Supply and demand of the consultant midwife
Over the past few decades advanced practitioner posts have emerged in the USA, Australia, Canada, New Zealand, Ireland and the UK. In the UK, consultant nurse and midwife posts were first introduced in 1998 at The Labour Party Conference by the then newly elected Prime Minister Tony Blair (Byrom et al, 2009). Despite advanced practice roles becoming a global phenomenon, a number of different definitions for ‘advanced practice’ have emerged from professional bodies (Sookhoo and Butler, 1999). Many of these definitions have led multiprofessionals to view advanced practice as predominantly a nursing issue rather than as a multiprofessional concept, which affects the whole of healthcare.
Perhaps one of the strongest arguments for defining advanced clinical practice in midwifery can be best explained with the example of the consultant midwife. When the consultant post was first introduced in the UK in 2000, there were not enough candidates who had the required level of professional development to undertake the role (Rogers, 2010). This under-fulfillment of consultant post holders demonstrates that advanced practice roles cannot work if an organisation has not prepared for the role, or if the post holder is not fully prepared for it (Rogers, 2010). There have been a number of studies that have considered the positive impact of consultant roles on health service provision, evidence-based practice and holistic individualised woman-centred care (Coster et al, 2006; Humphrey et al, 2007; Rogers, 2010). In a study by Coster et al (2006) the majority of midwife consultants (80%) believed they had a positive impact on making services more client focused.
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