Listening to your experiences of maternity services and information sharing

What we are doing

We’re working with the NHS to improve how information about your health is recorded and shared during your pregnancy and after your baby has been born. This could include information about treatment or advice you’ve received, tests and scans you’ve had or decisions you’ve made about your maternity care.

Some of the questions we are exploring are:

Did your maternity team have all the information they needed about you to provide care that was right for you?
Did you create a care plan and was it accessible to the team caring for you? Could you access it and update it?

Did you have the information you needed to make informed decisions about your care and did your maternity team use this information to meet your needs?
Were there gaps in the information needed for your or your baby’s care? What information wasn’t available that you think should have been?

Workshops

We recently held a series of workshops, each focusing on different aspects of maternity care. The topics we covered are shown in the boxes below. Your experiences shared in these sessions will really help us make improvements in how we document and share information about pregnancy and postnatal care for all. If you want to talk to us, we’d love to hear from you. Please email us at info@theprsb.org.

Our consultation for this standard has now finished. The new draft standard will be published in May 2024.

Making a plan for your care based on your needs
Making informed decisions about care
Unplanned pregnancy
Becoming pregnant under the age of 18

Health inequalities and how experiences of health can be different for different groups of people
Having a named midwife during your maternity experience

Pelvic floor health during and after pregnancy
Postnatal checks
Stopping smoking

Maternal medicine – specialist consultant-led care for people with existing or pregnancy related health conditions

Using mental health services related to your pregnancy

Fetal medicine – specialist care for when there are concerns about the health of an unborn baby
Multiple births such as twins or triplets
Bereavement and loss

CHAT theory also explicitly addresses five areas which if addressed systematically will help overcome stakeholder differences in pursuit of the common goal:

1. Understanding the artefacts that characterise the group and its activity.
• The artefacts might be clinical settings or the forms and templates used to capture and share information. During the pilot we heard about hard copy Dialog response forms; locally generated templates for collating information from different systems; letters and emails to GPs; images, poems or other non-text artefacts that service users might want to include in their ‘about me’ or care plan.

2. Understanding the multi-views of the group. Such groups are always a community of multiple points of view, traditions and interests.
• Different participants in the group will have different roles and will bring to the group and their roles their own histories, language, and ‘rules’. During our Stocktake preparations and workshops we worked with psychiatrists, mental health nurses, occupational therapists, social workers, transformation leads and voluntary sector representatives, all professions and interests with their own language, approaches professional ‘rules’ but united in their interest in care plans, care planning.

3. Activity systems (like the ICSs) take shape and get transformed over periods of time. ‘Historicity’ is a term coined to express how the group’s problems and potentials can only be understood against their own history.

• ‘We’ve always done it this way’, ‘that didn’t work before’, ‘it’s always like this’, ‘it wasn’t always like this’, ‘they are changing things again’, are all typical statements that often frustrate those charged with overseeing change initiatives. Without addressing the experiences that lie behind such comments you risk repeating mistakes of the past, alienating your stakeholders or just not understanding the real starting point for your transformation project. This is particularly the case for the implementation of the PCSP standard, the success of which will be largely reliant on point-of-care practices and information protocols as well as having systems which are user friendly and appropriately configured.

4. The central role of contradictions as sources of change and development. Contradictions are not the same as problems or conflicts. Contradictions are historically accumulating structural tensions within and between activity systems. Collectively addressing contradictions in how policy, practice, culture and technology interact will empower teams to find genuinely novel solutions for apparently intractable challenges, like interoperability and shared care plan/planning.

This links to the fifth principle that:

5. the possibility of expansive transformations in activity systems. As the contradictions of an activity system are aggravated, some individual participants begin to question and deviate from its established norms. In some cases, this escalates into collaborative envisioning and a deliberate collective change effort. “An expansive transformation is accomplished when the object and motive of the activity are re-conceptualised to embrace a radically wider horizon of possibilities than in the previous mode of the activity.”