Personalised Care and Support Plan

In February 2023, during a focus group, Kernow MNVP found that the nationally required Personalised Care and Support Plan was not being embraced by local maternity staff, and service users often hadn’t seen it or didn’t understand it.

Kernow MNVP brought together service users and community teams to reimagine and coproduce this important planning document.

They used the core values and principles of the Kernow Parenting Journey to make sure the document uses accessible language, imagery where appropriate, time appropriate information, and consistent and clear messaging throughout the parenting journey to support informed decision-making.

The Personalised Care Plan work has informed development of the digital offer – Natters Bitesize – which contains a series of educational videos and resources to support individuals through the four trimesters of pregnancy.

Quality surveillance and governance

[Pictured: Donna Ockenden visit, March 2024]

Kernow MNVP continue to develop and embed their involvement in quality surveillance and governance across the Royal Cornwall Hospitals NHS Trust (RCHT).

Kernow MNVP is involved in several monthly forums where they share insight and intelligence gathered through their engagement work, provide critical friendship and challenge through a service user lens, and support the system to develop and ensure a transparent safety culture. Kernow MNVP also support the governance processes at system level through our involvement in the LMNS board, which receives a monthly maternity and neonatal safety report from RCHT, enabling escalation of any safety concerns or support needs through the system, up to regional level if required.

Regular monthly oversight and governance meetings attended by Kernow MNVP:

• LMNS Board
• LMNS Transformation Steering Group
• Maternity and obstetric business and governance
• Maternity audit review meeting
• Maternity Forum
• Maternity guidelines
• Maternity improvement plan review
• Neonatal audit and guidelines
• Neonatal business and governance
• Ockenden actions compliance review
• Patient Experience Group
• Perinatal mortality review meeting
• Perinatal patient safety
• PULSE (senior midwifery leadership group)
• RCHT Infant Feeding Steering Group
• Safety Champions
• Staff and patient feedback triangulation meeting

By embedding the service user voice within the quality surveillance pathway locally, Kernow MNVP ensures the feedback from families is truly influential in making changes to improve care.

Kernow Parenting Journey (KPJ)

The Kernow Parenting Journey (KPJ) was originally an independent engagement and research project which ran from June 2021. In April 2023, the project moved into a delivery phase which aligned with Kernow MNVP’s work to ensure robust collaboration and coproduction, maintaining its strongly developed multiagency partnership approach.

The focus of the project remains to develop recommendations, embed core values and principles, and shape the system offer with delivery of information and support to families across their parenting journey for children aged 0-2 years.

June 2023: Developing a maternity antenatal programme

KPJ’s recommendations for a tiered maternity antenatal programme were developed, and the Silver option was implemented by the LMNS.

• Gold – Full Pregnancy Circles with trained facilitators, parent education and clinical care combined.
• Silver – Three points of face-to-face contact: baby care session led by Midwifery Support Workers, birth planning at 36 weeks and a postnatal group, often run in conjunction with the Health Visiting Team.
• Bronze – Maternity Natters Digital, where all antenatal contact is online via Zoom.

October 2023: Pregnancy Circle Group – care facilitation training

Members of the community midwifery team from across Cornwall and the KPJ Lead were trained in this UCL accredited course ahead of the full Pregnancy Circle programme launch in 2024.

November 2023: KPJ core values and principles

KPJ values and principles were adopted by the Start for Life programme for supporting parents with children aged 0 to 25 and shaping multiagency and partnership working.

December 2023 – March 2024: Maternity Natters Bitesize

A move away from existing online classes to a video resource library, presenting a parenting road map linked to the Personalised Care and Support Plan and a series of antenatal videos (KPJ website to be live in due course).

Read the report

Shaping and supporting MNVPs nationally

In 2023, following the publication of the NHS England delivery plan, neonatal care was formally added to the MVP remit. Kernow MVP became Kernow MNVP and the team worked to include and embed neonatal care into their work locally.

Kernow MNVP worked with the Cornwall Integrated Care Board, NHS England and representatives from around the country to develop new national MNVP guidance (published November 2023). This gives systems a framework of principles to support them to effectively commission and set up an MNVP.

Kernow MNVP continues to lead the way nationally for MNVP development and are supporting other systems as they work towards embedding service user voice in their work.

The main principles of the new guidance include:

• Engagement and listening to families: This includes things such as community engagement, surveys and 15 steps visits, and involves collecting, analysing and reporting the findings and intelligence gathered.
• Strategic influence and decision making: This includes involvement in quality surveillance, governance and service development. The guidance requires the MNVP to have strategic leadership that is enabled to work alongside the senior leadership team at provider level.
• Infrastructure: This includes things like administrative support, project management and the infrastructure needed to run a successful programme of work. In Cornwall this is provided through a commissioning arrangement with external organisation such as Evolving Communities.

15 Steps to good maternity and neonatal services at Royal Cornwall Hospital

In October 2023, Kernow MNVP visited the Royal Cornwall Hospital and used NHS England’s 15 Steps checklist to reflect on whether the maternity and neonatal settings and staff were:

Welcoming and informative

Safe and clear

Friendly and personal

Organised and calm

Accessible and inclusive.

The visiting group included staff and volunteers from Kernow MNVP and Healthwatch Cornwall, service users and midwives. During the day they observed: Wheal Fortune, Neonatal Unit, Truro Birth Centre, Wheal Rose, Day Assessment Unit and the Delivery Suite.

Their report presents the group’s findings, highlighting what they liked and what they felt could be improved. It includes recommendations for change and reflects on progress made since their previous visits and recommendations.

Kernow MNVP has shared the report with the Local Maternity and Neonatal System (LMNS) and the hospital leadership team. They will monitor progress made by the Royal Cornwall Hospitals NHS Trust and repeat the 15 Steps visit in 2024.