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CASELOADMIDWIFERY  October 2006

CASELOADMIDWIFERY October 2006

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Subject:

Re: CASELOADMIDWIFERY Digest - 12 Oct 2006 to 13 Oct 2006 (#2006-25)

From:

Denise Hynd <[log in to unmask]>

Reply-To:

Caseload midwifery <[log in to unmask]>

Date:

Sat, 14 Oct 2006 09:27:16 +0800

Content-Type:

text/plain

Parts/Attachments:

Parts/Attachments

text/plain (895 lines)

Dear Sarah
I am sure there is UK evidence about the cost effectiveness of caseload.
But prooving this was one way caseload was brought in South australia
There are many angles such as reduced intervention reduced costs this I 
understand has been the outcome at the Ryde MGP (NSW) and most units which 
go caseload plus there has been increased breastfeeeding and happier mothers 
and families which gives local politicians good pmedia opportunities!!

Or using your midwives more effectively for example

In February 2004, when the Women's and Children's Hospital offered Adelaide 
women the option of caseload care through their "Midwifery Group Practice" 
they were overwhelmed by positive consumer and midwifery responses. 
Previously a comparative audit confirmed evidence of the cost efficiency of 
this model of care. As WCH recognises that high-risk women

have an increased need for the advantages of continuity of midwifery care, 
the Adelaide MGP care choice is not limited to low risk women. This service 
is providing care in a mixture of settings, including the hospital, the 
community or a woman's home. Initially the program was to meet the needs of 
500 women in the first year, however this number has been doubled to meet 
the demand. Adelaide women also have the availability of 2 midwifery led 
birth centres and a community based primary midwifery service.



Since above another hospital the Flinders has introduced caseload and more 
are to follow

In NSW (again Australia) another means to gain support is the loss of 
medical specialists leading to potential closure of small unit and the vocal 
unwillingness of local women to be sent further away from home. This 
requires action by a local consumer group - is there not a NCT or AIMS group 
in your area surely these women object to being denied personalised care?

Women and midwives becoming politically active together brought women 
centred maternity services to NZ

I hope this email is resent complete

Denise Hynd

"Let us support one another, not just in philosophy but in action, for the 
sake of freedom for all women to choose exactly how and by whom, if by 
anyone, our bodies will be handled."

- Linda Hes

----- Original Message ----- 
From: "CASELOADMIDWIFERY automatic digest system" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Saturday, October 14, 2006 7:01 AM
Subject: CASELOADMIDWIFERY Digest - 12 Oct 2006 to 13 Oct 2006 (#2006-25)


> There are 4 messages totalling 793 lines in this issue.
>
> Topics of the day:
>
>  1. [MCVic] Caseload models (4)
>
> ----------------------------------------------------------------------
>
> Date:    Fri, 13 Oct 2006 08:15:10 +0000
> From:    Sarah Hunt <[log in to unmask]>
> Subject: Re: [MCVic] Caseload models
>
> Dear Jean,
> We would very much like to set up a Caseload scheme here in 
> Gloucestershire
> but our managers and employers tell us that it is not cost effective as 
> our
> hospital is already staffed and having your own midwife with you during
> labour means your are potentially paying 2 midwives. How was your scheme 
> set
> up and how have you overcome the 'costs' argument? I wonder whether 
> Northern
> Ireland Maternity Service is in the same grip of financial cuts as we are 
> in
> England?
>
> Sarah Hunt, Community Midwife, Gloucestershire
>
>
>>From: Jean Greer <[log in to unmask]>
>>Reply-To: Caseload midwifery <[log in to unmask]>
>>To: [log in to unmask]
>>Subject: Re: [MCVic] Caseload models
>>Date: Thu, 12 Oct 2006 22:12:27 +0100
>>
>>Hello Karen,
>>I am one of a team of 6 caseload midwives working in the Royal/Jubilee
>>Maternity Service, Belfast, N. Ireland.   We all work full time and each
>>carry a personal caseload of 35 - 38 women per year.  We work in pairs
>>sharing the on-call with our work partner.   The service is targeted at
>>'low risk women' and is midwifery-led, but we continue to provide 
>>midwufery
>>care for the women on our caseloads who develop complications and whose
>>care becomes consultant led.  Antenatal and postnatal care can be provided
>>at home or in hospital.  All babies are born in hospital.  This service 
>>has
>>been up and running for 8 years now, and is very popular - with all
>>midwives fully booked.
>>Good luck with the research and ler us know if we can be of any 
>>assistance.
>>Jean Greer
>>
>>
>>>From: Marlene Gryesten / Aalborg Sygehus <[log in to unmask]>
>>>Reply-To: Caseload midwifery <[log in to unmask]>
>>>To: [log in to unmask]
>>>Subject: [MCVic] Caseload models
>>>Date: Thu, 12 Oct 2006 07:35:55 +0200
>>>
>>>Hi Karen
>>>On a note from Denmark.
>>>Currently I am one of the two midwife team in a 120 cases caseload, all
>>>women living in the same district and doing birth at our local university
>>>hospital or at home. We have worked since june 1, 2004; We have made a
>>>peticulous evaluation on all work time through two years as we started
>>>this model as a work load project. Now in Denmark there is three other
>>>teams working and on our National Midwifery Congress November 6, we will
>>>debate, amongst other stuff, wether Caseload midwifer needs to be
>>>implemented as a part of the care offered from most midwiferycenters.
>>>Ou first report was on client satisfaction, second on work envirenmental,
>>>and the final one soon to be published is including a focus interview
>>>regarding some of the fun sideeffects! Like a rise in Homebirth, and 
>>>again
>>>the final count up on oncall hours versus actual work hours - all in
>>>danish!
>>>The things we discuss in Denmark now is, first and foremost:
>>>
>>>- How it is possibel to work being on call 50% of your life, and still
>>>function well! The evaluation of our workstudy shows, that the quality of
>>>work life will increase for certain midwifes as the above quality and
>>>selfsatisfaction of the continuity of care is a strengthener in it self,
>>>and with a caseload of 120 women, our average oncall load is 3 and a half
>>>our per 24 hour oncall period.
>>>-Since we know this model will never be a possibility for all pregnat
>>>women, then how do we decide who should have the possibility /choice ?
>>>
>>>All for now, good luck
>>>Marlene Gryesten
>>>Aalborg-Denmark
>>>
>>>
>>>________________________________
>>>
>>>
>>>Hi Karen
>>>Birralee Maternity Service at Box Hill hospital has a small caseload
>>>group.
>>>Maternity Coalition published an article about it Birth Matters Vol 10.1
>>>March 06 'Know your midwife at Birralee' (authors Melody Bourne, Alice
>>>Barden and Helen Gordon.) Nic Dutton is one of the midwives in KYM there
>>>and
>>>could fill you in with more information.
>>>My (very biased) observation:
>>>Most of the hospital midwives I have spoken to about caseload seem to
>>>think
>>>it's a dirty word. Midwifery managers seem to like to stick to rosters,
>>>and
>>>talk about their wonderful team models.
>>>There is a UK email list Caseload midwifery
>>>[log in to unmask]
>>>It has been quiet lately, but would be a link with international work.  I
>>>have put a cc to that list - I think I'm still on it.
>>>You always come up with interesting big words.  I learnt reciprocity from
>>>you, and now you'll have me talking about interdisciplinarity!
>>>All the best
>>>Joy Johnston
>>>
>>>-----Original Message-----
>>>From: Karen Lane [mailto:[log in to unmask]]
>>>Sent: Wednesday, 11 October 2006 1:23 PM
>>>To: [log in to unmask]
>>>Subject: [MCVic] Caseload models
>>>
>>>Hello out there,
>>>
>>>I was wondering if people could advise what hospitals are using
>>>caseload models or preparing to install caseload?
>>>
>>>I want to construct a national research study of interdisciplinarity
>>>in health care using caseload in maternity care as an case study.
>>>
>>>If you are aware of international cases, I would also be grateful for
>>>that information.
>>>
>>>Many thanks,
>>>
>>>Karen Lane
>>
>>_________________________________________________________________
>>Be the first to hear what's new at MSN - sign up to our free newsletters!
>>http://www.msn.co.uk/newsletters
>
> ------------------------------
>
> Date:    Fri, 13 Oct 2006 11:26:58 +0100
> From:    Jean Greer <[log in to unmask]>
> Subject: Re: [MCVic] Caseload models
>
> Dear Sarah,
> Nine years ago, in resonse to Changing Childbirth, the DOH offered a smal=
> l=20
> grant to all matenity services to develop a model of care that would prov=
> ide=20
> continuity of carer to 'low risk' women.  We applied for this and used it=
> to=20
> develop our partnership caseload team.  An accurate economic evaluation o=
> f=20
> the service is very difficult as many of the costs/benefits are difficult=
> to=20
> quantify, but where it has been attempted caseload service is believed to=
> be=20
> cost neutral.  The 6 midwives on our team were core staff before the team=
> =20
> was set up so the total number of midwives employed by the trust was=20
> unchanged, it is only the manner in which the midwives work that is=20
> different.  The number of women we look after has been determined by 
> the=20
> Dept of Manpower Services who advise that 1 full time equivalent midwife =
> is=20
> employed for every 35 women booked.  There are undoubtably additional cos=
> ts=20
> but they are small e.g.
> 1  All midwives were employed at a higher grade. (I suspect AforC, when i=
> t's=20
> eventually implemented, will neutralise this benefit.)
> 2  All midwives are paid an on-call allowance.
> 3  All midwives have mobile phones provided by the Trust.
> 4  All midwives claim a mileage allowance for home visits.
> To counter these costs I suggest you argue that all evaluations of caselo=
> ad=20
> teams have consistently shown:
> 1  An increased normal delivery rate.
> 2  A reduced epidural rate and a reduction in other interventions in labo=
> ur.
> 3  Shorter stays in hospital.
> 4  An increased breastfeeding rate.
> 5  Increased satisfaction with the service.
> It will be argued that in these evaluations the benefits did not reach=20
> statistical significance, but this was often only because the sample size=
> s=20
> were of necessity small and many studies had insufficient power.  Also no=
> =20
> studies focused on the problems of practicing normal midwifery in a=20
> consultant-led labour ward.  In the recent national audit the RJMS had th=
> e=20
> distinction of having the highest c/s rate in the UK.   Rome wasn't built=
> in=20
> a day but it was built!!  Unfortunately, as you can see, the costs are=20
> easier for an accountant to quantify than the benefits.
> Trusts in N. Ireland have the same economic constraints as the rest of th=
> e=20
> NHS, but the RJMS is still able to offer one to one midwifery support for=
> =20
> all women in labour.   If I was you I would argue that a woman may as wel=
> l=20
> have a midwife she knows as one she doesn't - the cost to the NHS is exac=
> tly=20
> the same!
> Good luck!!!
> Jean Greer
> Caseload Team
> Royal/Jubilee Maternity Service
> Belfast
>
>
>
>
>>From: Sarah Hunt <[log in to unmask]>
>>Reply-To: Caseload midwifery <[log in to unmask]>
>>To: [log in to unmask]
>>Subject: Re: [MCVic] Caseload models
>>Date: Fri, 13 Oct 2006 08:15:10 +0000
>>
>>Dear Jean,
>>We would very much like to set up a Caseload scheme here in Gloucestersh=
> ire=20
>>but our managers and employers tell us that it is not cost effective as =
> our=20
>>hospital is already staffed and having your own midwife with you during=20
>>labour means your are potentially paying 2 midwives. How was your scheme=
> =20
>>set up and how have you overcome the 'costs' argument? I wonder whether=20
>>Northern Ireland Maternity Service is in the same grip of financial cuts=
> as=20
>>we are in England?
>>
>>Sarah Hunt, Community Midwife, Gloucestershire
>>
>>
>>>From: Jean Greer <[log in to unmask]>
>>>Reply-To: Caseload midwifery <[log in to unmask]>
>>>To: [log in to unmask]
>>>Subject: Re: [MCVic] Caseload models
>>>Date: Thu, 12 Oct 2006 22:12:27 +0100
>>>
>>>Hello Karen,
>>>I am one of a team of 6 caseload midwives working in the Royal/Jubilee=20
>>>Maternity Service, Belfast, N. Ireland.   We all work full time and eac=
> h=20
>>>carry a personal caseload of 35 - 38 women per year.  We work in pairs=20
>>>sharing the on-call with our work partner.   The service is targeted at=
> =20
>>>'low risk women' and is midwifery-led, but we continue to provide=20
>>>midwufery care for the women on our caseloads who develop complications=
> =20
>>>and whose care becomes consultant led.  Antenatal and postnatal care ca=
> n=20
>>>be provided at home or in hospital.  All babies are born in hospital. =20
>>>This service has been up and running for 8 years now, and is very popul=
> ar=20
>>>- with all midwives fully booked.
>>>Good luck with the research and ler us know if we can be of any=20
>>>assistance.
>>>Jean Greer
>>>
>>>
>>>>From: Marlene Gryesten / Aalborg Sygehus <[log in to unmask]>
>>>>Reply-To: Caseload midwifery <[log in to unmask]>
>>>>To: [log in to unmask]
>>>>Subject: [MCVic] Caseload models
>>>>Date: Thu, 12 Oct 2006 07:35:55 +0200
>>>>
>>>>Hi Karen
>>>>On a note from Denmark.
>>>>Currently I am one of the two midwife team in a 120 cases caseload, al=
> l=20
>>>>women living in the same district and doing birth at our local univers=
> ity=20
>>>>hospital or at home. We have worked since june 1, 2004; We have made a=
> =20
>>>>peticulous evaluation on all work time through two years as we started=
> =20
>>>>this model as a work load project. Now in Denmark there is three other=
> =20
>>>>teams working and on our National Midwifery Congress November 6, we wi=
> ll=20
>>>>debate, amongst other stuff, wether Caseload midwifer needs to be=20
>>>>implemented as a part of the care offered from most midwiferycenters.
>>>>Ou first report was on client satisfaction, second on work envirenment=
> al,=20
>>>>and the final one soon to be published is including a focus interview=20
>>>>regarding some of the fun sideeffects! Like a rise in Homebirth, and=20
>>>>again the final count up on oncall hours versus actual work hours - al=
> l=20
>>>>in danish!
>>>>The things we discuss in Denmark now is, first and foremost:
>>>>
>>>>- How it is possibel to work being on call 50% of your life, and still=
> =20
>>>>function well! The evaluation of our workstudy shows, that the quality=
> of=20
>>>>work life will increase for certain midwifes as the above quality and=20
>>>>selfsatisfaction of the continuity of care is a strengthener in it sel=
> f,=20
>>>>and with a caseload of 120 women, our average oncall load is 3 and a h=
> alf=20
>>>>our per 24 hour oncall period.
>>>>-Since we know this model will never be a possibility for all pregnat=20
>>>>women, then how do we decide who should have the possibility /choice ?
>>>>
>>>>All for now, good luck
>>>>Marlene Gryesten
>>>>Aalborg-Denmark
>>>>
>>>>
>>>>________________________________
>>>>
>>>>
>>>>Hi Karen
>>>>Birralee Maternity Service at Box Hill hospital has a small caseload=20
>>>>group.
>>>>Maternity Coalition published an article about it Birth Matters Vol 10=
> .1
>>>>March 06 'Know your midwife at Birralee' (authors Melody Bourne, Alice
>>>>Barden and Helen Gordon.) Nic Dutton is one of the midwives in KYM the=
> re=20
>>>>and
>>>>could fill you in with more information.
>>>>My (very biased) observation:
>>>>Most of the hospital midwives I have spoken to about caseload seem to=20
>>>>think
>>>>it's a dirty word. Midwifery managers seem to like to stick to rosters=
> ,=20
>>>>and
>>>>talk about their wonderful team models.
>>>>There is a UK email list Caseload midwifery=20
>>>>[log in to unmask]
>>>>It has been quiet lately, but would be a link with international work.=
>  I
>>>>have put a cc to that list - I think I'm still on it.
>>>>You always come up with interesting big words.  I learnt reciprocity f=
> rom
>>>>you, and now you'll have me talking about interdisciplinarity!
>>>>All the best
>>>>Joy Johnston
>>>>
>>>>-----Original Message-----
>>>>From: Karen Lane [mailto:[log in to unmask]]
>>>>Sent: Wednesday, 11 October 2006 1:23 PM
>>>>To: [log in to unmask]
>>>>Subject: [MCVic] Caseload models
>>>>
>>>>Hello out there,
>>>>
>>>>I was wondering if people could advise what hospitals are using
>>>>caseload models or preparing to install caseload?
>>>>
>>>>I want to construct a national research study of interdisciplinarity
>>>>in health care using caseload in maternity care as an case study.
>>>>
>>>>If you are aware of international cases, I would also be grateful for
>>>>that information.
>>>>
>>>>Many thanks,
>>>>
>>>>Karen Lane
>>>
>>>_________________________________________________________________
>>>Be the first to hear what's new at MSN - sign up to our free newsletter=
> s!=20
>>>http://www.msn.co.uk/newsletters
>
> _________________________________________________________________
> Windows Live=99 Messenger has arrived. Click here to download it for free=
> !=20
> http://imagine-msn.com/messenger/launch80/?locale=3Den-gb
>
> ------------------------------
>
> Date:    Fri, 13 Oct 2006 12:29:05 +0100
> From:    Jane Sandall <[log in to unmask]>
> Subject: Re: [MCVic] Caseload models
>
> Dear all
> We are running a programme at St Thomas's in London. Three group practices
> have been set up in community bases with @ 6 WTE midwives in each 
> practice.
> The aim is for each midwife to do 36 birth a year which entails doing more
> bookings to achieve this number. The caseload is all risk and women are
> referred routinely from a range of local GPs. The aim is to meet NSF
> Standard 11 targets See
> http://www.dh.gov.uk/PolicyAndGuidance/HealthAndSocialCareTopics/ChildrenServices/ChildrenServicesInformation/fs/en
> which focus on reducing inqualities, early access to midwife as first 
> point
> of contact, early booking, user involve,ent and woman centred care, 
> choice,
> a focus on health and wellbeing and normality. The NSF states that "All 
> NHS
> maternity care providers and Primary Care Trusts develop 'communitybased
> continuity of care' schemes for women from disadvantaged and 
> minoritygroups
> and communities" and for "All women are offered the support of a named
> midwife throughout pregnancy".
>
> The aim is for woman to have relational continuity with the same midwife
> throughout her pregnancy, and childbearing episode. The aim is for 1 
> midwife
> to provide the majority of antenatal and postnatal care (backed up by a
> partner) and to provide intrapartum care if working. Intraprtum care 
> ouside
> normal working hours is provided by partner or back up partners in the
> group. Women are referred to specialist professionals as aproriate 
> including
> obstetricians. Women are able to birth at home, in an alongside  home from
> home unit and hospital birth centre. The programme has been running for 
> one
> year. We are evaluating a range of processes and outcomes of this 
> programme.
> You can see further details by going to the project web site.
> http://www.kcl.ac.uk/projects/1to1caseload
>
> bw
> Dr Jane Sandall
> Professor of Midwifery and Women's Health
> Health and Social Care Research Division
> King's College, London.
> 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/schools/medicine/research/hscr/sandall.html
>
>
> ----- Original Message ----- 
> From: "Jean Greer" <[log in to unmask]>
> To: <[log in to unmask]>
> Sent: Friday, October 13, 2006 11:26 AM
> Subject: Re: [MCVic] Caseload models
>
>
> Dear Sarah,
> Nine years ago, in resonse to Changing Childbirth, the DOH offered a small
> grant to all matenity services to develop a model of care that would 
> provide
> continuity of carer to 'low risk' women.  We applied for this and used it 
> to
> develop our partnership caseload team.  An accurate economic evaluation of
> the service is very difficult as many of the costs/benefits are difficult 
> to
> quantify, but where it has been attempted caseload service is believed to 
> be
> cost neutral.  The 6 midwives on our team were core staff before the team
> was set up so the total number of midwives employed by the trust was
> unchanged, it is only the manner in which the midwives work that is
> different.  The number of women we look after has been determined by the
> Dept of Manpower Services who advise that 1 full time equivalent midwife 
> is
> employed for every 35 women booked.  There are undoubtably additional 
> costs
> but they are small e.g.
> 1  All midwives were employed at a higher grade. (I suspect AforC, when 
> it's
> eventually implemented, will neutralise this benefit.)
> 2  All midwives are paid an on-call allowance.
> 3  All midwives have mobile phones provided by the Trust.
> 4  All midwives claim a mileage allowance for home visits.
> To counter these costs I suggest you argue that all evaluations of 
> caseload
> teams have consistently shown:
> 1  An increased normal delivery rate.
> 2  A reduced epidural rate and a reduction in other interventions in 
> labour.
> 3  Shorter stays in hospital.
> 4  An increased breastfeeding rate.
> 5  Increased satisfaction with the service.
> It will be argued that in these evaluations the benefits did not reach
> statistical significance, but this was often only because the sample sizes
> were of necessity small and many studies had insufficient power.  Also no
> studies focused on the problems of practicing normal midwifery in a
> consultant-led labour ward.  In the recent national audit the RJMS had the
> distinction of having the highest c/s rate in the UK.   Rome wasn't built 
> in
> a day but it was built!!  Unfortunately, as you can see, the costs are
> easier for an accountant to quantify than the benefits.
> Trusts in N. Ireland have the same economic constraints as the rest of the
> NHS, but the RJMS is still able to offer one to one midwifery support for
> all women in labour.   If I was you I would argue that a woman may as well
> have a midwife she knows as one she doesn't - the cost to the NHS is 
> exactly
> the same!
> Good luck!!!
> Jean Greer
> Caseload Team
> Royal/Jubilee Maternity Service
> Belfast
>
>
>
>
>>From: Sarah Hunt <[log in to unmask]>
>>Reply-To: Caseload midwifery <[log in to unmask]>
>>To: [log in to unmask]
>>Subject: Re: [MCVic] Caseload models
>>Date: Fri, 13 Oct 2006 08:15:10 +0000
>>
>>Dear Jean,
>>We would very much like to set up a Caseload scheme here in 
>>Gloucestershire
>>but our managers and employers tell us that it is not cost effective as 
>>our
>>hospital is already staffed and having your own midwife with you during
>>labour means your are potentially paying 2 midwives. How was your scheme
>>set up and how have you overcome the 'costs' argument? I wonder whether
>>Northern Ireland Maternity Service is in the same grip of financial cuts 
>>as
>>we are in England?
>>
>>Sarah Hunt, Community Midwife, Gloucestershire
>>
>>
>>>From: Jean Greer <[log in to unmask]>
>>>Reply-To: Caseload midwifery <[log in to unmask]>
>>>To: [log in to unmask]
>>>Subject: Re: [MCVic] Caseload models
>>>Date: Thu, 12 Oct 2006 22:12:27 +0100
>>>
>>>Hello Karen,
>>>I am one of a team of 6 caseload midwives working in the Royal/Jubilee
>>>Maternity Service, Belfast, N. Ireland.   We all work full time and each
>>>carry a personal caseload of 35 - 38 women per year.  We work in pairs
>>>sharing the on-call with our work partner.   The service is targeted at
>>>'low risk women' and is midwifery-led, but we continue to provide
>>>midwufery care for the women on our caseloads who develop complications
>>>and whose care becomes consultant led.  Antenatal and postnatal care can
>>>be provided at home or in hospital.  All babies are born in hospital.
>>>This service has been up and running for 8 years now, and is very
>>>popular - with all midwives fully booked.
>>>Good luck with the research and ler us know if we can be of any
>>>assistance.
>>>Jean Greer
>>>
>>>
>>>>From: Marlene Gryesten / Aalborg Sygehus <[log in to unmask]>
>>>>Reply-To: Caseload midwifery <[log in to unmask]>
>>>>To: [log in to unmask]
>>>>Subject: [MCVic] Caseload models
>>>>Date: Thu, 12 Oct 2006 07:35:55 +0200
>>>>
>>>>Hi Karen
>>>>On a note from Denmark.
>>>>Currently I am one of the two midwife team in a 120 cases caseload, all
>>>>women living in the same district and doing birth at our local 
>>>>university
>>>>hospital or at home. We have worked since june 1, 2004; We have made a
>>>>peticulous evaluation on all work time through two years as we started
>>>>this model as a work load project. Now in Denmark there is three other
>>>>teams working and on our National Midwifery Congress November 6, we will
>>>>debate, amongst other stuff, wether Caseload midwifer needs to be
>>>>implemented as a part of the care offered from most midwiferycenters.
>>>>Ou first report was on client satisfaction, second on work 
>>>>envirenmental,
>>>>and the final one soon to be published is including a focus interview
>>>>regarding some of the fun sideeffects! Like a rise in Homebirth, and
>>>>again the final count up on oncall hours versus actual work hours - all
>>>>in danish!
>>>>The things we discuss in Denmark now is, first and foremost:
>>>>
>>>>- How it is possibel to work being on call 50% of your life, and still
>>>>function well! The evaluation of our workstudy shows, that the quality 
>>>>of
>>>>work life will increase for certain midwifes as the above quality and
>>>>selfsatisfaction of the continuity of care is a strengthener in it self,
>>>>and with a caseload of 120 women, our average oncall load is 3 and a 
>>>>half
>>>>our per 24 hour oncall period.
>>>>-Since we know this model will never be a possibility for all pregnat
>>>>women, then how do we decide who should have the possibility /choice ?
>>>>
>>>>All for now, good luck
>>>>Marlene Gryesten
>>>>Aalborg-Denmark
>>>>
>>>>
>>>>________________________________
>>>>
>>>>
>>>>Hi Karen
>>>>Birralee Maternity Service at Box Hill hospital has a small caseload
>>>>group.
>>>>Maternity Coalition published an article about it Birth Matters Vol 10.1
>>>>March 06 'Know your midwife at Birralee' (authors Melody Bourne, Alice
>>>>Barden and Helen Gordon.) Nic Dutton is one of the midwives in KYM there
>>>>and
>>>>could fill you in with more information.
>>>>My (very biased) observation:
>>>>Most of the hospital midwives I have spoken to about caseload seem to
>>>>think
>>>>it's a dirty word. Midwifery managers seem to like to stick to rosters,
>>>>and
>>>>talk about their wonderful team models.
>>>>There is a UK email list Caseload midwifery
>>>>[log in to unmask]
>>>>It has been quiet lately, but would be a link with international work. 
>>>>I
>>>>have put a cc to that list - I think I'm still on it.
>>>>You always come up with interesting big words.  I learnt reciprocity 
>>>>from
>>>>you, and now you'll have me talking about interdisciplinarity!
>>>>All the best
>>>>Joy Johnston
>>>>
>>>>-----Original Message-----
>>>>From: Karen Lane [mailto:[log in to unmask]]
>>>>Sent: Wednesday, 11 October 2006 1:23 PM
>>>>To: [log in to unmask]
>>>>Subject: [MCVic] Caseload models
>>>>
>>>>Hello out there,
>>>>
>>>>I was wondering if people could advise what hospitals are using
>>>>caseload models or preparing to install caseload?
>>>>
>>>>I want to construct a national research study of interdisciplinarity
>>>>in health care using caseload in maternity care as an case study.
>>>>
>>>>If you are aware of international cases, I would also be grateful for
>>>>that information.
>>>>
>>>>Many thanks,
>>>>
>>>>Karen Lane
>>>
>>>_________________________________________________________________
>>>Be the first to hear what's new at MSN - sign up to our free newsletters!
>>>http://www.msn.co.uk/newsletters
>
> _________________________________________________________________
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> ______________________________________________________________________
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> ______________________________________________________________________
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> ------------------------------
>
> Date:    Fri, 13 Oct 2006 14:29:15 +0100
> From:    "Cooke, Pauline" <[log in to unmask]>
> Subject: Re: [MCVic] Caseload models
>
> Sarah=20
>
> Do look at the study done at Hammersmith and Queen Charlottes (report
> available from TVU) which found a caseload scheme to be cost neutral.
>
> We have 2 gps of mws here at St Mary's working in partnerships and
> providing continuity of carer to 36 women per yr each. We take women of
> all risks as long as they live in one of 2 Sure Start areas. Our
> outcomes are good (we won the APPG award for Promoting Normal Birth in
> 2005) and one of the gps has a home birth rate of 20%. We audit
> regularly and our outcomes remain excellent in terms of normal birth,
> breastfeeding, low CS rates, intact perinea.
>
> Pauline
>
> Consultant midwife
>
> -----Original Message-----
> From: Caseload midwifery [mailto:[log in to unmask]] On
> Behalf Of Sarah Hunt
> Sent: 13 October 2006 09:15
> To: [log in to unmask]
> Subject: Re: [MCVic] Caseload models
>
> Dear Jean,
> We would very much like to set up a Caseload scheme here in
> Gloucestershire=20
> but our managers and employers tell us that it is not cost effective as
> our=20
> hospital is already staffed and having your own midwife with you during=20
> labour means your are potentially paying 2 midwives. How was your scheme
> set=20
> up and how have you overcome the 'costs' argument? I wonder whether
> Northern=20
> Ireland Maternity Service is in the same grip of financial cuts as we
> are in=20
> England?
>
> Sarah Hunt, Community Midwife, Gloucestershire
>
>
>>From: Jean Greer <[log in to unmask]>
>>Reply-To: Caseload midwifery <[log in to unmask]>
>>To: [log in to unmask]
>>Subject: Re: [MCVic] Caseload models
>>Date: Thu, 12 Oct 2006 22:12:27 +0100
>>
>>Hello Karen,
>>I am one of a team of 6 caseload midwives working in the Royal/Jubilee=20
>>Maternity Service, Belfast, N. Ireland.   We all work full time and
> each=20
>>carry a personal caseload of 35 - 38 women per year.  We work in pairs=20
>>sharing the on-call with our work partner.   The service is targeted at
>
>>'low risk women' and is midwifery-led, but we continue to provide
> midwufery=20
>>care for the women on our caseloads who develop complications and whose
>
>>care becomes consultant led.  Antenatal and postnatal care can be
> provided=20
>>at home or in hospital.  All babies are born in hospital.  This service
> has=20
>>been up and running for 8 years now, and is very popular - with all=20
>>midwives fully booked.
>>Good luck with the research and ler us know if we can be of any
> assistance.
>>Jean Greer
>>
>>
>>>From: Marlene Gryesten / Aalborg Sygehus <[log in to unmask]>
>>>Reply-To: Caseload midwifery <[log in to unmask]>
>>>To: [log in to unmask]
>>>Subject: [MCVic] Caseload models
>>>Date: Thu, 12 Oct 2006 07:35:55 +0200
>>>
>>>Hi Karen
>>>On a note from Denmark.
>>>Currently I am one of the two midwife team in a 120 cases caseload,
> all=20
>>>women living in the same district and doing birth at our local
> university=20
>>>hospital or at home. We have worked since june 1, 2004; We have made a
>
>>>peticulous evaluation on all work time through two years as we started
>
>>>this model as a work load project. Now in Denmark there is three other
>
>>>teams working and on our National Midwifery Congress November 6, we
> will=20
>>>debate, amongst other stuff, wether Caseload midwifer needs to be=20
>>>implemented as a part of the care offered from most midwiferycenters.
>>>Ou first report was on client satisfaction, second on work
> envirenmental,=20
>>>and the final one soon to be published is including a focus interview=20
>>>regarding some of the fun sideeffects! Like a rise in Homebirth, and
> again=20
>>>the final count up on oncall hours versus actual work hours - all in=20
>>>danish!
>>>The things we discuss in Denmark now is, first and foremost:
>>>
>>>- How it is possibel to work being on call 50% of your life, and still
>
>>>function well! The evaluation of our workstudy shows, that the quality
> of=20
>>>work life will increase for certain midwifes as the above quality and=20
>>>selfsatisfaction of the continuity of care is a strengthener in it
> self,=20
>>>and with a caseload of 120 women, our average oncall load is 3 and a
> half=20
>>>our per 24 hour oncall period.
>>>-Since we know this model will never be a possibility for all pregnat=20
>>>women, then how do we decide who should have the possibility /choice ?
>>>
>>>All for now, good luck
>>>Marlene Gryesten
>>>Aalborg-Denmark
>>>
>>>
>>>________________________________
>>>
>>>
>>>Hi Karen
>>>Birralee Maternity Service at Box Hill hospital has a small caseload=20
>>>group.
>>>Maternity Coalition published an article about it Birth Matters Vol
> 10.1
>>>March 06 'Know your midwife at Birralee' (authors Melody Bourne, Alice
>>>Barden and Helen Gordon.) Nic Dutton is one of the midwives in KYM
> there=20
>>>and
>>>could fill you in with more information.
>>>My (very biased) observation:
>>>Most of the hospital midwives I have spoken to about caseload seem to=20
>>>think
>>>it's a dirty word. Midwifery managers seem to like to stick to
> rosters,=20
>>>and
>>>talk about their wonderful team models.
>>>There is a UK email list Caseload midwifery=20
>>>[log in to unmask]
>>>It has been quiet lately, but would be a link with international work.
> I
>>>have put a cc to that list - I think I'm still on it.
>>>You always come up with interesting big words.  I learnt reciprocity
> from
>>>you, and now you'll have me talking about interdisciplinarity!
>>>All the best
>>>Joy Johnston
>>>
>>>-----Original Message-----
>>>From: Karen Lane [mailto:[log in to unmask]]
>>>Sent: Wednesday, 11 October 2006 1:23 PM
>>>To: [log in to unmask]
>>>Subject: [MCVic] Caseload models
>>>
>>>Hello out there,
>>>
>>>I was wondering if people could advise what hospitals are using
>>>caseload models or preparing to install caseload?
>>>
>>>I want to construct a national research study of interdisciplinarity
>>>in health care using caseload in maternity care as an case study.
>>>
>>>If you are aware of international cases, I would also be grateful for
>>>that information.
>>>
>>>Many thanks,
>>>
>>>Karen Lane
>>
>>_________________________________________________________________
>>Be the first to hear what's new at MSN - sign up to our free
> newsletters!=20
>>http://www.msn.co.uk/newsletters
>
> ------------------------------
>
> End of CASELOADMIDWIFERY Digest - 12 Oct 2006 to 13 Oct 2006 (#2006-25)
> ***********************************************************************
>
>
> -- 
> No virus found in this incoming message.
> Checked by AVG Free Edition.
> Version: 7.1.408 / Virus Database: 268.13.3/473 - Release Date: 12/10/2006
>
> 

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