Improving maternal postnatal check uptake in General Practice using an opt-out equitable model of access

Are your postnatal patients falling through the gaps? Research indicates that up to 40% of women in England do not have a 6-week postnatal check recorded in primary care.

Dr Dhiviya Tharan discussed how a sustainable, 12-month Quality Improvement Project transformed service delivery using an equity-focussed “opt-out” model of access.

In this session, she demonstrated how to operationalise the principles of Proportionate Universalism, ensuring a universal maternal postnatal consultation offer while proactively removing barriers to access for the most vulnerable cohorts. She explored the theory of equitable access in postnatal care and how the delivery of postnatal care could be a critical intervention point for reducing health inequalities.

Principles for Equitable Postnatal Care In General Practice:

• Design for the hardest to reach – not the easiest to serve
• Proactive over reactive; opt-out over opt-in
• Protect postnatal appointments from displacement by competing demand
• Keep care rooted in General Practice – for continuity, safeguarding, and trust
• Recognise and name the hidden workload – make it visible

Take home questions for GPs:

• What proportion of eligible individuals in your practice receive a dedicated maternal postnatal check? Do you know?
• Who initiates the appointment – your practice or the patient?
• Who is delivering the check, and is the setup genuinely adequate for its purpose?
• Does your current access model reach younger, more deprived, or minoritised groups?
• What would it take to implement changes in your practice?

Useful Resources:

NHS England GP six to eight week maternal postnatal consultation – what good looks like guidance

NHS England Improving postnatal care: a toolkit for integrated care