As the Scottish maternity service grew and the pressure on it increased, it became clear that its midwives needed extra support. So, in 2008, NHS Scotland introduced higher-level support roles and started employing maternity care support workers (MCSWs).
So far, 82 MCSWs have been or are being trained. They represent 2% of the total Scottish maternity workforce and 15% of the support workforce. Most are employed on Agenda for Change band three.
NHS Education for Scotland decided to find out what impact this role has had on maternity services. It commissioned London South Bank University to carry out a study – the first evaluation of higher-level support roles in maternity – into how MCSWs have changed the experience for midwives, mothers and their families, and also how MCSWs feel about their role in the service.
The study found that MCSWs were increasing capacity and productivity by freeing up the time of busy midwives. They performed a wide range of tasks including observing and recording maternal and healthy baby vital signs, parenting skills, one-to-one support for mothers with specific needs including young mothers, breastfeeding information, guidance and support, hearing tests and venepuncture.
When asked about the role, one MCSW said: ‘The midwifery team have found the support very beneficial. The women I care for benefit from another tier of support.’
Another added: ‘We have just taken the burden from the midwives.’
Midwives have also found that MCSWs give women extra support that the midwives themselves might not have time for. ‘We have seen the MCSWs’ role enhancing the midwife from beginning to end,’ said one midwife.
Another commented: ‘The biggest feedback that we have had from women – and we have had a lot – is around breastfeeding and general parenting support in the early days of postnatal care.’
The role has been accepted and integrated into maternity teams, although there were limited anecdotal reports of some opposition to the role. One senior midwife said: ‘[We have to] work to dispel the myths that are around. That’s a problem that’s rehearsed every time you bring a support worker in.’
The national competency framework and training had resulted in unambiguous, appropriate and consistent role boundaries. However, while midwives were confident to delegate tasks, there were still some concerns. One said: ‘Midwives can feel very vulnerable delegating tasks. Concerns are very real.’
More could be done to integrate MCSWs into workforce planning, and Scottish maternity services would like to see a substantial increase in support worker numbers. The study also found that services planned to develop the role to improve the interface between the acute and community settings, increase the role in public health, assisting – but not replacing – midwives at home births and providing one-to-one support for mothers with specific needs.
The evaluation of MCSWs in Scotland shows that the role can improve capacity, productivity and quality without impinging on the role of midwives.
Further inforamtion
For further information about the MCSW programme, please contact Lucy Powls, educational projects manager on Tel: 0131 220 8699 or email:
lucy.powls@nes.scot.nhs.net
For further information about the MCSW evaluation, please contact Richard Griffin at London South Bank University via email:
griffir3@lsbu.ac.uk
The report is available from:
tinyurl.com/impact-mcsws
