Report explores 'shocking' Neighbourhood Midwives collapse

On January 24 last year, 121 pregnant residents being cared for by Neighbourhood Midwives, set up in 2016, were told it would shut the following week.

At the time Walthamstow MP Stella Creasy told the Observer the service’s closure was “a mystery” and that a lot of residents “sing its praises and want it to continue”.

The service was paid for by the Waltham Forest clinical commissioning group (CCG), which decides how NHS money is spent, as part of a two-year pilot scheme to improve maternity care.

At the end of the pilot, the contract was extended for another year on October 31 in 2018, three months before the service was suddenly forced to close.

Former Neighbourhood Midwives user Victoria Frederick and her son Hendrix (Archive)

Waltham Forest mum, Victoria Frederick, one of many who used the service (Archive photo)

An NHS report on the collapse, put to the council’s Health Scrutiny committee on December 17, said it was unclear who Neighbourhood Midwives reported to once the pilot ended.

It reads: “There was... a lack of clarity over where the pilot could report into for discussion, support and effective decision-making when complex new issues arose.

“Once the seriousness of the financial challenge Neighbourhood Midwives… (was realised), there was no one single board, group, or forum that the managing director could approach to raise the concerns.”

The report also argues new services need “a payment mechanism” that allows “security of income while they become established” and that the NHS should “acknowledge start-up costs as well as operational costs”.

It adds: “Commissioners may need to acknowledge that these kinds of initiatives may initially be “loss leaders” and plan accordingly.”

It also suggested Neighbourhood Midwives would have benefited from help “to navigate the complexities of NHS contract management and identify alternative funding sources”.

From our archive: Neighbourhood Midwives' 'success speaks for itself'

In April this year, former CEO Annie Francis wrote in Q Health that “the complexities of the NHS commissioning and funding structures proved neither agile or flexible enough to accommodate and adapt to the needs of a small independent provider”.

She added that the service had been “hugely successful and loved” by those it cared for.

Speaking at the meeting last night, Cllr Richard Sweden (Lab and Co-op, Wood Street) agreed there was “ubiquitous acclaim for the model” at the time, which made its closure “shocking”.

The NHS has responded to what it views as the inherent risks of setting up services like Neighbourhood Midwives by deciding to focus on supporting NHS providers instead.

It intends to learn from the successes of Neighbourhood Midwives for its own care, such as by offering better “continuity of care” for expecting parents.

In a statement on February 1 last year, Waltham Forest CCG said it had not “withdrawn funding” from the service and shared “the disappointment of many” that it had to close.

They added that all those who were expecting care from Neighbourhood Midwives would “receive alternative NHS maternity care provision”.

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