Continuity counts

By Lia Brigante and Mary Ross-Davie on 23 November 2018 Midwives Magazine Midwifery Continuity of Carer - MCOC

Lia Brigante and Mary Ross-Davie explain the rules of the new continuity-of-carer board game.

We’ve all played snakes and ladders, Monopoly, draughts or chess, but now there’s Continuity Counts – the board game for midwives! Launched at the RCM conference in October, Continuity Counts is designed to support midwives and maternity services to move towards more continuity of carer by helping to explain, through playing the game, what a caseload might feel like if a continuity model of care is implemented.

The background

Midwifery continuity of carer (MCoC) is a model of maternity care where a primary midwife sees a woman through her whole maternity journey – providing the majority of her antenatal, labour and birth and postnatal care, supported by a ‘buddy’ and a small team of six to eight midwives. Evidence shows that continuity of carer works. It works for women and it enables midwives and their maternity colleagues to deliver better and safer care (Sandall et al, 2016). MCoC is a key element of current maternity policies both in England and Scotland (Better births and Best start), which recommend that MCoC becomes the central model of maternity care.

Implementation of MCoC raises many uncertainties for midwives about how their working lives might look and feel. This game aims to address these concerns and questions especially in regard to workload, caseload size and work-life balance. The board game is a fun way to engage with this increasingly important way of working.

How to play

The game can be played by a small group of midwives (up to seven players) without an external facilitator, as it comes with clear instructions. Midwives can decide when and how they are able to play the game to fit around their busy schedules. The game contributes to teams getting together and thinking seriously about how they can implement continuity in their local areas. It helps teams to spend time together exploring what a year and a month might feel like providing MCoC, with each midwife holding a caseload of around 35 women.  

It aims to help teams understand more about providing continuity across the woman’s journey through pregnancy. It will also encourage discussions about how they might choose to manage their time as a team.

A game is a good way of getting a team talking to each other and discussing concerns in a more light-hearted and non-threatening way. Midwives often like interactive and visual ways of learning, and a game seemed a good way of getting them to learn through fun. The game prototype was initially piloted across Scotland and proved highly successful. It will be great to have the game being played across the rest of the UK.

Where to get it

The game will be available across the UK first through RCM national and regional officers, and through them to workplace representatives and branch officers. The RCM will provide the opportunity of applying for a game to all HoMs, directors of midwifery and consultant midwives in the UK.

The board game joins the RCM’s other continuity initiatives, which include an online learning module on the RCM’s i-learn platform and the RCM position statement on continuity of carer. Workshops on continuity have also been held in trusts and boards across the UK. 

Lia Brigante is RCM quality and standards advisor and Mary Ross-Davie is RCM director for Scotland