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How We Got Here

The best start: five-year plan for maternity and neonatal care was published in 2017. The strategy outlines a vision for future planning, design and safe delivery of maternity and neonatal services in Scotland. It puts family at the centre of decisions, while promoting every woman, baby and family receives person centred care.

Since 2017, the Scottish Government tasked NHSGGC with implementing 23 out of the 76 Best Start recommendations. Delivering these necessary changes was predicted to take 5 years.

We’ve outlined the user involvement work that we hosted prior to the COVID-19. It shows how we worked with patients and staff to evaluate how well we implemented Best Start recommendations. 

Clyde Early Adopter work – continuity of carer evaluation 

Our Clyde region is one of five Early Adopter sites selected to implement a number of Best Start recommendations. Midwifery teams across Clyde are testing new care models to promote patients seeing the same staff throughout their maternity journey. This is known as “continuity of carer”.  

During local evaluation, we recognised we need to listen to women’s experiences to assess many aspects of continuity of carer. The Patient Experience Public Involvement (PEPI) Manager has provided advice, guidance, tools and support to the Clyde Early Adopter group over the last 12 months. This allows us to analyse the new model of care from a patient perspective. 

Purpose of Evaluation 

  • Explore whether women felt they received continuity of carer throughout their pregnancy, labour and birth, and postnatal care  
  • Understand how this new model has made a positive difference to patients’ overall care and relationship with midwives  
  • Find out what is important to women as they go through their maternity journey 
  • Identify and reflect on what we’ve done well and where where we can improve.
Local implementation of Care Opinion 

Care Opinion is used to capture patients’ experiences of continuity of carer models in Clyde. The PEPI Team support the Chief Midwife and Lead Midwives to respond and act on all maternity Care Opinion feedback.

The Lead Midwives respond to feedback, share positive experiences with teams and identify areas for improvement. They’re also required to demonstrate how feedback has made a difference and what changes have been made as a result.  

Midwifery staff can encourage patients to share their experiences on Care Opinion through word of mouth. There are also pop-up banners on display across maternity sites and regular promotion of Care Opinion on NHSGGC social media. PEPI is investigating how we can promote Care Opinion on Badgernet – the electronic maternity record that patients can now access.  

Care Opinion feedback should influence and inform the development of maternity services, alongside other feedback sources. Positive labour stories at the Inverclyde Royal Hospital and Vale of Leven’s Community Maternity Units could be used as part of ongoing promotion of these Birthing units.

Review of NHSGGC’s Maternity Services Liaison Committee 

Local review

The PEPI Manager and Chief Midwife explored new approaches to engaging with patients to shape maternity services. They connected with Seona Talbot, Sure Start Manager in Northern Ireland and President of the National Childbirth Trust. Seona successfully changed their organisation’s approach to user involvement, after facing similar challenges to NHSGGC with traditional Maternity Services Liaison Committees (MSLC). They adopted a co-producing model, including using social media to engage.

Most of their user involvement happens on Facebook, where they capture real time feedback and engage on specific transformation projects. The maternity staff also inform patients how their views have influenced the services. It was agreed our Chief Midwife would discuss this model with the Directorate Management Team. They would also agree the future of the MSLC with the Director.

As part of this work, the service should find out how patients want to help shape maternity services. This would allow them to use the work as an opportunity to co-design their user involvement activity. 

National review

During this time, the Scottish Health Council carried out a national scoping exercise for the Scottish Government. They examined how NHS Boards across Scotland involve patients to develop maternity services, which included MSLC and other activities.

Moving Forward Together third sector event 


We hosted A Moving Forward Together event with Third Sector organisations on Wednesday 19 June 2019. The Moving Forward Together programme sets out our vision to transform health and social care services to meet the needs of the local population. We shared information on how our services are changing and engaged with third sector organisations to shape what the services will look like. The event was also an opportunity to raise awareness of Best Start and the future vision for maternity and neonatal care in NHSGGC.  

Poster presentations were on display throughout the event. They included key information on the national Best Start framework and what the continuity of care model will mean for patients locally. The PEPI Manager provided support by developing content and attending the event to display the poster and engage with attendees about Best Start. 

Third sector organisations

No maternity related third sector organisations were able to attend the event. However, we’ll continue to explore opportunities to engage with these organisations, as this is part of us building and maintaining relationships with our key stakeholders. It also supports a partnership approach to service development and redesign. The approach will allow us to reach out more patients and their families, and gather more views and experiences for service redesign. 

Engagement with women and partners around maternity visiting 

As required, we involve partners and allow them to provide support to patients during the antenatal and postnatal period. As part of this, each health board has to review accommodation provision and ensure they have a local policy for partners having a presence overnight.  

Within NHSGGC, the PEPI Team gathered views and experiences of patients and their partners. They asked people to comment on visiting times and their preferences around partners having a presence overnight. This involved visiting our postnatal and antenatal wards and carrying out 1:1 conversations using a semi-structured approach.  

In total, the PEPI Manager spoke to 29 people during 19 conversations with patients and their partners. The views and experiences informed the revision of the Board’s maternity visiting policy and accommodation provision for partners. The findings also helped plan the Maternity person centred visiting workshops led by our Person Centred Visiting team. These workshops were due to take place in March and April 2020, but were subsequently postponed as a result of the COVID-19 Pandemic.