Abstract
Background
Current UK health policy recommends the transition of maternity services towards provision
of Midwifery Continuity of Carer (MCoCer) models. Quality of healthcare is correlated
with the quality of leadership and management yet there is little evidence available
to identify what is required from midwifery managers when implementing and sustaining
MCoCer.
Aim
To develop a theoretical framework that represents midwifery managers’ experiences
of implementing and sustaining MCoCer models within the UK’s National Health Service
(NHS).
Methods
Charmaz’s grounded theory approach was used for this study. Five experienced UK based
midwifery managers were interviewed to elicit views and understanding of the social
processes underlying the implementation and sustaining of MCoCer. Interviews were
transcribed and analysed and focus codes developed into theoretical codes resulting
in an emergent core category.
Findings
The theoretical framework illustrates the core category ‘Leading Meaningful Midwifery’.
To manage MCoCer models midwifery managers require a trust and belief in woman centred
philosophy of care. They need the skills to focus on non-hierarchical transformational
leadership and the courage to assimilate alternative models of care into the NHS.
Promoting and protecting the MCoCer model within current services is essential whilst
forming a culture based on high quality, safe MCoCer.
Discussion
MCoCer models that have sustained within the NHS have had supportive leadership from
midwifery managers who have the necessary skills, attitudes, aptitudes and behaviours
identified within the findings. Sustainable implementation of MCoCer is achieved through
development of a values-based recruitment and retention policy within all areas of
midwifery and encouraging midwives with previous experience in MCoCer or supportive
philosophies towards it, to manage the model.
Conclusion
Providing the appropriate support for MCoCer is time consuming and personally demanding
for midwifery managers, however, implementing and sustaining MCoCer was shown by participants
who valued MCoCer models to be rewarding, bringing meaning to their midwifery leadership.
Keywords
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Article info
Publication history
Published online: November 20, 2021
Accepted:
October 23,
2021
Received in revised form:
October 23,
2021
Received:
March 4,
2021
Identification
Copyright
© 2021 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
