Chitongo S, Pezaro S, Fyle J, Suthers F, Allan H Midwives’ insights in relation to the common barriers in providing effective perinatal care to women from ethnic minority groups with ‘high risk’ pregnancies: A qualitative study. Women Birth. 2022; 35:(2)152-159

Corrigan AE, Lake S, McInnes RJ Normalisation process theory as a conceptual framework for continuity of carer implementation. Women Birth. 2021; 34:(2)e204-e209

Maternity high impact area: reducing the inequality of outcomes for women from black, Asian and minority ethnic (BAME) communities and their babies. 2020. (accessed 21 November 2021)

Jepsen I, Mark E, Nöhr EA, Foureur M, Sörensen EE A qualitative study of how caseload midwifery is constituted and experienced by Danish midwives. Midwifery. 2016; 36:61-69

Kapur N The NHS long term plan. Sushruta J Health Policy Opinions. 2020; 12:(1)10-11

Lang N, Jose S, Rogers A, Maric H, Lyon V, Nightingale P Better births: early findings from north-west London. Br J Midwifery. 2019; 27:(9)555-561

McInnes RJ, Aitken-Arbuckle A, Lake S, Martin CH, MacArthur J Implementing continuity of midwife carer-just a friendly face? A realist evaluation. BMC Health Services Res. 2020; 20:(1)1-15

National Maternity Review. 2016. (accessed 21 November 2021)

NHS Employers. NHS terms and conditions of service handbook. Handbook amendment number 48. 2022. (accessed 16 August 2022)

NHS Institute for Innovation and Improvement. 2018. (accessed 21 November 2021)

Newton MS, McLachlan HL, Forster DA, Willis KF Understanding the ‘work’ of caseload midwives: a mixed-methods exploration of two caseload midwifery models in Victoria, Australia. Women Birth. 2016; 29:(3)223-233

North London Partners Local Maternity Service. 2019. (accessed 21 November 2021)

Midwife-led continuity models versus other models of care for childbearing women. 2016.

Symon A, McFadden A, White M, Fraser K, Cummins A Adapting the quality maternal and newborn care (QMNC) framework to evaluate models of antenatal care: a pilot study. PLoS One. 2018; 13:(8)

Vasilevski V, Sweet L, Smith L, Dell M Part-time positions in caseload midwifery group practice: impact on satisfaction and quality of care. Women Birth. 2021; 34:(6)e567-e574

A midwifery team's journey implementing and sustaining continuity of care

02 September 2022
16 min read
Volume 30 · Issue 9


The continuity of carer model of care for midwifery is set to roll out exponentially. However, setting up and sustaining midwifery teams primed to deliver this model is a new process for many healthcare professionals. In this article, a case study is presented of a continuity of carer team set up in London to enhance the quality of midwifery care. Reflections on the associated challenges, learning, recommendations and sustainability are shared to assist others embarking on similar journeys. During its first 2 years, the team was able to achieve high levels of continuity and were able to consistently meet set targets. Quality improvement strategies were embedded throughout. Challenges, including data collection techniques and poor communication, were also explored. Improved communication, safe staffing levels, continuous evaluation, shared learning and co-creation will be essential in future quality improvement activities in this area.

Better Births (National Maternity Review, 2016) is a plan for transforming NHS maternity care in England into a safer and more personalised maternity system. The re-introduction of midwifery continuity of care (referred to as ‘continuity’ in this article) is an important part of making women's care personalised and increasing their safety. This will work alongside other components such as the maternity and neonatal safety improvement programme (NHS England, 2020a) and improved perinatal mental healthcare. The Department of Health's (2017) aim was for the majority of women in the UK to have access to continuity by 2021. This is significant, as continuity has the potential to improve outcomes for both mothers and babies (Sandall et al, 2016) and research indicates that midwives working in a continuity model can more effectively provide women with access to timely information (Symon et al, 2018). In order to reach targets set out by the North London Partners Local Maternity Service (2019), services in London have been organising various forms of continuity and many more continuity teams will be needed to sustain this style of midwifery in the future (Lang et al, 2019).

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