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What do service users want and who cares?

02 August 2015
4 min read
Volume 23 · Issue 8


The NHS Constitution (Department of Health (DH), 2013a) sets out the principles and values of the NHS in England: care should be planned and provided in partnership with service users and their families and this patient-focused approach should be of a consistently high quality with respect, dignity, compassion and care as core values.

The newly updated Code (Nursing and Midwifery Council (NMC), 2015) concurs with this philosophy by stating the interests of service users must come first by ensuring their privacy, dignity and confidentiality are preserved and their needs are recognised, assessed and met. Furthermore, the introduction of revalidation (NMC, 2015) to replace the post-registration education and practice (Prep) standards (NMC, 2011) includes the requirement for midwives to demonstrate to the NMC on a regular basis that they continue to remain fit to practise. This will, in part, be evidenced by written reflective accounts, based on the requirements of the Code, using feedback from service users, patients, relatives, colleagues and others (NMC, 2015).

This article will provide a definition of a service user in the context of maternity services and outline current policy and professional body requirements in relation to service user involvement in care. It will assess the literature with regards to service user expectations of ‘a good midwife’ and the Friends and Family Test (FFT) (NHS England, 2015) to consider the relationship between policy, practice and service user experiences and expectations.

The word midwife originates from Middle English: probably from the obsolete preposition mid meaning ‘with’ and wife in the archaic sense of meaning ‘woman’ (Oxford Dictionaries, 2015). The current International Confederation of Midwives (ICM) (2011) definition concurs, stating that the midwife ‘works in partnership with women’. Therefore, the idea of the midwife working with women is not new; however, the expectation of women being equal partners in the decision-making process about their care has become a priority in recent government policy and professional regulation.

There is no one definition of a healthcare service user. The Health Professions Council's (HPC) definition is (Chambers and Hickey, 2012: 5):

‘Those who typically use or are affected by the services of registrants once they qualify from programmes and become registered (e.g. patients, clients, carers, organisational clients, colleagues e.t.c.)’

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