Implement midwife as named caseload holder for healthy women antenatal, intrapartum, postnatal | Board implementation groups to progress locally, considering optimum midwife managed care programme to deliver Guidance: Normally the midwife would be lead professional, with caseload responsibility for healthy women experiencing uncomplicated pregnancies, throughout the antenatal, intrapartum and postnatal periods.1,2,3 Where the midwife is caseload holder, the midwife would be named as such on SWHMR and would have professional accountability for the case, as outlined in the relevant Nursing and Midwifery Council regulations.5,6 This would be explicit in Board SMR returns to ISD. Women with more complex needs would have obstetric led care, delivered by the wider maternity team, including midwives, throughout these periods.1,2,3 Within this team, neonatologists would have initial responsibility for medical care of the ill baby. Where the obstetrician is caseload holder, the obstetrician would be named as such on SWHMR and would have professional accountability for the case. This would be | December 2008 | NHS Boards | Local work ongoing to engage stakeholders and address records coding | Green | |
| explicit in Board SMR returns to ISD. It is expected that women will transfer between midwife led and maternity team care as risk alters.1,2,3,4 However, it is anticipated that women may continue to have choice in relation to the caseload holder. GPs have ongoing responsibility for the woman's medical care throughout pregnancy and post birth, including responsibility for the baby's ongoing medical care as required. Care of healthy mothers and babies normally transfers to the health visitor anytime from day 10 postnatal and they have responsibility for the ongoing care of healthy children until school age. | December 2008 | NHS Boards | | | |
Discontinuation of admission CTG for healthy women suitable for midwife managed care | NHS Boards to progress, while awaiting nationally agreed normal birth pathway Guidance: It is expected that healthy women, presenting in labour with uncomplicated pregnancies, will not routinely have an admission CTG. | August 2008 | NHS Boards | Already current practice in most areas | Green | |