A radical restructuring of antenatal care for high-risk pregnancies Great Western Hospitals NHS Foundation Trust

The Great Western Hospitals NHS Foundation Trust team worked with stakeholders to redesign the antenatal care for all high-risk pregnancies. The new service offers a more 'one stop' experience for patients. A patient with a multiple pregnancy and hypertension would, for example, have an ultrasound scan, blood pressure monitoring and a specialist clinic appointment during one visit to the hospital.

Changes introduced to the service included:

• a significant increase in direct consultant-delivered care
• trainees being present in a learning capacity, without being depended on as much for service delivery
• more time per consultation in certain clinics, to allow detailed discussions to take place
• fewer unnecessary follow-up appointments.

Outcomes

The project improved patients' experience of antenatal care, by reducing the need for repeat appointments which can cause anxiety and inconvenience for patients and families.

The restructured antenatal service was incorporated into the organisation’s core business and priorities through business plans, objectives, job planning and job descriptions. This helped to ensure the innovation’s sustainability. There is an ongoing training process in place as well as a strategy for succession planning. The service has been able to withstand challenge and variation.

Who was involved

The project team consulted with a wide group of stakeholders: patient representatives, lead primary and secondary care professionals, senior management and clerical staff.