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I have been reading some fascinating reports about Community Hubs in Australia, New Zealand and Scandinavia. These are very much in line with what Julia Cumberlege advocates in ‘Better Births’, her recent report on the maternity services:

                “This report envisages more births taking place in the community…..Commissioners and providers should work towards bringing services together in community hubs.”

The Barkantine Birth Centre, which is co-located with a GP practice, dental surgery and pharmacy, is cited in ‘Better Births’ as an example of best practice. There, all the midwives use a common framework to explain birth choices and risks, thereby ensuring consistency of advice and avoiding distress on the part of women when they discover that each has been told a different story. Midwives also feel supported in knowing ‘what to say’, thereby making it less likely that personal experiences and views bias the information they share with women. Community hubs that include maternity care could, according to ‘Better Births’, be centred on a Children’s Centre, a GP practice, a Community Centre or a Midwifery Centre such as the Barkantine.

On the other side of the world, there are moves to develop hubs which have schools at their heart. In Australia, there are also children’s services call-centres which are staffed by a multi-disciplinary team of midwives, health visitors, teachers and police. Parents can ring and be referred immediately to whichever professional is best placed to answer their query. All staff are trained in interview techniques that allow them to drill down quickly and compassionately to what the caller’s main issue is, so that they can pass them on quickly to the right member of staff.

For these community hubs to work, it is essential that data about children and families is shared between all professionals who need to know it. In the UK, data linkage seems to be a huge challenge. For years, I have been talking to mothers and fathers who have wearily told me stories of having to repeat key – and sometimes distressing – information about their circumstances to different professionals who did not have access to their notes. The ‘notes’ were always located somewhere other than inside the service the parents were currently trying to access.

Similarly, health professionals complain all the time – quite rightly – about inputting data onto a system that cannot ‘speak to’ systems in other trusts or parts of the country, or be used by other health and social care professionals.

I raise these issues because what struck me most about the ‘Better Births’ report was the cry heard on pretty well every page for there to be more TIME – more time for midwives and doctors to talk to women and their families; more time to discuss the woman’s choices with her and understand why she is making them; more time for women and their families to think through what they want, and to properly understand the huge amount of information that is directed their way. Co-locating professionals from different disciplines on the same site; ensuring that services are truly responsive to local demographics; shared data systems – all of these would help make more TIME to offer better care to families with young children and would provide better job-satisfaction for professionals. We already are blessed with Children’s Centres – they’re just sitting there waiting to become community hubs. How soon can we get organised?

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