experience, including working out what needs to change in order to create an environment that will nurture and support similar models to thrive in the future.

* This session is part of a series of webinars being run by the Reimagining Health and Care group.

Check out the upcoming webinars:

‘We know New Public Management fails but what else can we do?‘ – Toby Lowe and Gary Wallace (21st May, 1.15pm)
Is there a better way than management by targets? Toby Lowe and Gary Wallace share the pioneering Human Learning Systems approach of Plymouth’s Health & Care system.

Watch previous webinars from this series:

Buurtzorg in the UK: learnings – and challenges – from the first 3 years’ – with Brendan Martin

‘Redesigning public services to put relationships at their heart’ – with Katie Rose

‘Using Communities of Practice and Self-Management to transform Special Educational Needs and Disability’ – with Neil Dunford

Annie is an experienced midwife with a rich and varied career spanning many years of client facing and clinical work. Annie was one of the founders as well as CEO of Neighbourhood Midwives (NM), an employee-owned midwifery social enterprise.

Based on the principles of Teal and self-management, NM offered continuity of carer to women and their families. Prior to closure in January 2019, NM had provided a very successful NHS service in Waltham Forest but due to commissioning and funding barriers was unable to continue beyond the two year pilot.