The local maternity and neonatal system (LMNS) is the maternity and neonatal arm of the Integrated Care System. The LMNS is responsible for implementing the Three-Year Plan across Southampton, Hampshire, Isle of Wight and Portsmouth. The LMNS programme is made up of multiple workstreams and projects, which are detailed below.
The Three-Year Delivery Plan for Maternity and Neonatal Services was published in March 2023 by NHS England. The plan sets out how the NHS will make maternity and neonatal services safer. The plan focuses on 4 key themes:
1: Listening and working with women and families for compassion
- Care is personalised
- Improved equity for mother and babies
- Work with service users to improve care
2: Grow, support and retain workforce
- Work towards having the right staff available for the best care for women and pregnant people
- Value our workforce
- Invest in skills
3: Developing and sustaining a culture of safety, learning and support
- Developing a safety culture
- Learning and improving
- Support and oversight
4: System-wide standards and structures that underpin safer, personalised and equitable care
- Standards that ensure best practice
- Data to inform learning
- Better use of digital technology in maternity and neonatal services
To contact the LMNS, please email the team at hiowicb-hsi.shiplmns@nhs.net.
The ambition of the digital workstream is for women and pregnant people to be able to access their maternity records and interact with their digital plans and information, to support informed decision-making, as well as accessing neonatal and early years health information to support their child’s health and development. The aim is that all maternity information required is available either by our app or Healthier Together, to ensure information shared is consistent and from reliable sources. This ensures that information meets accessibility standards, with non-digital alternatives available for those who require or prefer them.
Across the LMNS our digital health records are easily accessed by all our four trusts, meaning if you are receiving shared care between two or more of our trusts the health records follow you. The benefits of this include clinicians having access to your full record, regardless of where that care took place, stories do not have to be repeated, and multiple sets of notes do not need to be shared across our trusts.
Our aim for the digital transformation for our staff includes accessing all healthcare information from one system, by interfacing with other hospital systems and interoperability with systems outside of maternity, to ensure that pregnancy information is available for all those who may give care during pregnancy. By meeting this aim, it means clinicians are not duplicating work onto multiple systems, it streamlines care pathways and workflows, as well as releasing essential time to care. The programme is also ensuring all clinicians are supported to make best use of digital technology with sufficient computer hardware, reliable Wi-Fi, secure networks, and training.
In 2023 the LMNS published the equity and equality action plan to respond to the inequalities and inequities experienced within the NHS and by mothers and babies in the UK. The NHS (2021) has released guidance to help Local Maternity Systems align their Equality and Equity Action Plans with the health inequalities work of Integrated Care Systems. For ‘equality’ there is a focus on promoting equal opportunities for all people who engage with the NHS. In the specific context of equity, the ambition is that all mothers and babies can achieve health outcomes that are as good as the groups with the best health outcomes. Families of course are a central component of this focus.
To oversee and support the maternity and neonatal services implementation of the Baby Friendly Initiative Project. The Baby Friendly programme is part of a wider global partnership between the WHO and UNICEF and provides evidence-based knowledge with clear standards to prevent inconsistencies of messages transforming healthcare for babies, mothers and families.
The maternity continuity of carer model is designed to ensure that women and pregnant people receive support from a dedicated team throughout their maternity journey. This ensures consistency and coordination of care throughout pregnancy, labour and the postnatal period. The model supports women and pregnant people to form a relationship with clinicians. This in turn builds trust, supports informed decision making and the delivery of person-centred care. The ambition is that this becomes the default model for all women and people accessing services, but the initial rollout has been prioritised to those most likely to experience poorer outcomes.
The Maternity Triage Line is a collaboration between the LMNS and maternity services operating in partnership with South Central Ambulance Service NHS Foundation Trust (SCAS). It incorporates the service previously known as Labour Line. This service was launched in November 2022. The Maternity Triage Line provides dedicated telephone call triage and support services for women in early labour and for antenatal queries from 20 weeks gestation onwards. It excludes early pregnancy calls up to 20 weeks gestation and postnatal calls. Women will be advised to download and access the Healthier Together app. The women triage their symptoms and will be directed to call the Maternity Triage Line when they score an amber status on the app.
The Integrated Care Board commission maternity and neonatal voices partnerships (MNVPs) which are designed to facilitate participation by women and families in local decision making. MNVPs listen to and reflect the views of local communities.
The Hampshire and Isle of Wight Perinatal Pelvic Health Service (PPHS) are responsible for the prevention, identification, and access to NICE-recommended treatment for ‘mild to moderate’ pelvic health problems antenatally and at least one year postnatally. PPHS will be established system-wide with shared protocols and standards so that all women within each Local Maternity and Neonatal System (LMNS) footprint can expect to receive the same level of care.
PPHS have three overarching functions:
- To embed evidence-based practice in antenatal, intrapartum and postnatal care to prevent and mitigate pelvic health problems resulting from pregnancy and childbirth.
- To improve the rate of identification of pelvic health problems antenatally and postnatally.
- To ensure timely access to NICE-recommended treatment for common pelvic health problems antenatally and postnatally.
Personalised care gives women and birthing people choice and control over how their care is planned and delivered. Based on informed decision making, supported by unbiased and evidence-based information, women and pregnant people will have the opportunity to develop their own personalised care and support plan (PCSP). The PCSP will reflect choices based on the individual’s physical health, mental health, social complexities, choices and wellbeing. It will be reviewed and updated at each contact.
The LMNS is working with all trusts to develop accessible PCSPs which can be created and updated by all women and pregnant people. To support personalised care and support planning, staff will be empowered to hold personalised conversations and given the tools to support women and birthing people to make informed decisions at each contact.
The LMNS works collaboratively to implement national and local recommendations focused on improving the safety and quality of maternity and neonatal services. Regular forums to share both good practice and learn from unplanned outcomes ensures learning is shared across the system. A direct reporting line to the regional safety group maximises learning beyond local systems.
The workforce workstream is responsible for implementing Theme 2 of the Three-Year Plan, to grow, support and retain the maternity and neonatal workforce.
The LMNS have developed the Maternity Careers Hub within the Wessex Maternity Academy website. This resource was developed in collaboration with midwives, maternity retention and workforce leads. The Maternity Careers Hub will give maternity staff access to career resources and materials. The Maternity Careers Hub will provide managers resources to support their staff in career conversations, succession planning and talent management.