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Government bids to add postnatal checks to 2019/20 GP contract

GPs may become contractually obligated to carry out a six-week postnatal check for new mothers as part of next year's GP contract.

The Government has asked for such a check to be 'considered' as part of the negotiations for the 2019/20 GMS contract.

As it stands, GP practices can opt out of additional maternal and child health surveillance services, but this check does not form part of these.

It is also not part of core GMS services, and Pulse understands that placing the six-week check under either option could be negotiated for the 2019/20 contract.

Health minister Steve Brine revealed the news when responding to an MP question regarding the current contractual obligations to carry out health checks for new mothers and their babies.

The National Childbirth Trust (NCT) tells women that 'six to eight weeks after the birth of your baby, you should arrange for a postnatal check-up with your GP, unless you've been offered an appointment to return to the hospital or midwifery unit where you gave birth'.

It says the check is 'about making sure you're feeling well and recovering as expected after your pregnancy and birth experience' and is 'also an opportunity to introduce your baby to your GP'.

Responding to a question from Jim Shannon MP, the shadow DUP spokesperson for health, Mr Brine said: 'A six-week postnatal check for all mothers and a six to eight-week check for all babies are not currently specified in the General Medical Services contract as something which general practitioners are required to provide.

'However, we have asked for the six-week maternal postnatal check, as recommended by the National Childbirth Trust, to be considered in the general practice contract negotiations for 2019/20.'

BMA GP Committee chair Dr Richard Vautrey said: 'This has been raised by a number of groups recently. It is not part of the contract although some practices do invite women to attend a specific review whilst others do this more informally based on the needs of and requests from individual patients.'

He added: 'All I can say is that it is subject to current negotiations.' 

What NCT says should be included in the six-week postnatal check

Although the NCT charity points out that there 'are no UK-wide guidelines' for what should happen at a six-week check, it says that 'in general, it tells women that the following areas should be covered':

  • Your general wellbeing - how have the first few weeks been for you? Are you coping OK? Do you feel you need extra support? Tommy's, a charity that funds research into stillbirth, premature birth and miscarriage, has developed a Wellbeing Plan that could help you think about how you're feeling and what support you might need.
  • Your perineum - does it feel OK? Did you have any stitches and, if so, does it feel as if it has healed? You may be offered an examination to see if your stitches have healed and that all the muscles used during labour and delivery are returning to normal.
  • If you had a caesarean, has the scar healed well?
  • Your blood pressure will be checked.
  • Your lochia (the discharge you have after birth) - is it still there or not and how heavy is it? When might you start your period?
  • Changes to your body post-birth. You may be weighed and you can get weight loss advice if you want it.
  • Feeding – if you're breastfeeding, how's it going? Do you need any support? Do you have any symptoms you're not sure about?
  • Your bladder and bowels - are you comfortable and feeling back to normal?
  • Contraception should always be discussed at this check so find out what your options are. You can also discuss any concerns or questions you might have about sex.

Source: The National Childbirth Trust

Readers' comments (3)

  • This is exactly what we do. Mostly for contraceptive advice but we cover the other issues. Not all new mums take it up though. We always used to do a post natal visit and check the new babies too, and picked up some heart murmurs that had been missed or weren't present when the baby left the hospital. We don't have the capacity to do this now, but it does worry me that we may not pick up a problem at an early stage. It also worries me that the number of checks a child has between birth and school age have been very much reduced. It is a balancing act between trying to give the best service, and what we actually have the capacity to deliver.

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  • Although many practices do these checks, there should be an absolute ban on moving any more work in to the contract until the government hits the GP recruitment target.

    It just does not make any sense.

    They must realise that capacity is reached. Pushing one more thing in to the contract means the least measured thing gets worse care. It is often those things which are more important - like automatically booking a follow up appointment for someone getting prednisolone for asthma. Or booking a follow up visit for someone who has had a fall and postural drop in bp (after stopping a medication).

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  • All this in 10 minutes......

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