Campaign Update: Incentives for Continuity of Carer now included in NHS Resolution Scheme

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AIMS Journal, 2020, Vol 32, No 2

By the AIMS Campaigns Team

Trust Boards will now have a strong incentive to make sure that Continuity of Carer is firmly on their agenda, otherwise they will miss out on extra funding.

In February, the AIMS Campaigns Team was pleased to see that Continuity of Carer had at last been included in the NHS Resolution's updated maternity incentive scheme - year three for 2020.¹ This is a scheme which provides financial incentives on an annual basis for Trusts to demonstrate achievement against 10 discrete ‘safety actions’, chosen to reflect the current safety agenda.

For the first time, the safety actions called on Trusts to report on their activity around the implementation of Continuity of Carer against nationally agreed targets as set out in the NHS England Long Term Plan.² This was really heartening news, as the AIMS Campaigns Team has been calling for Continuity of Carer to be included in every piece of work which aims to address maternity safety. On the one hand, Continuity of Carer was being understood as an important contribution to the safety of mothers and babies, whilst, on the other hand, it has until now been excluded from this high profile NHS Resolution programme designed "to support the delivery of safer maternity care". That just didn't strike us as right.

Whilst it was announced³ at the end of March that this scheme has now been paused - currently until the end of August to allow for an NHS-wide focus on the coronavirus pandemic - AIMS is pleased to note that it has certainly not been cancelled. This means that Trust Chief Executives will need to demonstrate, when the scheme recommences, how they and their Boards are working effectively to meet the national target for #ContinuityofCarer alongside other maternity safety actions. These actions are usually linked to much-wanted refunds on annual Trust contributions into the NHS insurance pot (the Clinical Negligence Scheme for Trusts, or CNST for short), although the incentive arrangements will likely be somewhat different this year,

AIMS is particularly pleased to see the heightened level of transparency demanded of Trusts in the 2020 arrangements. Trusts have been asked to develop, for example, written action plans which set out how they will ensure that a minimum of 51% of women are placed onto a Continuity of Carer pathway by March 2021. These action plans were due to be shared with Board safety champions no later than Friday 28 February 2020. AIMS has seen some of these plans and would encourage campaigners to get hold of their local plan. Progress against these local plans was due to be overseen by the local Trust Board at least monthly. Whilst these dates are now subject to change, AIMS believes that these arrangements represent a hugely welcome step-up in accountability and transparency at the local level around Continuity of Carer, just as AIMS has been calling for.⁴ For the first time, it means that local activists will now able to scrutinise how their local Trust is seeking to implement the national ambition, with local Continuity of Carer action plans - and records of Board discussions about the progress in meeting these action plans - all made available as part of the publicly accessible Trust Board documentation.

AIMS very much welcomes this move. We know that too many Trusts are not being open about their activity around policy implementation in this area. AIMS is hopeful that this initiative will serve to underpin an increasingly robust national implementation strategy, as it will allow barriers to implementation to be systematically identified and supportively resolved, rather than concealed. The time is right for this shift in implementation approach and AIMS looks forward to all Trusts working constructively towards the national ambition within this new framework.

Birth Activists: what you can do to make a difference in your local area

• Review your local action plan Get hold of your Trust’s local action plan (which should have been finalised before the end of February 2020) and check that this plan reassures you that your local Trust was on track to meet the national #ContinuityofCarer ambition. No doubt this action plan will need to be updated later this year; your early review of the initial document will put you in a good position to contribute to an updated plan.
• Keep #Continuityofcarer on the agenda amongst your fellow service user representatives. Make sure they know about this new scheme and know that they can use it to help coproduce and scrutinise efforts local towards national targets. (The local #ContinuityofCarer action plan should have been co-produced with local service users. Was it?) From September, make sure that this issue is once again on the agenda of your local MVP: MVPs have a key role in supporting the successful implementation of this key plank of the Maternity Transformation Programme.

Keep AIMS informed about what is happening in your local area to enable us to identify what further support birth activists might need and to share examples of good practice. You can email us at campaigns@aims.org.uk.

References

1. NHS Resolution “Maternity incentive scheme – year three” February 2020 resolution.nhs.uk/wp-content/uploads/2019/12/Maternity-Incentive-Scheme-Year-three.pdf

2. NHS England Long Term Plan www.england.nhs.uk/long-term-plan/

3. NHS Resolution Announcement March 2020 resolution.nhs.uk/2020/03/26/pause-in-reporting-procedure-for-the-maternity-incentive-scheme/

4. AIMS “Campaign Update: Continuity of Carer and Better Births Implementation” AIMS Journal, 2019, Vol 31, No 4 www.aims.org.uk/journal/item/coc-campaign-update