Neighbourhood Midwives in Waltham Forest

By Annie Francis and originally published at neighbourhoodmidwives.org

Who are Neighbourhood Midwives?

NM describe themselves as an aspiring Teal organisation (Reinventing Organisations) using similar principles to the well known Buurtzorgmodel in Holland. Their passion is to create a safe, supportive and nurturing environment that facilitates their midwives own choice of working practices as well as clinical and personal development.

Adopting such innovative models of care has not been not without its challenges but there has been huge learning gained throughout the first year of their pilot, which can be used to improve and develop their service as they go into the second year.

There has been a wide range of processes and working documents produced to facilitate integrated working with other local providers. This knowledge is being shared across the system to inform and enable others to consider whether this is something they can implement in their own areas.

As Buurtzorg has demonstrated, this model has the potential to scale and grow, one team at a time, wherever it is commissioned. Their belief is that by developing an exemplar for self-managing teams, as well as integrating new providers into the system, they can introduce positive change in a gradual and sustainable way.

NM was the brainchild of a small group of midwives working independently who were keen to explore the idea of providing their relationship-based model of care within the NHS in the UK. As well as a potential solution to the lack of indemnity insurance, it was also seen as a way to increase the limited range of choices available for women and midwives in the bureaucratic and hierarchical rigidity of the wider system.

Neighbourhood Midwives is part of the exciting work of the Maternity Transformation Programme in the UK. NM  was commissioned by Waltham Forest CCG in November 2016 to offer a continuity midwifery service to women having straightforward pregnancies. In 2017 their pilot was shortlisted for the ‘Policy into Practice RCM Awards 2018 and is described as a ‘trailblazer’ in an article about the Standards for Continuity of carer:  (Nursing Times December 2017).

Their ultimate aim is to be a fully 100% NHS commissioned service

Vision

Neighbourhood Midwives’ vision is for every woman to have the choice of a positive birth experience, supported by a midwife she knows and trusts.

Mission

• Neighbourhood Midwives Limited was incorporated as a company under the Companies Act in March 2012. As an employee owned social enterprise organisation, we are committed to ensuring that our midwives have a meaningful say in how it grows and develops. Everyone in the organisation is a valued partner who is offered a supportive environment which facilitates their own clinical and personal development.
• Neighbourhood Midwives’ purpose is to be a vibrant, successful business with a strong spirit of independence and a partnership culture of collaboration and mutual support. We have in place a strong, evidence-based clinical governance framework that prioritises the safety of women and their babies and our mission is to provide a self-funded and NHS-commissioned caseload midwifery service, based in the local community, wherever it is required.

Principles

At the heart of achieving their vision and mission lie six core principles:

• Neighbourhood Midwives operates at all times to the highest clinical standards as described in our clinical guidelines and policies

• We deliver truly personalised care and form lasting and deep partnerships with our clients

• Neighbourhood Midwives is strongly committed to operating as a social enterprise with an 
ambition to generate and share value both with our partners and the communities we serve

• As part of this we have an ambition and passion to find ways to work with the most disadvantaged in society

• We operate a dynamic and thriving employee owned culture which is truly transparent, inclusive and innovative
• We strive to limit ways we impact upon our environment and hold the ultimate goal to become carbon neutral.

Neighbourhood Midwives as a sustainable and scalable choice:

If we are to prove there is another way, a good starting point is the concept of ‘Small is Beautiful’ – EF Schumacher’s book of economics, which could be summed up as:

‘Things are best done at the smallest appropriate scale’ (The Guardian). Rather than trying to manage complex rotas involving set hours, limited time oncall and/or twelve hour shifts for large numbers of midwives, our hub and spoke model puts the decision making and ownership of their work/life balance back into the hands of the midwives themselves. Each practice of six midwives (the spoke) is a self managing unit, supported by a central team (the hub) and with access to a ‘coach’ for facilitated reflection and advice.

We are an aspiring Teal organisation (Reinventing Organisations) using similar principles to the well known Buurtzorgmodel in Holland. Our passion is to create a safe, supportive and nurturing environment that facilitates our midwives own choice of working practices as well as clinical and personal development.

Adopting such innovative models of care more widely is not without its challenges but there has been huge learning gained throughout the first year of our pilot, which can be used to improve and develop our service as we go into the second year.

There has been a wide range of processes and working documents produced to facilitate integrated working with other local providers. This knowledge is now being shared across the system to inform and enable others to consider whether this is something they can implement in their own areas.

As Buurtzorg has demonstrated, this model has the potential to scale and grow, one team at a time, wherever it is commissioned. Our belief is that by developing an exemplar for self-managing teams, as well as integrating new providers into the system, we can introduce positive change in a gradual and sustainable way. Our intention is that our midwifery-led initiative can deliver the continuity that women want and that midwives can be enabled and supported to provide.

If you have any questions, or would like any further information, please do get in touch, we would love to hear from you… 

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