Unwarranted variation in the provision of midwifery care

There are a number of examples of unwarranted variation in healthcare, both in the UK and globally. Unwarranted variation has the potential to divert resources to areas where they are uncalled for, and is a source of concern, as it suggests that the care women are receiving may depend upon where they live. It also implies that NHS resources are not being used in the most efficient way (Royal College of Obstetricians and Gynaecologists, 2016).

The term ‘postcode lottery’ is often used in the UK to describe unwarranted variation, and midwives are aware of these often unjust variations in care provision. Some variation in care is normal and to be expected; yet, there is much that is ‘unwarranted’ and cannot be explained, justified or even defended. Identifying the variation in care settings can provide opportunities for improvement. As the NHS continues to face challenges, understanding where variation in care and outcomes occurs, and what this variation means, is needed more than ever if the quality and safety of maternity services and the experience of mothers are to be improved (National Maternity and Perinatal Audit, 2017).