Care pathways

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Care pathways

• Debra Bick
• Yana Richens
• Porvee Patel
• Celine Van Valkenhoef

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Maternity project
Needs Assessment
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Workstream objective

• Define best practice ensuring expectant mothers
  are offered
• early assessment by a midwife to ensure care is
  right for them and further assessments during
  the course of pregnancy
• information to enable informed choices, e.g.
  about relative benefits and risks of different
  locations to have their baby and about pain
  relief
• care before birth provided at local one-stop
  centres
• services that meet their choice of where they
  give birth e.g. at home, in a midwifery unit, or
  in an obstetric (doctor-led unit)
• care with same team from early pregnancy until
  after the birth whenever possible
• one-to-one midwifery care during established
  labour
• care following birth in local, one-stop centres
  as well as at home

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Workstream focus and deliverables

• Focus of work
• Identify pathways to work on, including audience
  (clinicians, commissioners)
• Undertake analysis of existing best practice
• Identify and develop links with other projects
  e.g. diabetes model of care
• Develop best practice pathways for maternity
  services in London including agreeing format
• Work with other projects to understand
  interdependencies and ensure alignment
• Identify distance from future state (what needs
  to be done)
• Scope anticipated areas of risk and opportunity
  resulting from implementation (workforce, estate)
  to impact on further work streams
• Deliverables
• Best practice pathways developed, signed off, and
  shared across London. In appropriate format for
  PCTs to utilise for commissioning. Including an
  understanding of the implications of
  implementation.

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Questions

• Who is the audience commissioners or providers?
  Based on the audience what format would be
  helpful so it can be used? How much detail should
  we go into?
• Should complex care be incorporated into a normal
  pathway or be separate? How could this be
  achieved?
• Should an optimal rate be defined for
• Caesarian sections
• Home births
• Downs Screening
• Dating, anomaly scans
• What quality metrics would you commission for
  maternity?

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