The NHS Community Midwifery Model is about choice. Under the proposed system midwives can choose either to be self-employed, and contracted by the NHS on a case by case
basis, or to be employed by the NHS but still paid per woman. This will run alongside the existing model of care. Midwives who don't wish to
switch to the new system can choose to stay working for the NHS under the current
shift system.
The beauty of having the NHS Community Midwifery Model in place would mean that each midwife in the UK would have it as an option at any point of her career that was right for her personal circumstances.
SHE would make the choice of when. If choosing to do so with small children then she would determine who she worked with, how many women she would take on and when they were due.
For example taking a small caseload of say 5 women a year who were all due in say a 6-8 week period would mean child care for the 24 hour period would be condensed with perhaps an au pair for this period, or when extended family support was available. Antenatal and post natal visits would
be arranged at a mutually convenient time. It might even be possible to
team up with another single parent midwife and cover each others childcare.
If more work was needed this pattern could be repeated twice a year. Of course there will be the occasion when there is a premature labour or an emergency earlier in the pregnancy
however, due to the small caseload these events only happen rarely and you will never
be called to come and staff a busy labour ward.
It is proposed that the NHS Community Midwifery Model would have its own funding stream and as seen
in our diagram (click here), a set sum per women would be paid to the NHSLA
to provide indemnity cover.
Under the NHS Community Midwifery Model the named midwife would work in a similar way to that in which independent midwives work now, planning their own holidays and therefore being able to inform clients when they are available. Some midwives
might work in pairs to enable on call cover for weekends etc but the named
midwife would usually plan her/his free time around their clients.
In practices where the model works, midwives may work 9 months of the year and have 3 months off (not necessarily in succession). It is all about flexible working for midwives and continuity for women. The midwives on call in this model
would only be on call for THEIR clients meaning that they would not be pulled into the hospital etc. If they
had 2-3 women a month due to give birth maximum, the midwife would probably still be called out less than if she were working as a community midwife in the current system.
The NHS Community Midwifery Model will benefit all women, not just those who
wish to have their babies at home. All women will receive the same model
of care, wherever they wish to have their babies. The only difference will be
the place of birth.
Under the NHS Community Midwifery Model women will have access to all appropriate screening, (laboratory and ultrasound facilities) and access to birth
centres, maternity units and obstetric and peadiatric services with their chosen midwife. The
model is about the 'midwifery aspect' of their 'maternity care' and in choosing this model of care, women would not give up
any entitlement to access other NHS services if necessary. For many women with uncomplicated pregnancies midwifery care will be all they require. For
others with more complex needs, the midwife will be a part of the interdisciplinary team and provide the ongoing continuity and support that
helps improve outcomes for the woman and her baby.
Take a look at our More
Information pages for answers to other queries you may have
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