Primary Care Antenatal Care – Important Information for Primary and Secondary Care providers

The Health and Safety Board (HSIB) have recently investigated a number of antenatal care cases which involved a potential key risk associated with the primary care-maternity care interface.  

Key Risk identified

When women and birthing people are told to access their GP or maternity team themselves to follow up specific issues, this can lead to information being lost in translation which can prevent the woman and the birthing person from receiving the care she needs. In addition, some women and birthing people may face challenges in reaching out to their maternity providers or GPs within the advised timeframe or at all due to a variety of circumstances, further impacting their care. This risk is heightened when the woman is vulnerable, doesn’t have English as a first language or when there are increased pressures in the receiving services that impact self-referral access.

The learning

It is evident that effective communication between primary and secondary care teams is essential to maintaining patient safety, therefore, we would like to remind all clinicians of the importance of clinician-to-clinician handover when escalating urgent maternity cases between primary and secondary care. This would ensure both teams can clearly transfer information and understand clinical concerns, enabling the right response and care delivery.

Ensuring effective system processes to support clinician- to clinician handover

In response to the concerns raised by HSIB investigations, a group of clinical and operational leads from across London was convened to explore the issues and consider collaborative solutions. The group was co-chaired by Nina Kazaezadeh (NHSE London chief midwife) and Agatha Nortley-Meshe (NHSE London Primary care Medical Director). The group have heard that more effective timely clinical communication and discussion between primary and secondary care requires better alignment of processes and pathways with clear escalation processes. The groups also recognised that there is further work in ensuring that there are appropriate and realistic shared expectations of all services involved in maternity care.

We want to hear from you

The group is committed to continuing to work together to improve processes, address inequalities, and develop guidance to support seamless care pathways that improve outcomes for women in London and their families. Key to this is ongoing engagement with stakeholders and we are eager to hear from clinicians and managers across primary care and maternity services about the issues that impact care delivery and how we can make things better

To provide feedback or for more information please contact england.londonprimarycare@nhs.net