New mums-to-be in Leeds are being denied access to a service which previously provided one-to-one support throughout their pregnancy, birth and beyond.
Hundreds of expectant women from across the city have used the One to One Service – preferring its more personalised care from one named midwife to the usual NHS model which offers less continuity of care. But that choice has now been removed by local healthcare chiefs, who have told mums-to-be they can no longer use it.
However women living in areas including Cheshire, Liverpool and Essex still receive this care for free and campaigners have slammed the healthcare postcode lottery which means the only way Yorkshire women can now access this kind of care – known as “case-loading” – is by hiring an independent midwife, at a cost of around £3,000.
Caroline Worsley felt so traumatised by the care she received during the birth of her first child she needed counselling to recover.
When she became pregnant again she was terrified of having a similar experience, so she was overjoyed when she discovered a service which would see her supported by one named midwife throughout both the pregnancy AND birth – something which rarely happens in modern NHS maternity care.
Her anxieties “evaporated” with the support she received from community-based midwifery service One to One and she found giving birth to second daughter Martha “very healing”.
The former health visitor, from Rawdon, said: “It was completely life-changing. The single most empowering experience of my life and I wouldn’t have it without One to One.”
Hundreds of Leeds women have opted for the service since 2013 – preferring it to the NHS model, which offers less continuity of care.
One to One users also receive more antenatal and postnatal home visits, the service is accessible seven days a week and they are offered free hypno-birthing sessions – which would usually cost up to £450.
The independent organisation was previously accessed through self and GP referrals and cost the NHS the same as using its own staff. However NHS England issued new guidelines in January, stating patients could only choose from local services commissioned by Clinical Commissioning Groups (CCGs). Because the service has not been commissioned by Leeds CCGs, local mums-to-be have been told it is no longer an option for them.
However it is commissioned in areas including Liverpool and Warrington and campaigners have slammed the postcode lottery which means the only way Yorkshire women can now access this kind of care – known as “caseloading” – is by hiring an independent midwife, at a cost of around £3,000.
Caroline said the move would force some mums-to-be into debt and she too would rather do that than risk another traumatic birth.
The 36-year-old said: “One thing I know for sure is that I can’t afford to have another bad birth so I would pretty much do whatever it took. I do know women who are getting into debt to pay for an independent midwife. If the NHS had a caseloading service comparable to One to One I would use it but what the NHS is currently offering definitely doesn’t compare.”
In a national survey of 25,488 women’s experiences of maternity care in England in 2010, 75 per cent of women had not previously met any of the staff who cared for them during their labour and birth.
Maternity campaigners across the UK want caseloading to be introduced by the NHS and many mums-to-be are also demanding it.
Emma Ashworth, the NCT’s (National Childbirth Trust) Maternity Services Liaison Committee regional co-ordinator, said: “One to One were offering an exceptional service.
“It’s not being commissioned and we want to know why. None of us understand this decision and we can’t get an answer.”
She said: “Caseloading midwifery is cheaper to offer, it has better outcomes for mothers and babies and costs the NHS less at the point of service and secondly because there are fewer problems with mothers and babies that need to be fixed by the NHS afterwards.”
The Selby mother-of-three added: “It’s inevitable with a fragmented service, where a woman is seeing different midwives all the time, that some women will not get the information they need to have the birth that they should be having. And some women end up severely traumatised.”
A spokeswoman for NHS Maternity Services in Leeds said: “Work is underway between commissioners and providers to ensure all women have personalised care.
“We do not commission or approve referrals to services not on the NHS Leeds CCGs funded contract list. Such services are not subject to local contracting or performance management and do not have established, safe routes into acute maternity care or obstetrics or provide integrated links for those with complex care needs.”
A new maternity services strategy is being drawn up by Leeds CCGs, delivery of which is due to begin by next year.
How does One to One add up?
John Ferguson, director of One to One, said the service had launched in Yorkshire after local women asked for it to.
He said in the last two years One to One had looked after around 150 women in Leeds and another 200 across the rest of Yorkshire.
Around a further 350 asked to use the service but were turned down by their GP. He believes at least 700 will now not receive the care they want over the next two years.
He said three quarters of service users were from deprived areas.