GPs and One to One Midwives

Who are One to One Midwives?

One to One Midwives are an NHS accredited midwifery service providing case loading midwifery in the community. One to One provides a woman with the same midwife throughout pregnancy who will provide all the antenatal, birth (Homebirth) and postnatal midwifery services. One to One is insured by the NHS Litigation Authority who insures NHS hospitals and has also been fully assessed and assured by the NHS Care Quality Commission

(CQC). The service was founded by a midwife and manages ‘all risk’ women in partnership with health and social care.

One to One midwives are currently commissioned for self or GP referral by 6 CCGs in the North West of England (Wirral, Liverpool, Warrington, Western Cheshire, South Cheshire and Vale Royal). In line with NHS England maternity guidance (Gateway 01110) One to One midwives can also accept GP referrals from other CCG areas. If a woman is referred by a GP the local CCG will fund the care we provide.

One to One midwives have safely looked after over 5000 women across the North of England over the last 4 years. The service aims not to replace the local NHS hospital midwifery service but compliment local provision by offering an alternative model of care that may meet some women’s needs better.

How can a GP refer to One to One or find out further information

GPs can refer by completing a GP referral form. This form can be obtained from,

• The women herself. When a woman contacts One to One midwives we send the woman the referral form to bring with her to the GP appointment.
• A GP can put in request for a referral form from the general enquires section of the website. http://www.onetoonemidwives.org/enquiries
• A GP can request a referral form from by telephoning the One to One service 0330 330 9121.

What do One to One Midwives offer?

One to One are not the same as traditional NHS midwifery services. One to One provides an enhanced community based case loading midwifery service with a clear focus on normality of pregnancy through a continuity of care model. This focus has already proved very successful to over 5000 women and the One to One service has the best normality outcomes in the UK. Examples of these outcomes include,

This enhanced service from One to One is provided at national maternity pbr Tarff so costs no more than hospital maternity services. Also One to One midwives do not take on paying women. One to One believes this model of care should be made available free to all women. It is the organisation vision for One to One to support such a model being available to all women everywhere.

How does the One to One service work?

The model of care is a purely woman focused model of care. Unlike traditional NHS midwifery where the woman has to fit in around the service, One to One deliver a service that is tailored to the woman herself. The model works as follows,

• A midwife with in 48hrs visits the woman at home from referral. 
• The women will have the same midwife throughout pregnancy and 6 weeks postnatal. 
• The midwife will undertake all aspects of care inc. bloods.
• The care will be provided at home inc. evenings and weekends.
• The woman has access to the midwife 24/7 by phone and txt.
• The midwife will link in with GP, HV & Obstetrician if required.
• Scans will be undertaken in the community.
• If the pregnancy does not go full term midwife will offer support.
• The woman can birth at home or hospital of choice. If HB the woman’s midwife (with a 2nd midwife) will do HB.
• The same midwife will visit daily as required to support breastfeeding and general health & well-being.

Our local midwives care for women in a community setting, including the woman’s home across 7 days. Our services include community scan clinics, screening tests, bloods, parent education classes, hypnobirthing and obstetric input should the need arise.

With One to One women are not required to decide on place of birth until late on in the pregnancy if they wish. Women can choose any local hospital to birth, they can birth at home or can birth in a community-based midwifery led birthing unit if available. One to One is also looking to establish community-birthing centers in all the areas they cover.

In relation to safety and quality, One to One midwives have localised pathways and policies assured by CCGs, CQC, and the Local Supervisory Authority of Midwives. These pathways and process link in with the women’s local hospital of choice, community services, safeguarding services, mental health services and social care.

How do One to One link in and communicate with local services?

One to One after referral will make contact with the women and commence care. Early on the One to One midwife will inform the women’s GP and local hospital if it has been identified as the place of the birth.

Women who are high risk will be given a joint care-plan that will have input as required from the GP, the women, the One to One midwife, the local obstetrician and local specialist e.g. endocrinologist for diabetes. The midwife who will accompany the women to all her hospital visits to ensure the agreed plan is followed will manage the care. Information, results etc. will be shared with all those involved.

For women with social issues then the One to One midwife will link in with local safeguarding, social care, health visiting, public health and any other bodies that require input. As the level of care from the One to One midwife is high then the women is able to have regular input and therefore regular assessments of need.

Communication between the One to One midwives, the women and other health and social care bodies is the absolute key for the care being provided.

How does One to One differ from traditional NHS Midwifery services?

The table below clearly demonstrates the difference between the One to One model and the typical NHS provision.

As a GP do you want your local women to benefit from the best outcomes in the UK?

As a GP should you be speaking to your CCG and asking how can this service be properly commissioned in your area?

Further information can be found by contacting:

John Ferguson – Commercial Director

E-mail - john.ferguson@121midwives.co.uk
General enquires can be made through the website and by telephone.
Website: http://www.onetoonemidwives.org/enquiries
Telephone: 0330 330 9121

Current articles with information on One to One midwives.

https://www.gov.uk/government/news/independent-midwives-insurance-options-outlined

http://www.cqc.org.uk/sites/default/files/media/reports/1-197591160_Birkenhead_Medical_Building_INS1-497647596_Scheduled_07-11-2013.pdf