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GPs go forth

Universal six-week postnatal check for new mothers confirmed in GP contract

GP practices will be required to provide a postnatal check to all new mothers between six and eight weeks after they have given birth, under new contract changes.

A total of £12 million of additional funding will be provided through the global sum to ensure all mothers receive the check - which is in addition to the GP appointment all babies receive at six to eight weeks.

NICE guidance recommeds a check for new mothers at this point to ‘ensure that the woman's physical, emotional and social wellbeing is reviewed’.

In the updated 2020/21 contract for GPs, revealed last week, NHS England and the BMA said the existing GP contract only funds checks for a newborn infant physical examination at six weeks, but there is no specific contractual requirement for practices to review the mother’s health.

It added: 'Recent research suggests that many practices already offer a postnatal check for new mothers, but not all. We want to make this a consistent offer for all mothers.'

The agreed contract changes mean from 2020/21:

  • All practices will be required to deliver a maternal check at six to eight weeks after birth (live and stillbirth), as an additional appointment to that for the six- to eight-week baby check 
  • The 'maternity medical services' additional service will become an essential service
  • The 'child health surveillance' additional service will also become an essential service
  • The contract’s current definition of the 'postnatal period' will be revised from two to eight weeks, to bring it in line with NICE guidance on best practice, along with the needs of women following birth

In line with NICE guidance, the maternal check should focus on:

  • A review of the mother’s mental health and general wellbeing, using open questioning
  • The return to physical health following childbirth, and early identification of pelvic health issues
  • Family planning and contraception options
  • Any conditions that existed before or arise during pregnancy that require on-going management, such as gestational diabetes

Last year the RCGP called for a six-week check for new mothers to come into funding allocations, to ensure GPs have time to check both the baby and mother's health. 

Kent GP Dr Stephanie deGiorgio, who has campaigned for the change, told Pulse: ‘I am delighted that the importance of maternal postnatal care is finally being understood by the Government and NHS England.

‘Funding maternal checks will give practices the freedom to do them in the way that works best for their patient cohort, and we will be providing a guidance template to ensure that it is a proper "top to toe" check of both the mental and physical health of the woman.

‘It will also be the start of a conversation, so that the woman knows she can access help for any problems that may develop later.’

Readers' comments (10)

  • Who is not doing this already?

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  • Hmm £16 per apt then. We are clearly a highly valued profession.

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  • National Hopeless Service

    Dr de Giorgio who has campaigned about GP workload is pleased that we are going to continue doing something that has absolutely no proven value? I am happy to do things of clinical proven value but I am fed up of doing 'nice' 'friendly' things in my 10-12 hour days.

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  • its a 30 min appt to do properly so should be paid at £150 a go. otherwise its a waste of my time. could be done by the practice nurse for contraception, midwife or HV for mood and social aspects and 6 weeks checks for babies are done by paediatricians in other countries.

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  • Bob Hodges

    'No proven value' is technically called 'General Practice' if you're going to be pedantic. How do you 'prove' the value of a maternal post natal check anyway.

    Its stands to reason its a good thing, not least if it gives the opportunity to explain to a new first time mum how to access GP services if they have concerns (i.e. PLEASE don't call 111 if we're open) about their baby. A lot of people don't have much support and are vulnerable. Remeving some unwarranted anxieties about accessing health services before they happen is a good thing.

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  • National Hopeless Service

    There was discussion about this over a year ago so I did a retrospective review of 12 months of 8 week post natal check. All physical and mental pathology of both mum and babe had been picked up before 8 weeks through midwife, health visitor contact and prior GP appointments.

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  • doctordog.

    Is this evidence based?
    I can’t be bothered to look as I think virtually everyone does it anyway.

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  • Bob Hodges

    It doesn't have to have 'evidence' - it's a good opportunity to start/renew a longitudinal relationship with a patient (and their baby) from a 'customer service' point of view (we ARE businesses whether you like or not and complaints cost you a lot of time/money and are less likely to come from happy patients):

    1) Explain how to access care in a an appropriate manner i.e. We see babies on triage come what may - reassure Mum.

    2) Feeding concerns - expalin about the colic the baby is about to start getting if they haven't already and explainhow to manage it. Might prevent calls/aggro in the next few weeks. NO IT ISN'T CMPA!! Stop reading Mumsnet!!

    3) Gestational diabetes? That has a HUGE improtance for ongoing maternal heath and chronic/metabolic disease (prevention IS possible with lower carb lifestyles etc).

    4) Post natal depression is NOT always picked up by 6 weeks by any stretch of the imagination.

    Use your imagination.....

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  • Healthcare policy driven by politics not evidence.

    We stopped in 2004 and found something useful to do with the time.

    The same airheads who regard this as a triumph will think £16 very generous.

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  • I never knew post natal checks are not in GMS contract

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