North east London has the highest birth rate in the UK and one of the fastest growing populations. When accessing and experiencing maternity services, we know there are health, social and economic inequities and inequalities, especially for women of Black, Asian and Mixed Ethnic backgrounds and those living in the most deprived areas.
North east London is the most ethnically diverse Integrated Care System (ICS) in the country, with 53% of our population identifying as from Black, Asian or Mixed ethnicity, compared with 11% across England overall.
Five of our Boroughs are in the 20 most deprived in England.
We know there are improvements to be made to ensure pregnancy and birthing experiences for all our women and pregnant people are equitable, safe, personalised and culturally appropriate. When we get it right for our populations who experience the poorest outcomes, we’ll get it right for everyone.
In November 2021, the North East London Local Maternity and Neonatal System (NEL LMNS) produced a needs assessment to look at the data and outcomes for women in our communities and identified a number of clinical outcomes and experiences that were poorer for certain communities than others. The needs assessment was produced in response to the equity and equality guidance for local maternity systems, and can be viewed here.
In order to develop next steps, and look towards creating a strategy and action plan to improve equity and equality for pregnant women, extensive engagement was undertaken by Healthwatch and Maternity Mates. Using surveys, interviews and focus groups with maternity service users, their families, advocates and maternity staff, we gathered over 1000 responses to understand the experiences and expectations of the women in our care.
From our engagement, key themes were identified focussed on; engagement, communication, information sharing and consent. It was evident that some difficult experiences and poor outcomes could have been different with more accessible information, stronger communication, greater cultural awareness and a trauma informed approach.
Bringing an equity lens to all our work, specifically for those from Black, Asian and Mixed ethnic backgrounds and those living in the most deprived areas, will mean:
- We ensure we understand, and adapt our practice, to meet the cultural and social needs of all the pregnant women we care for.
- We ensure we communicate with pregnant women and their families in a way that is accessible, transparent and kind.
- We ensure we develop a culture of trauma informed care to better inform our practice and provide more positive experiences for pregnant women and staff.
- We ensure we support the health and wellbeing of our staff by providing the resources and tools they need to care for their pregnant women.
Our strategy and action plan has been worked on collaboratively with maternity staff, public health colleagues, Healthwatch and Maternity Voices Partnership Chairs. It describes our commitment to listen and work with our maternity service users and their advocates, to improve services and experiences that better meet the needs of those who use them, putting an equity lens on all we do and establishing different ways of working to ensure everyone receives safe and personalised care.
The action plan will provide direction for the maternity units in north east London, acknowledging our communities have different needs, and each maternity unit will need to develop a localised plan to fulfil these.
The full report can be viewed here, with a summary version also available that can be viewed here.