6. CORE-R: Recognising the importance of Access and Inclusion

The R in CORE reminds us to recognise the importance of Access and Inclusion.

Let’s consider four main factors that may affect women's ability to engage with digital clinical consultations:

Firstly, her own personal characteristics and needs (for example, does she speak sufficient English? does she have any other communication challenges? being hard of hearing? or neuro-diverse?).

Secondly, is she confident and knowledgeable about navigating NHS systems? Is she aware of how to seek advice?

Thirdly, does she have access to digital resources (e.g., internet, mobile data, personal phone); and

Fourthly, does she live in an environment where she is able to talk openly and privately about her concerns and needs?

Our next scenario involves a pregnant woman in a busy home environment.

A key principle of maternity care is that it needs to be safe, inclusive and accessible.

This woman has gestational diabetes with stable levels of blood glucose on home testing. You have suggested to this woman, that your next consultation is via a phone call. In the meantime, you have told her to call the maternity unit if she has any concerns.

An illustraion of a Wise owl who will help guide learning.

What are the factors you need to consider to make sure that this is an appropriate and safe course of action?

There will be situations where maternity care providers will need to consider carefully whether they can continue with the consultation.

Sometimes a discussion about re-scheduling may be appropriate but it will not always be possible to proceed with the consultation, if the woman’s situation does not support this.

Activity

Drag any potential factors that you think could impact on maternity care to help reduce the risks displayed in the home environment image. (Only correct selections will change the image.)

Keyboard users can tab to the items and use the directional keys and the space bar to make a selection. Then select "Factor Items" in the same way, finally checking your choice through the "Check Selection" button which appears along with a feedback/answer box below.

Child playing with dog:	The child playing with dog could be potentially distracting if mother is concentrating on an online meeting
Curious friend:	The presence of a curious friend during an online consultation could raise potential safeguarding concerns, as they may inadvertently overhear or gain access to sensitive information, compromising the confidentiality of the session.
High noise levels:	High noise levels from children playing inside the flat and everyday noises outside can significantly disrupt an online consultation, making it challenging for both the healthcare provider and patient to hear and concentrate on the conversation.
Low or no funds in electricity meter:	The lack of funds for the electricity pay meter could disrupt the meeting by causing an unexpected power outage, leading to delays and potential interruptions.
Poor Internet/WIFI Connection:	A poor internet connection can hinder the quality of an online consultation by causing video and audio lags, making it difficult to effectively communicate and share important medical information and advice.