Claire Mason reflects on the evaluation of the National Integrated Care Framework co-design process that she is currently conducting for the Birth Companions Institute.
Claire Mason, Research Fellow in the Centre for Child and Family Justice Research at Lancaster University, is a longstanding partner and friend of Birth Companions. Claire’s work focuses on the lived experience of mothers within the child protection and family justice systems. She has worked on research projects at local, regional, and national levels including research into parents who appear in recurrent care proceedings and state intervention at birth.
Led by The Birth Companions Institute, the National Integrated Care Framework to improve outcomes for pregnant women, mothers and babies with children’s social care involvement is currently being developed through a period of co-design. This process has brought together practitioners from across systems, including health, social care, housing, criminal and family justice, and the voluntary sector, to work alongside mothers with lived experience of children’s social care involvement.
The co-design has drawn on women’s lived experience, practitioners’ practice-based knowledge and learned experience, and wider research evidence about what supports better care during pregnancy and the baby's first two years. This work has shaped a set of principles and experience statements which describe how care and support should feel when things are working well within and across systems, from the perspective of mothers, babies, wider family members, and practitioners.
We are now starting to test out ways for local areas to work with the Framework in practice. Three multi-agency ‘test and learn’ sites: Sheffield, Norfolk and Hackney in East London, are working with an early draft of the Framework to understand how pregnant women, mothers, babies, and wider family members experience their journey through local systems when there is children’s social care involvement during pregnancy and the baby’s first two years, and to identify areas of priority for action.
The Framework principles, illustrated with co-created experience statements, offer a shared reference point for conversations about practice and ambition from multiple perspectives.
Each test and learn site will use these to look closely at a small number of moments that matter in their local system. These are points in a pregnant woman, mother, baby, or family’s journey that local partners identify as particularly significant.
These moments will often include points of transition, handover, or interface between services, where it is especially important that care feels joined up and well understood. They may also include less obvious or visible moments, such as how information is shared or explained, how a concern is raised, or how support is offered following a difficult decision.
Each site will choose moments that reflect their own local knowledge, feedback from women and families, available data, and current policy or practice priorities. Focusing on a small set of specific moments that matter is a practical way of giving the sites a focused and manageable starting point for this first phase of work, without any suggestion that every family’s journey is the same, or that other parts of the journey matter less.
Jairzina Weir, Senior Manager for Maternity at NHS North East London Integrated Care Board, is closely involved in the development of the Framework and in Hackney’s role as ‘test and learn’ site. She said:
“As a commissioner, I have seen how a tailored, trauma-informed approach, delivered by Birth Companions in their specialist Izzy Project here in Hackney, supports women least likely to engage with traditional services. It is encouraging to see the learning from this project now helping to shape a national framework, by offering a practical and tested model of effective support.”
As a practice-focussed researcher with a commitment to co-design and system reform, I'm also delighted to be involved in this ambitious project. In my role as the evaluator, I have had the privilege of being part of the co-design process and working closely with the Birth Companions team in the first phase of this framework. The evaluation will focus specifically on how the co-design process has been experienced by those involved, including understanding what has helped or hindered meaningful participation and shared learning.
I am also working alongside the three ‘test and learn’ sites to draw together insights from their experience of implementing the Framework in their local areas. This will help shape the next phase of the framework development and support wider national engagement.
For me personally this work feels especially important because it's rooted in the belief that better systems are possible when they're shaped by lived experience and practice knowledge, underpinned by robust research. The shared commitment to improve support and compassionate care for pregnant women, babies and their families demonstrated by participants throughout the co-design phase has been inspiring and I’m looking forward to this next stage of work.
