In Practice: Case study - The centre of a healthy community
Tuesday, October 2, 2007
In an effort to cut infant mortality rates, children's centres in Birmingham are to offer maternity services. And although there are many obstacles to be overcome, there can be huge benefits, as Jo Stephenson reports.
Objectives Offering maternity services through children's centres is at the heart of a redesign of services in Birmingham as part of efforts to reduce infant mortality rates. The Cherry Tree Children's Centre is located in Lozells, an area that has one of the highest mortality rates in the city. By making midwives part of the centre's multi-agency team, families should get more holistic support.
What was done Antenatal appointments were moved from local GP surgeries to the centre where midwives Nicky Coker and Sandra Lee run four half-day clinics per week.
The service is commissioned by the Heart of Birmingham Primary Care Trust while the midwives are employed and line managed by the local hospital. The centre's health and family support workers talk to mums in the waiting area to make them aware of the services the centre offers, such as breastfeeding support, benefits advice and play sessions.
"It's about developing seamless services for mothers and their babies and it gives us as a children's centre an opportunity to work with women we might not otherwise see," adds centre manager Andy Killeen.
The issues Space has been a big issue and Killeen has had to juggle the demands of different services. "It's a large investment of space but I do see it very much as an investment," he says. He admits it has been a challenge integrating the midwives into the well-established children's centre team. "We've worked together as a Sure Start programme team for a number of years and the midwives came with different patterns of working and management, so it's an ongoing process," says Killeen. Communication is important and midwives often can't come to team meetings because of their workload. However, they are part of a health network that sees workers meet monthly.
Outcomes An independent evaluation of the service redesign by University of Coventry was very positive, explains Kayode Odetayo, who manages the Birmingham Infant Mortality Project for the Birmingham Health and Wellbeing Partnership. It found most parents preferred going to children's centres and midwives liked working in that way. The number of people failing to show up for appointments has gone down and more families are using the children's centre.
"We hope to see a long-term improvement in mortality rates," says Killeen. At the moment, families who use different GP surgeries come on different days but the aim is to make the service more flexible and more "locality-based" so mums will always go to their nearest children's centre for an appointment.
TOP TIPS
DO
- Communicate - make sure all centre staff understand the midwives' role and how that links in with their work
- Integrate the midwives into the centre team, so it's a seamless service
- Provide toys in the waiting area as many mums already have young children
DON'T
- Allow an "us-and-them" culture to develop. It's a danger if midwives are coming into an established service
- Forget to involve midwives in planning the space they will be using.