Cathy Warwick CEO of RCM presenting at the Better Births event 2017 please see http://www.midwiferyunitnetwork.com/better-births-event/

1. Community Hubs: the vision
Professor Cathy Warwick, CBE
RCM CEO

2. The Royal College of Midwives | www.rcm.org.uk
2The Drivers
• The user at the centre of care
• Care at the convenience of the
user
• Place based systems of care
• Local when possible centralised
when necessary
• A shift from hospital to
community
• Multidisciplinary working

3. The Royal College of Midwives | www.rcm.org.uk
3The Concept - England
It is a local centre where women can access
various elements of their maternity care, such as
the Portsmouth Birth Centre. They could be
located in a children’s centre, or in a
freestanding midwifery unit.
Hubs will act as “one stop shops” for many
services, and provide a fast and effective referral
service to the right expert if a woman and her
baby need more specialised services.

4. The Royal College of Midwives | www.rcm.org.uk
4The Concept - Scotland
Integrated team care for women, babies and families will, over time,
take place in local community ‘hubs’.
It is anticipated that a number of the community hubs will utilise
accommodation currently housing freestanding midwifery units, while
others may be located in community premises or other
public sector premises.
These hubs would be local care settings for a range of services,
designed around the needs of the service user. A community hub
would become a facility where people feel they can identify
with the services delivered from the hub, in an environment where
they feel comfortable.

5. The Royal College of Midwives | www.rcm.org.uk
5
The NHS needs to organise its services around women
and families. Community hubs should be identified to
help every woman access the services she needs, with
obstetric units providing care if she needs more
specialised services.
The rationale - England

6. The Royal College of Midwives | www.rcm.org.uk
6The rationale - Scotland
Women have indicated that routine services should be
delivered as close to home as possible, to minimise
disruption to normal family life and to avoid time
consuming and stressful travelling.
NHS and other public sector community services are
continually evolving… as a result of the integration of
health and social care. This will facilitate a move to a
higher level of integration of professional teams, based on
shared objectives, and increased co-location.

7. The Royal College of Midwives | www.rcm.org.uk
7What’s in One - England
These might be ultrasound services, smoking
cessation services or voluntary services
providing peer support. Women may also be
able to meet professionals who will be involved
with them after childbirth, for example, their
health visitor. In some community hubs there
may be birthing facilities.

8. The Royal College of Midwives | www.rcm.org.uk
8What’s in one? - Scotland
Ideally the hubs will include, for example,
extended opening hours for appointments, and
may, in some cases, include birthing facilities.
Women will access the majority of their
antenatal and postnatal care in these hubs,
which may include scanning facilities and most
midwives will work from these hubs.

9. The Royal College of Midwives | www.rcm.org.uk
9Working with other parts of the system - England
A community hub approach will only work if it is
supplemented by rapid identification of
complications and referral to more specialist
care, as it is at the Barkantine Birth Centre in
East London. Around four out of every ten
women will develop a complication that requires
some form of more specialist expertise.

10. The Royal College of Midwives | www.rcm.org.uk
10Working with other parts of the system - Scotland
Women with complex care needs may
require to have some care provided in the
hospital setting where there is access to a
wider range of facilities, but, where
possible, a significant proportion of
services should be delivered through the
hubs.

11. The Royal College of Midwives | www.rcm.org.uk
11How prescriptive? - England
“This report does not seek to overly
dictate the model of community hubs.
Their nature and location will be
dependent on what services are already
available locally and what makes sense
for the community.”

12. The Royal College of Midwives | www.rcm.org.uk
12How prescriptive? - Scotland
Community hubs should be
designed on the basis of a local
needs assessment to ensure they
meet the needs of localities, rather
than offering one standard model.

13. The Royal College of Midwives | www.rcm.org.uk
13The Challenges
• Are changes to roles and
competencies needed?
• Are changes to working patterns
necessary?
• Is ‘small’ beautiful and efficient?
• Will they succeed in times of
austerity?

14. THANK YOU
For further information
Website: www.rcm.org.uk
Telephone: 0300 303 0444
Email: info@rcm.org.uk
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