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The Together Project: supporting the delivery of good practice in maternity services for parents with learning disabilities

Start date

September 2019

End date



Despite directives to improve maternity care in general and to improve care for parents with learning disabilities, the maternity experience of parents with learning disabilities is often poor and lacking reasonable adjustments to care.

In response, the Together Project, led by the University of Surrey, brings together parents with learning disabilities, researchers, and health and social care professionals to develop resources to support the workforce in delivering good maternity care to parents with learning disabilities.

The Together Project is funded by Health Education England and the National Institute for Health and Care Research.

Co-producing the Together Project Toolkit and the Maternity Passport

A research team at the University of Surrey conducted interviews with key stakeholders (health and social care professionals, parents with learning disabilities and their informal supporters/carers) to understand views of best practice and to inform resource development. Working together, they co-produced two resources:

  1. The Together Toolkit for professionals working in maternity services, to support the delivery of good care for people with learning disabilities during their pregnancy.
  2. A Maternity Passport to be held by people with learning disabilities who are pregnant and to include the relevant information needed by the professionals who support them.

Find out more: Supporting the delivery of good maternity care for parents with learning disabilities



Scott Watkins

Scott Watkins

Expert by experience


Darya Tobutt

Darya Tobutt


Advisors and collaborators (across all phases)

Harman Admane

Public Health Lead LD & Autism, Public Health Team, Surrey County Council

Sarah-Jayne Ambler

Clinical Research Manager in Midwifery, Medway NHS Foundation Trust

Carys Banks profile image

Dr Carys Banks

NIHR Research Fellow

Jim Blair

Jim Blair

Independent Consultant Nurse Learning Disabilities and Associate Professor (Hon) Learning Disabilities at Kingston and St George's Universities

Lauren Bowller

Autism and Learning Disabilities Nurse Specialist, Royal Surrey NHS Foundation Trust

Sharon Bunford

Named Midwife for Safeguarding Vulnerable Women and Babies, Professional Midwifery Advocate, Royal Surrey NHS Foundation Trust

Caroline Eynon

Lecturer Midwifery, School of Health Sciences, University of Surrey

Professor Ann Gallagher

Professor Ann Gallagher

Head of Nursing and Professor of Care Education, Ethics and Research - University of Exeter

Rebecca Greenacre profile image

Rebecca Greenacre

Lead Midwife for Education, Director of Studies, Teaching Fellow Midwifery

Helen Guest

Coproduction Programmes Manager, Active Prospects

Kathryn Hollins

Consultant Parent, Child & Family Psychiatrist & Psychotherapist, Surrey and Borders Partnership NHS Foundation Trust

Amy Hykin

Student Midwife, University of Surrey

Ali Jabeen

Operations Manager Elfrida Society Parent’s Project

Isabel Jameson

Midwife, University Hospital Southampton NHS Foundation Trust

Professor Sally Kendall

Professor of Community Nursing and Public Health Centre for Health Services studies, University of Kent

Rowan March

Student Midwife, University of Surrey

George Matuska

Learning Disability and Autism Lead, Kent and Medway NHS and Social Care Partnership Trust

Lindsay Meadows

Specialized family carer advocate, Mencap

Gaynor Morrison

Safeguarding Midwife, Royal Surrey NHS Foundation Trust

Fiona Piddington

Programme Manager, LD and Autism, programme Manager for South East, Health Education England

Polly Strauss

Midwife, University Hospitals Sussex NHS Foundation Trust

Cath Taylor profile image

Professor Cath Taylor

Professor of Healthcare Workforce Organisation and Wellbeing

Dr Kate Theodore

Clinical Psychologist and Senior Lecturer, Royal Holloway University of London

Jade Vallance

Jade Vallance

Director of Care, Active Prospects

Danielle Wallace

Research/Fetal Medicine Midwife, Medway NHS Foundation Trust

Vicki Ward

Learning Disabilities and Autism Nurse for Children & Young People, Royal Surrey NHS Foundation Trust

Mariam Watling

Public Health Lead – LD & Autism, Public Health Team, Surrey County Council

Liz Williams

Joint Strategic Commissioning Convener- Learning Disability and Autism and all age Mental Health, Joint Strategic Commissioning Unit Surrey Heartlands ICS & Surrey County Council

Elfrida Society Logo

Parents with learning disabilities

Working with Elfrida Society Parent’s Project

Active Prospects logo

Experts with lived experience of learning disability

Working with the Coproduction team at Active Prospects


Midwifery journal article

Read article


The Together Project Toolkit and guidelines

In this toolkit, we focus on three elements of practice essential to delivering good maternity care to parents with learning disabilities:

  1. Identifying need
  2. Preparing for parenthood
  3. Supporting the journey to baby and beyond.

For each of these three elements of practice, we will provide a practice discussion followed by actions for you to complete and questions for you to reflect on and discuss with colleagues. At the end of the toolkit there are useful resources or ‘tools’ to support you in delivering good care for parents with learning disabilities.

Maternity Passport

The Together Project produced a Maternity Passport to be completed with and held by parents. This will support personalised preparation for parenthood and enable consistent and individualised information sharing with professionals, family and friends.

The Maternity Passport seeks to support inter-professional collaboration by enabling each professional to see who else is involved in parents’ support circle and to understand what has, or has not, been discussed with them. The Maternity Passport can also support identification of gaps in support to alert professionals to necessary referrals.

The Together Project educational film

In this film, experts (by profession or by experience) highlight seven essential elements to recognising and supporting parents with learning disabilities:

  1. Increase learning disability awareness
  2. Adopt a positive mindset
  3. Build trust
  4. Respectfully ascertain need
  5. Reach out for specialist support
  6. Consider advocacy needs
  7. Make reasonable adjustments.

How to access the resources

The Together Project resources are free to use but we ask you to have regard to the following conditions of their use:

  1. Do not distribute these resources to anyone else – if anyone asks for a copy please direct them to this web page so they can download them
  2. If you use these resources or any part of them, we would be grateful if you would please:
    1. Acknowledge the authorship team
    2. Send copies of any reports/papers that are produced to Dr Anna Cox (
    3. Let us have any comments/suggestions that you feel might improve these resources so that your experience can be incorporated into subsequent updates.

Download the Together Project resources


  1. Mencap. (2020). Learning disability explained
  2. Best Beginnings website
  3. National Maternity Review (2016) Better Births Improving outcomes of maternity services in England. A Five Year Forward View for maternity care London: NHS England
  4. Beake, S., Clark, L. L., Turner, T., & Bick, D. (2013). A mixed methods study to develop and pilot a competency assessment tool to support midwifery care of women with intellectual disabilities. Nurse Education Today, 33(8), 901-906. doi:10.1016/j.nedt.2012.08.007
  5. Working Together with Parents Network update of the DoH/DfES Good practice guidance on working with parents with a learning disability (2007) - Social Care Online (

Research themes

Find out more about our research at Surrey: