Improving maternity care by commissioning through local community groups and organisations

Members of the Bristol, North Somerset, and South Gloucestershire (BNSSG) Local Maternity and Neonatal System (LMNS) Equality and Equity group participated in a focus group to discuss experiences of funding community groups to improve maternity and childbirth care. Participants included representatives from key stakeholder organisations such as acute trusts, primary care, local authorities, and voluntary, community, and social enterprise (VCSE) organisations, many of whom had been involved in securing funding for initiatives like Black Mothers Matter and Maternity Champions.

The group highlighted a disconnect between statutory maternity services and the communities they serve, emphasizing the importance of addressing maternal health inequalities through collaboration with community organisations. For them, the environment for commissioning has shifted beyond rationale and responsibility for change, to practical strategies for achieving it. These strategies focus on building an integrated system where healthcare providers, local authorities, and VCSE organisations work collaboratively and pool resources effectively. This thinking is summarised below:

Summary
Trust and relationships can act as an essential currency to enable the development of and funding for community groups. Strong interpersonal relationships within and across organisations promote safety and trust, essential for addressing systemic racism, prejudice, hierarchical structures, and closed organisational cultures that perpetuate health inequalities. ‘Boundary spanners’ can act as system connectors, stepping away from their ‘base’ organisation to ‘bridge the gap’ between public sector and community organisations. Defining and developing shared vision, goals and approaches to measurement and evaluation can permit joint working towards meaningful change. Integrated systems that can sustainably fund community organisations to support maternity care require commissioners to adopt adaptive, longterm approaches to investment.

These findings are developed further under the following headings:
• Trust and Relationships
• Boundary Spanners
• Creating a Shared Vision & Aligning Goals
• Evolving integrated systems
This is followed by some recommendations in the form of opportunities with potential to be developed further in local and wider commissioning systems.