Reflecting on the co-design process for a new National Integrated Care Framework to improve outcomes for pregnant women, mothers and babies with children’s social care involvement.
The Birth Companions Institute is currently leading a co-design process, to develop a new National Integrated Care Framework for women with children's social care involvement during the first 1001 days.
Here, Nlanda, a member of our Lived Experience Team, reflects on what it is like being part of the co-design community for this collaborative project.
Being part of this work with Birth Companions has been a deeply meaningful experience. For many women and families involved with children's social care during pregnancy and the first two years of a child's life, systems can feel fragmented, overwhelming, and isolating. When you've lived through that experience, it can feel like no one is really advocating for you, and that your voice doesn't matter.
That's why being part of the co-design community has been so surprising and inspiring. Coming into meetings with professionals and other members with lived and learned experience, I've seen that people genuinely care. Everyone brings different expertise and insights, and it's that diversity which ensures that nothing is missed. Where one person might not spot a certain challenge, another is able to highlight it, ensuring that women, babies, and families – especially those who are less visible or face complex circumstances – are seen and supported. Witnessing that level of commitment and consideration has genuinely moved me during my time on this hugely important project.
The work itself is large and complex. There are many layers to connect, multiple agencies involved, and a lot of things to consider in order to deliver consistent, coordinated, and compassionate support. At times it can feel daunting. But the right people are in the room, people are committed to doing the hard work, listening, and shaping a framework that will truly improve outcomes for families. The conversations aren't always simple, but the dedication of everyone involved shows that the framework will be meaningful in practice, not just on paper.
What has stood out to me is how different this feels from what many women and families have experienced before. Often, systems are built without those who have lived through them, which means important realities are missed; especially for those facing more complex or less visible challenges
In one of the meetings, I remember a conversation about continuity of care. From a professional perspective, it can sometimes be seen as difficult to maintain, often due to pressures like limited funding or understaffing and therefore not always prioritised. But someone with lived experience shared how, in reality and in practice, not having that continuity can lead to disengagement. Having to repeat your story again and again, rebuilding trust, and feeling uncertain can be exhausting and at times re-traumatising
For women from more adverse or marginalised backgrounds, this can then be misunderstood and translated as not engaging or not working well with services, when actually they are understandably overwhelmed
We have also spoken about how simple things can make a real difference – like being clearly told when care is changing, when there will be a handover, or when support is ending ahead of time. Without that clarity, women and families can be left feeling uncertain or even uncared for, even when that isn’t the intention
What stood out to me was that some of these changes don’t necessarily require more funding, but a shift in awareness, practice and exposure to these lived perspectives. The room paused, really listened, and the conversation changed to how to effectively integrate the lived perspective. Those moments stayed with me, because it showed how powerful it is when lived experience isn’t just heard, but actively shapes the work
On a personal level, being part of this process has changed how I see system change. It suddenly seems possible. Instead of experiencing decisions happening to women and families, I've seen how decisions can be shaped with them involved. Lived experience is valued, voices are heard, and solutions are built collaboratively. I also recognise that the absence of lived experience input in the past may be part of why current frameworks have sometimes fallen short in their consideration and care for families. It's clear that in the National Integrated Care Framework, it isn't just talk – action is happening, and the framework is being designed to work for real people.
I believe the National Integrated Care Framework will provide women, babies, and families with care that is coordinated, compassionate, and consistent across agencies. With the expertise, insight, and commitment gathered through this co-design process, I can be confident that this framework will deliver change, making the experience of care more supportive, consistent, and effective for families who need it most.
To discuss any of the issues or themes mentioned here, get in touch.
