“There is compelling evidence that ongoing supportive relationships between women and their maternity care provider improves health outcomes for women and babies, and women’s experience of care.”
(Sheila Kitzinger Symposium, 2015)
The Templeton report is based on the work carried out at the Sheila Kitzinger Symposium on relational continuity of care in maternity. The purpose of the Sheila Kitzinger Symposium, held at Green Templeton College in 2015, was to explore relational continuity within maternity services in the UK. The symposium comprised health professionals, leaders, service user representatives and academics. Using current research and examples from the UK, the report emphasises the benefits and potential barriers with recommendations for future research.
No. of pages: 39
A few of the key areas in the report are highlighted below.
Continuity of Care Models
Relational continuity refers to a supportive relationship between a woman and her maternity care provider. Aspects of this include:
· Providing relational continuity through a case loading or small team model
· Models can be community or hospital based
· Provision of care can include low and high risk women.
The main emphasis is that a woman’s care is provided by a single midwife who sees her consistently during pregnancy and is her main point of contact. The midwife should be supported by the wider multi disciplinary team.
Benefits to women and babies include improved health outcomes and increased satisfaction with care. More limited research has shown potential benefits to midwives of working within this model. There is some indication that these models are cost neutral although implementation would involve an initial financial outlay.
Barriers include lack of local support, inter-professional tension and midwives not wanting to work within the model due to financial or time management concerns. The report details how to address this through good inter-professional communication and engagement and addressing midwives fears regarding working within these models
Implementation and Scale up
A clear implementation strategy necessitates regional and system wide leadership. Monitoring and evaluation is required, with incentives and flexibility offered to those working in the model. An initial small scale implementation can provide proof of concept leading to scale up of the service that should be sustainable and acceptable to providers.
The report identified:
· Need for systematic reviews of range of interventions and outcomes
· Cost-effectiveness studies
· Research on how to implement and scale up services
· Research into staff experience of working in continuity models.