Quality standard
Quality statement 3: Continuity of carer
Quality statement 3: Continuity of carer
Quality statement
Pregnant women have coordinated care from a small team of midwives. [2012, updated 2023]
Rationale
A small team of midwives (about 4 to 8 individuals), working with other healthcare professionals throughout pregnancy, can ensure that the needs of the pregnant woman and her baby are met. This team is the main point of contact, coordinating care and sharing information with one another and other healthcare professionals. This helps to ensure consistency of midwifery input and safer, more personalised and responsive maternity care. It should only be implemented if local maternity systems have identified they can fulfil safe minimum staffing requirements. Providing coordinated care during pregnancy supports the NHS national programme of continuity of carer.
Quality measures
The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly. Achievement will be dependent on the ability of local services to fulfil safe minimum staffing requirements.
Process
The proportion of pregnant women who received care from a small team of midwives throughout their pregnancy.
Numerator – The number in the denominator who received care from a small team of midwives throughout their pregnancy.
Denominator – The number of pregnant women.
Data source: Data can be collected from information recorded locally such as antenatal care records. NHS Digital's Maternity Services Data Set includes placement on the continuity of carer pathway and the NHS Digital Maternity Services dashboard shows monthly data on the proportion of women on continuity of carer pathways, including at trust level.
Outcome
The proportion of women who gave birth who said they saw or spoke to members of the same team of midwives at antenatal appointments.
Numerator – the number in the denominator who said they saw or spoke to members of the same team of midwives every time at antenatal appointments.
Denominator – the number of women who gave birth.
Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, from patient experience surveys. The annual Care Quality Commission Maternity Survey collects data about women's experiences of the continuity of their antenatal care, including: At your antenatal check-ups, did you see or speak to the same midwife every time?
What the quality statement means for different audiences
Service providers (maternity services) ensure that protocols and processes are in place for women and their babies to have access to a small team of midwives. Providers monitor staffing levels to ensure it is safe to implement. Providers ensure that systems are in place for information to be shared between healthcare professionals involved in the woman's care so that any concerns about her or her baby's health are recognised.
Healthcare professionals (midwives) working in a small team, are responsible for planning consistent, individualised care for a woman and her baby during pregnancy. They communicate and share information with other midwives in the team and with other healthcare professionals in a timely and effective manner, so that any concerns about the woman or baby's health are recognised.
Commissioners (integrated care systems) ensure that they commission services that give pregnant women access to a small team of midwives who ensure that consistent and individualised care is provided. Commissioners seek ongoing assurance that providers are monitoring staffing levels to ensure it is safe to implement. Commissioners ensure that systems are in place to enable information to be shared quickly and easily between and within services in the antenatal period.
Pregnant women have access to a small team of midwives who they can contact and who coordinate care for her and her baby (working with one another and other healthcare professionals).
Source guidance
Antenatal care. NICE guideline NG201 (2021), recommendation 1.1.12
Definitions of terms used in this quality statement
Small team of midwives
A midwifery team (about 4 to 8 individuals) that takes responsibility for ensuring that the needs of the woman and her baby are met. This involves being the main point of contact and coordinating her care. Through effective communication within the midwifery team and with other healthcare professionals, consistency of midwifery input is supported and any concerns about the woman or baby's health are recognised. [Adapted from NICE's guideline on antenatal care, terms used in this guideline and expert opinion]