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The IPA undertook a study on behalf of The Royal College of Midwives examining Innovation and Improvement in Maternity Services. They looked at examples of innovative practice from across the country, where midwives are leading on improving services for women and families and, crucially, generating savings.
At Nottingham University Hospital Trust which needed simultaneously to improve services and increase value for money ‘Productive Maternity’ – brought together a team of midwives and managers to map and redesign their work. They aimed to change culture – encouraging continuous improvement and helping staff take pride in their work. Partnership was vital. As the project was led by two midwives, it was better able to engage staff. But the support of senior management was also important in removing barriers and providing up-skilling where needed.
Midwives in Basildon and Thurrock recognised they could increase the quality of care by focusing their time where it was most needed – caring for women in labour. They did this by recruiting more Midwife Support Workers. Working with their local Strategic Health Authority, they developed a bespoke two-year apprenticeship course which trained people up for the role.
The South Central Strategic Health Authority identified the need for £12m in savings in maternity services. Their approach was to strengthen the existing maternity framework by bringing commissioners and providers closer together. They learnt that networks – when properly resourced and well-led – can be a powerful driver of innovation.
The case studies offer some lessons for the future of the NHS. Change works best when it’s led by the people on the ground. Midwives are best placed to understand their job, and the changes necessary to improve services. Midwife-led innovations are more likely to gain the support and buy-in of their colleagues. Sometimes they need help to fulfill this role, for example encouraging them to see innovation as part of their job and helping them to develop skills that might be lacking. But there can be little doubt; if you’re looking to improve midwifery services, don’t ask a consultant, a civil servant or a politician. Ask the people who will know. Ask the Midwives.
You can read the full report on the IPA website, www.ipa-involve.com.
