The NCT statement on the closure of The Albany Midwifery Practice.
The NCT has deep concerns about the closure of the Albany Midwifery Practice for a number of reasons. These concerns are rooted in ensuring the provision of the best possible care for women and their growing families.
We believe that the model used is not at fault. The Albany has been well respected as a particular Practice and, more importantly, upheld as a model of care explicitly designed to meets both the clinical and psycho-social needs of women, babies and the wider family. By enabling midwives to practice using the full extent of their commitment and skills it retains experienced midwives within the NHS. For almost a decade, King’s College Hospital NHS Foundation Trust has renewed the Albany’s 2-yearly contract, suggesting that the model has worked well for the Trust, as well as for families and for the self-employed Albany midwives.
The NCT is concerned that the contract has been terminated suddenly – a situation which we understand to be due to a breakdown in communication and good contract management. This poor management has lead to difficult relationships between the Trust and the Practice, and questions being raised about the care provided.
The King’s College Hospital NHS Foundation Trust decision to terminate the contract with the Albany may be a simple, expedient solution for the Trust, in that it removes a management problem. This has repercussions, however, for the reputation of the model of care the Albany provided. Any damage to the reputation of the model will mean that other trusts are less likely to adopt similar arrangements for women in their areas.
The NCT propose the following way forward:
1. King’s College Hospital NHS Foundation Trust to recognise the role that their poor contract management has played in the current situation, and clearly distinguish this from the principle of the model of care, in any public statements made;
2. Community-based midwifery care, including contracts with self-employed midwifery practices, should generally be commissioned and managed by PCTs, rather than acute trusts;
3. Good practice guidance must be developed by the Department of Health, by appointing a senior midwife with appropriate experience, for the management of these contracts, training of NHS and self-employed staff, and communication on key issues, including reporting.
It is imperative that these issues are dealt with at the most senior level, and we call on the Department of Health to lead on this. The NCT wants families in all areas, especially vulnerable and marginalised women, to have care that is tailored to their particular social and clinical needs, and to have support in achieving a positive start to family life. This can be achieved by protecting and expanding this model.