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New midwifery staffing models to be tested locally

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Local regions in England are being encouraged to apply to test new approaches to maternity services including a workforce model that would see small groups of midwives share caseloads to ensure continuity of care.

Following a major national review of maternity services earlier this year, NHS England is looking for early adopter sites to pilot the review’s recommendations, which includes the new workforce model.

It has identified nine areas of work to take forward recommendations of the review report – called Better Births – of which sites will be expected to test a combination.

“I will be continuing to argue for more midwives”

Cathy Warwick


These include supporting local transformation by establishing new systems and local community hubs for women to access multiple maternity services through, promoting good practice for safer care, and improving access to perinatal mental health services.

Other areas are transforming the workforce, increasing choice of care for women, reforming the payment system, and improving prevention, according to the group leading the work, called the maternity transformation programme.

Sharing data and information – through helping to identify a set of indicators to benchmark quality – and harnessing technology by, for example, helping to develop a digital maternity tool which allows women to access their own health records are other areas of work that will take place.

One of the key recommendations of the review was the new staffing model that would see four to six midwives in the community take responsibility for a caseload between them to ensure women are cared for by professionals they know.

The review suggested one midwife would take the lead, that an identified obstetrician would work with the group and a caseload of around 30 to 40 births per midwife should be expected.

“We are resolute in our determination to implement this vision and move forward at pace”

Sarah-Jane Marsh

But to deliver the new staffing structure across England, the review concluded a “significant increase in the midwifery workforce is not required”.

Royal College of Midwives chief executive Cathy Warwick, who is a member of the programme board for testing the recommendations, said the work already done was “encouraging” but that more midwives were needed.

“I will be continuing to argue for more midwives whilst also highlighting the importance of ensuring that the workforce is able to work in the most effective way.

“Continuity of carer, ensuring that women see the same midwife or group of midwives, is critical to achieving that,’ she said.

Programme board chair Sarah-Jane Marsh said: “Better Births has given us a powerful blueprint for how we can now move towards safer, more personalised maternity services in England for each and every woman and baby that relies on us.’

“We are resolute in our determination to implement this vision and move forward at pace.

“We have already identified seven parts of the country that will pioneer choice and personalisation, and are now calling on more local areas to play a vital role in delivering the ambition by testing new approaches to maternity services across the country,” she added.

Expressions of interest should be submitted to the maternity transformation programme team by 19 September.

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