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All expectant mums to get continuity of carer by 2021

Midwives say plans must be backed with funding

Jo Carlowe

Friday, 22 December 2017

New guidance has been published to promote continuity of carer for maternity services.

NHS England’s Continuity of Carer guidance sets out two main models of approach to support the introduction of national targets, with the aim of introducing continuity of carer to all new mothers by 2020/21.

The two main models in the Implementing Better Births: Continuity of Carer guidance, are as follows:

  • Team continuity – where each woman has an individual midwife, who is responsible for co-ordinating her care, and who works in a team of four to eight, with members of the team acting as backup to each other.
  • Full case loading – where each midwife is allocated a certain number of women and arranges their working life around the needs of the caseload.

Nearly three quarters of women told the NHS how important it is for them to know and form a relationship with the professionals caring for them. Women have said that they see many midwives and doctors over the course of their pregnancy and birth, and that they do not always know who they are and what their role is.

For some women, this has led to confusion when navigating maternity services. Building a relationship or personal continuity over time has been found to improve outcomes and experience for both women and their babies.

Familiarity and trust is also found to be most beneficial for women with complex or specialist needs such as mental health conditions.

The guidance also highlights the importance of each team having an obstetrician that the midwife can call for advice and to plan obstetric care as appropriate.

Commenting, Gill Walton, CEO of the Royal College of Midwives, said: “This is a very positive step for women and for our maternity services. We know that continuity of carer delivers safer care and a better experience for women.

“At the moment we also know that many women are not getting continuity. This is why this document is so important as it sets out ways in which this can be achieved.

“Maternity services are, however, currently hard pressed and working hard to deliver the best possible service with often limited staffing and resources. Any change to the way that services are provided has to be realistic, stepwise and adequately resourced with the right number of midwives.”

She added: “Implementing continuity of carer across the maternity journey is a significant change in the ways of working for many midwives. Midwives are central to providing this service and they must be supported and engaged in any process of change, with appropriate education and preparation for changes in their roles.

“Implementing continuity of carer across the maternity journey for women will need adequate funding and resourcing. The government must factor in additional money for maternity services as this moves forward.”

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