Postnatal care: Developing a living library to promote a human-centred model of care

Chelsea and Westminster Hospital NHS Foundation Trust

This project is under way, and will run until March 2020.

  • Project led by Chelsea and Westminster Hospital NHS Foundation Trust, in partnership with NIHR CLAHRC North West London and Qulturum, Improvement and Patient Safety Hub, Jönköping County, Sweden. 
  • Aiming to design a human-centred model of care in postnatal services, to better meet women and their families’ needs and support staff.
  • Will create a bespoke ‘living library’ model for postnatal care at Chelsea and Westminster Hospital, adapting learning from Sweden.

Underfunding, fragmentation of care and other service pressures have meant that postnatal care in the NHS is not delivering an experience that effectively meets women and their families’ needs. 

NHS postnatal wards have traditionally provided a ‘medical model’ of care, often meaning women’s non-physical needs aren’t fully met. A poor postnatal experience can lead to higher rates of postnatal depression and post-traumatic stress disorder, and lower mother and baby bonding rates and breastfeeding rates.

There is a national shortage of midwives and maternity support workers, and a significant proportion of staff feel unwell due to work-related stress. Innovative ways of supporting staff and women and their families in postnatal care are needed.

This project will involve transforming the delivery of postnatal care at Chelsea and Westminster Hospital by developing a ‘living library’ model, similar to that used in several clinical specialties in Sweden. It offers human-centred care by promoting dialogue and interpersonal relationships between those delivering and receiving care, and providing the opportunity to share life stories and appreciate diversity and intercultural differences. 

The ‘living library’ concept lends people rather than books. The ‘books’ are the people who have similar lived experiences, and they are ‘borrowed’ to ‘readers’.

The initial focus will be on developing ‘books’ for women who are particularly at risk, for example where the mother or baby have received care in an intensive care unit, first-time mothers with emergency operative deliveries or significant obstetric complications, and those with challenges in accessing care (e.g. language, hearing, mobility or learning difficulties). 

A pilot phase will involve 50 women, with another 200 being involved in the project roll-out.

Contact information

For more information about this project, please contact Dr Sunita Sharma, Consultant Obstetrician and Gynaecologist, Chelsea and Westminster Hospital NHS Foundation Trust.

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