Innovation in practice One-to-One midwives were the first organisation commissioned to provided midwifery care outside of an NHS trust in August 2010 and the first maternity services to become CQC registered and obtain NHS LA insurance.
Description of innovation A social enterprise, grounded in a philosophy of women being at the centre of their care and a woman’s right to self-determination. An organisational model based on evidence, conceptualised and led by experienced, passionate midwives with outstanding outcomes for women.
Discussion Since being commissioned over 10,000 women have received midwifery and shared care in a continuity model. Continuity of midwifery carer shows improved health outcomes and experiences for women (Sandall et al 2016) and cost effectiveness (Tracy et al 2013) when care is focused on women and her community. This is also the evidenced informed basis for maternity care services as outlined by government directives and women’s needs (NHS England 2016). Yet, wide scale implementation of continuity of carer has not been implemented, potentially due to the organisation of maternity services within the framework of an NHS trust (Jervis 2016) and maternity care organised on a commercial model rather than on relationships (Kirkham 2017).
The model of care is provided within a framework that is based in evidence, supportive, united and multidisciplinary (Wainwright & Collins 2015) and based on a social model of care in which women and midwives relationship is central. This has involved challenging accepted norms of service implementation as regulators, commissioners, inspectors and local acute trusts are unfamiliar with this. Additionally, the clash of culture and model is evident when midwives and women interact with the multidisciplinary teams at local Trusts (Wainwright & Collins 2015).
Conclusion Continuity of midwifery care can be implemented on a large scale, it provides midwives with job satisfaction and women with positive outcomes. However, more work is needed on relationships and understanding with other agencies when providing care which is centred around women.
Preferred presentation mode Oral
References
Jervis, B., 2016. Continuity within the NHS: it can and does happen, but why not for everyone? Part one—a macro level analysis. MIDIRS Midwifery Digest, 26(3), pp.297-303.
Kirkham, M., 2017. A Fundamental Contradiction: the business model does not fit midwifery values. Midwifery Matters, Spring
NHS England (2016). Better births: improving outcomes of maternity services in England. A Five Year Forward View for maternity care. https://www.england.nhs.uk/wp-... uploads/2016/02/national-maternity-review-report.pdf [Accessed 14 June 2016].
Sandall, J., Coxon, K., Mackintosh, N., Rayment-Jones, H., Locock, L., Page, L., Relationships: the pathway to safe, high-quality maternity care. Sheila Kitzinger symposium at Green Templeton College, Oxford: summary report. Oxford. Green Templeton College. http://www.gtc.ox.ac.uk/ images/stories/academic/skp_report.pdf [Accessed 14 June 2016].
Tracy, S.K., Hartz, D.L., Tracy, M.B., Allen, J., Forti, A., Hall, B., White, J., Lainchbury, A., Stapleton, H., Beckmann, M. and Bisits, A., 2013. Caseload midwifery care versus standard maternity care for women of any risk: M@ NGO, a randomised controlled trial. The Lancet, 382(9906), pp.1723-1732.
Wainwright, K. and Collins, M., 2015. Caseloading midwifery—an ever evolving model of care? MIDIRS Midwifery Digest, 25(2), pp.186-189.
Studies of and contributions to practice and/or service organisation
