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CASELOADMIDWIFERY  April 2005

CASELOADMIDWIFERY April 2005

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Subject:

Re: caseload midwifery meeting at ICM

From:

Vicki Van Wagner <[log in to unmask]>

Reply-To:

Caseload midwifery <[log in to unmask]>

Date:

Thu, 14 Apr 2005 10:57:14 -0400

Content-Type:

text/plain

Parts/Attachments:

Parts/Attachments

text/plain (622 lines)

I will be at ICM and very interested in this kind of a meeting.

Vicki

Vicki Van Wagner, RM, PhD(c)
[log in to unmask]
Associate Professor
Ryerson University
Ontario Midwifery Education Programme

----- Original Message -----
From: "Jo Alexander" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Thursday, April 14, 2005 10:09 AM
Subject: Re: caseload midwifery in Ontario


Hi Jane
I'd be interested in attending also.
Jo

________________________________

From: Caseload midwifery on behalf of Forrester, Mandy
Sent: Thu 14/04/2005 12:26
To: [log in to unmask]
Subject: Re: caseload midwifery in Ontario



Dear Jane,
I am a community manager working in Hampshire. I will be in Brisbane and
would like to meet to discuss midwifery led care.

Kind regards,
Mandy Forrester

        -----Original Message-----
        From:   Caseload midwifery [SMTP:[log in to unmask]]
On Behalf Of Jane sandall
        Sent:   05 April 2005 07:15
        To:     [log in to unmask]
        Subject:        Re: caseload midwifery in Ontario

        Dear colleagues
        We at King's College are at the beginning of an exciting project
where we
        have the opportunity to develop 3 commnity based caseloading group
practices
        within the NHS at Guys and St Thomas's hospital in London. The
project
        involves a clinical project co-ordinator who will lead the
implementation
        and support staff developmentand a feasibility evaluation looking at
the
        possibility of conducting an RCT once the practices are up and
running. We
        are developing  toolkits both for implementation and managing a
caseload and
        for the evaluation of a complex intervention. The project is led by
Lesley
        Page and myself and we are drawing on our previous experience of
work in
        this area. Some of these include the following publications which
may be
        useful to other people.

        I am involved in a Cochrane review of midwifery led care versus
other models
        of care but this work only includes trials and I am now in the
process of
        reviewing the literature in this area looking at sustainability for
the
        midwife, oeganisation and ddeelivery of care and effectiveness. I
would
        welcome people to post publications to the list both on the
implementation
        and evaluation.

        I wonder how many people are going to Brisbane and whether it would
be
        helpful to arrange a meeting for those of us working in this area?

        bw
        Jane Sandall


        Dr Jane Sandall
        Professor of Midwifery and Women's Health
        Women & Family Health Research Group,
        Health and Social Care Research Division
        King's College, Waterloo Bridge Wing,
        150 Stamford Street,
        London, SE1 9NH
        Tel: 020 7848 3605
        Fax: 020 7848 3764
        e-mail:[log in to unmask]
        http://www.kcl.ac.uk/nursing/research/women.html

        Publications

        Sandall,J. (2004) Questions and answers, caseload midwifery,
National
        Childbirth Trust Research Digest.

        Humphrey,C. Ehrich,K. Kelly,B. Sandall,J. Redfern,S. Morgan,M.
Guest,D.
        (2003) Human Resources Policies and Continuity of Care, Journal of
Health
        Organization and Management, Vol 17,2:102-121.

        Sandall,J. Bourgeault,I. W.Meijer. BA. Schuecking, (2001) Deciding
who
        cares: winners and losers in the late twentieth century, pp 117-138,
(Eds)
        Raymond DeVries, Cecilia Benoit, Edwin van Teijlingen, Sirpa Wrede,
Birth by
        Design: Pregnancy, maternity care and midwifery in North America and
Europe,
        Routledge.



        Sandall,J. (1998) Occupational burnout in midwives: new ways of
working and
        the relationship between organisational factors and psychological
health and
        wellbeing, Risk, Decision & Policy, 3, 3:213-232



        Sandall,J. (1997) Midwive's burnout and continuity of care, British
Journal
        of Midwifery, 5, 2:106-111.



        Sandall,J. (1996) Continuity of midwifery care in Britain: A new
        professional project, Gender, Work and Organisation, 3, 4:215-226.



        Sandall,J. (1995) Choice, Continuity and Control: Changing
Midwifery,
        towards a sociological perspective, Midwifery, 11:201-209.


        Sandall J. (1997) Planning an evaluation: bibliographic, financial
and human
        resources, pp125-141, in (Eds) R.Campbell, J.Garcia, The
organisation of
        maternity care: a guide to evaluation, Hochland and Hochland,
Cheshire.



        Garcia,J. Campbell,R. Sandall,J. Stevens,T.  (1997) Assessing the
impact on
        caregivers of changes in care, pp65-78, in (Eds) R.Campbell,
J.Garcia, The
        organisation of maternity care: A guide to evaluation, Hochland and
        Hochland, Cheshire.

        Sandall,J. (1999) Team midwifery and burnout in midwives in the UK:
        practical lessons from a national study, Original article, MIDIRS
Midwifery
        Digest, 9, 2:147-151.



        Sandall,J. (1998) The 'double shift' - motherhood and midwifery,
Editorial,
        British Journal of Midwifery, 6, 1:4-6.



        Sandall,J. (1997) Changing Childbirth: the impact of midwifery work
on
        midwives' lives, MIDIRS Midwifery Digest,7, 2:283-285.



        Sandall,J. (1997) Time to abandon team midwifery? Using evidence to
organise
        maternity care, MIDIRS Midwifery Digest,7, 2:285-286.



        Sandall,J. (1996) Moving towards caseload practice: what evidence do
we
        have? Editorial, British Journal of Midwifery, 4,12:620-621.



        Sandall,J. (1995) Editorial, Burnout and midwifery: an occupational
hazard?
        British Journal of Midwifery, 3, 5:246-248.



        Sandall,J. Davies,J. Warwick,C. (2001) Evaluation of the Albany
Midwifery
        Practice Final Report,

        Nightingale School of Nursing and Midwifery, King's College, London.



        Roth,C. Sandall,J. (2000) Evaluation of team midwifery in Tower
Hamlets,
        Department of Midwifery, City University, London.



        Sandall,J. (1998) Midwifery work, family life and well-being: a
study of
        occupational change, Unpublished Doctoral Thesis, Department of
Sociology,
        University of Surrey.


        Page LA, Jones B, Cooke P, Harding M, Stevens T, and Wilkins R
(1994)
        One-to-One Midwifery Practice British Journal of Midwifery
2(9):444-447



        Page LA (1995) One-to-One Midwifery Practice: A Vision Evaluated.
        Professional Care of Mother and Child 5(6):146-147



        McCourt C,  Page LA, Hewison, J, Vail, A (1998) Evaluation of
One-to-One
        Midwifery: Women's Responses to Care.   Birth 25(2):73-80



        Page L,  McCourt C, Beake S, Hewison J, Vail A (1999) Clinical
interventions
        and outcomes of One-to-One midwifery practice.  Journal of Public
Health
        Medicine 21(3):243-248



        Page LA, Beake S, Vail A, McCourt C, Hewison J (2001) Clinical
Outcomes of
        One-to-One Midwifery Practice.  British Journal of Midwifery.
9(11),700-706



        Page LA, (2003). One-to-One midwifery restoring the "with woman"
        relationship in midwifery. Journal of Midwifery and Women's
Health.48 (2).



        Page L, McCourt C (1996) Report on the Evaluation of One-to-One
Midwifery
        Practice. The Centre for Midwifery Practice, Thames Valley
University.



        Beake S, McCourt C, PageL,(2001) Evaluation of One-to-One Midwifery.
Second
        Cohort Study. The Hammersmith Hospitals NHS Trust and Thames Valley
        University.



        Page L (1995) Putting Principles into Practice. In: Page L (ed)
Effective
        Group Practice in Midwifery: Working with Women 12-31.  Blackwell
Science,
        Oxford.



        Page L, Ball J, Garvey M, Jackson-Baker A, Flint C (1995) Who's Left
Holding
        the Baby? Meeting the challenge of the Winterton  In:  Page L (ed)
Effective
        Group Practice in Midwifery: Working with Women 59-75.  Blackwell
Science,
        Oxford.



        Page L, Bentley R, Jones B, Marlow D (1995) Transforming the
Organization
        In: Page L (ed) Effective Group Practice in Midwifery: Working with
Women
        77-94.  Blackwell Science, Oxford.



        Page L, Wilkins R (1995) Evaluating Innovations in the organization
of
        Midwifery Practice In: Page L (ed) Effective Group Practice in
Midwifery:
        Working with Women 174-188.  Blackwell Science, Oxford.



        Page LA, Cooke P, Percival P (1999) Providing One-to-One Practice
and
        enjoying it  In: Page LA (ed) The New Midwifery: Science and
Sensitivity in
        Practice.   Churchill Livingstone, Edinburgh




        ----- Original Message -----
        From: "Johnston" <[log in to unmask]>
        To: <[log in to unmask]>
        Sent: Tuesday, April 05, 2005 2:44 AM
        Subject: Re: caseload midwifery in Ontario


        >I have found this discussion, and the one about student caseloads,
very
        > useful.  Thankyou to everyone who is contributing.  My involvement
with
        > caseload is in private practice - the only way I can achieve such
a
        > standard
        > in Melbourne Australia, and if a woman wants me to be her primary
carer we
        > plan homebirth, with a hospital backup arrangement.
        >
        > I found good information also in the article in MIDIRS (March 05,
page 27)
        > by Annie Lester 'The argument for caseload midwifery' (reprinted:
Lester
        > A.
        > Midwifery Matters, issue 103, Winter 2004 pp9-12).
        >
        > I wonder if anyone is presenting papers about caseload midwifery
at the
        > ICM
        > Congress in Brisbane in July?
http://www.midwives2005.com/index.shtml  I
        > looked at the program, and couldn't see at a glance anything
obviously
        > based
        > on caseload or group practice.
        >
        > I think one-to-one is the 'gold standard' of midwifery practice,
but
        > really
        > doubt that this belief is widely accepted in midwifery.  I plan to
attend
        > the congress, and wave the flag for the Maternity Coalition
(Australia's
        > national maternity consumer advocacy organisation.)
        >
        > Joy Johnston
        >
        >
        > -----Original Message-----
        > From: Vicki Van Wagner [mailto:[log in to unmask]]
        > Sent: Tuesday, 5 April 2005 5:40 AM
        > To: [log in to unmask]
        > Subject: caseload midwifery in Ontario
        >
        > Chris - what you have reported below is very relevant to/confirms
the
        > experience of and the evaluation results of the Ontario
government's
        > review
        > of our midwifery system (not published but I will try to get you
an
        > official
        > source). As many of you may know the Ontario system (and midwifery
in most
        > of Canada) is currently organized and funded based on "caseload
practice".
        >
        > Midwives are currently paid "full time" compensation for providing
care to
        > a
        > caseload of 40 births as primary midwife and 40 births as second
midwife
        > (some of which are not  actually attended if there is a transfer
of care)
        > as
        > we have a system where normally there are two midwives from the
group
        > practice at each birth. Midwives can choose to provide care to a
part-time
        > caseload if they wish.
        >
        > We are also given an "overhead" fee per course of care to run our
        > practices -ie to rent a clinic, hire support staff, buy supplies
and
        > equipment etc.
        >
        > All of this is currently under renegotiation so more specific
details re
        > compensation levels etc may change soon.
        >
        > Vicki Van Wagner, RM, PhD(c)
        > [log in to unmask]
        > Associate Professor
        > Ryerson University
        > Midwifery Education Programme
        >
        > ----- Original Message -----
        > From: "Christine McCourt" <[log in to unmask]>
        > To: <[log in to unmask]>
        > Sent: Friday, April 01, 2005 1:18 PM
        > Subject: Re: Beg, borrow and steal
        >
        >
        > Hi Folks
        >
        > We have a general evaluation of caseload midwifery report which
includes
        > economic analysis, and also a specific economic report - both from
our
        > eval of the implementation of caseload midwifery at QCCH in
London. Both
        > can be posted to anyone who wants them. if interested please
contact
        > [log in to unmask]
        >
        > A later report (2001) evaluating the service several years down
the
        > line, including economic evaluation, can be downloaded from our
website
        > but it is just being re-jigged so I will post the web address when
the
        > new site is live, next week.
        >
        >
        >
        > The important message from these studies (admittedly in one
context) is
        > that caseload midwifery is not necessarily more expensive than
        > conventional care. This may seem counter-intuitive because people
        > perceive it as a more personal service, a bit of a luxury perhaps,
but
        > there are inbuilt 'inefficiencies' in conventional hospital
services.
        > For example, having women spend less time in hospital overall, or
less
        > time with medics, can free up resources for midwifery input and
        > community-based services. If interventions are reduced, this may
also
        > save resources, which are needed for one-to-one support in labour
or
        > similar. whether such potential savings can be realised in
practice may
        > depend on the local service configuration, cultural issues,
ability to
        > tap into ongoing changes etc. It may require a lot of
collaboration,
        > leadership and imagination, to facilitate the change.
        >
        > In these studies, we calculated that a caseload of 40 in an urban
        > context should be manageable. this means births per year for a
WTE - mws
        > may pick up slightly more women given that some will have
miscarriages
        > or move away.
        >
        > We also - from research on midwives' experiences, suggested that
        > midwives' with personal/partnership caseloads should not be used
as a
        > back up cover for labour ward or similar, as the flexibility
demanded of
        > them to cover for births on the caseload means they must have the
        > flexibility and autonomy to manage their work to ensure they take
rest
        > time and are not overloaded. although caseload midwives might be
        > 'on-call' more frequently than with a team system, they should not
be
        > expected to be called out for much of that time. The inevitable
        > occasional bad week should be balanced by the quiet ones
        >
        > Chris
        >
        >
        >
        >
        > -----Original Message-----
        > From:   Caseload midwifery on behalf of Forrester, Mandy
        > Sent:   Fri 4/1/2005 3:12 PM
        > To:     [log in to unmask]
        > Cc:
        > Subject:        Re: Beg, borrow and steal
        > Hi Chris,
        > Could you also send me the same?
        >
        > Thanks,
        > Mandy
        >
        >> -----Original Message-----
        >> From: Caseload midwifery [SMTP:[log in to unmask]]
On
        > Behalf
        >> Of Christine McCourt
        >> Sent: 17 December 2004 10:58
        >> To:   [log in to unmask]
        >> Subject:      Re: Beg, borrow and steal
        >>
        >> Joy
        >>
        >>
        >>
        >> If you contact me, I can let you have some info on economic
issues
        >>
        >>
        >>
        >> [log in to unmask]
        >>
        >>
        >>
        >> Dr. Christine McCourt
        >>
        >> Reader in Maternity, Health and Social Sciences
        >>
        >> Faculty of Health and Human Sciences
        >>
        >> Thames Valley University
        >>
        >> 32 Uxbridge Road
        >>
        >> London W5 2BS
        >>
        >>
        >>
        >> Tel: (44) 208 280 5287
        >>
        >>
        >>
        >> -----Original Message-----
        >> From: Caseload midwifery
[mailto:[log in to unmask]] On
        >> Behalf Of Joy Kemp
        >> Sent: 14 November 2004 23:29
        >> To: [log in to unmask]
        >> Subject: Beg, borrow and steal
        >>
        >>
        >>
        >> Dear caseload list
        >>
        >>
        >>
        >> We (myself and a small group of colleagues) are shortly hoping to
        > begin
        >> work on writing a proposal for a caseload midwifery practice,
targeted
        >> towards the most disadvantaged women in our local area (Maidstone
and
        >> Tunbridge Wells in Kent).  There are a group of midwives
committed to
        > such
        >> a way of working, but no financial support available from our
trust.
        >> Unfortunately we are not eligible for sure start funding.  I hope
to
        > get
        >> funding from the PCT and/or any other pots of cash anyone is
aware of.
        >>
        >>
        >>
        >> I have read fairly widely, and we have done a workshop with the
Albany
        >> midwifery practice in London.  However, we are keen not to
re-invent
        > the
        >> wheel, so would be very grateful to hear from any of you who have
been
        >> involved in setting up such a scheme.  I would be interested in
copies
        > of
        >> any plans, proposals, etc - anything that would help us, and any
        > general
        >> tips on what to do/not to do.  Also, any literature which you
would
        >> consider to be essential reading to get us started.  Also, if
there
        > are
        >> other practices which are not too far away from us which would be
        > helpful
        >> to visit, we would love to hear from you.
        >>
        >>
        >>
        >> Many thanks
        >>
        >>
        >>
        >> Joy Kemp
        >>
        >
        >
        >
        >
        > --
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1/04/2005

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