Service reorganisation will reshape the way that maternity care is delivered

NHS services are currently being reconfigured. This restructuring is intended to streamline services, release efficiency savings, improve the quality of care, and shift care away from hospital settings wherever possible.

It is unclear the extent to which all new services will be sustainable. Maternity networks are currently being developed in a number of areas. These may deliver economies of scale and improve quality by supporting women’s choice (for example increasing capacity for home births). Larger acute settings will create opportunities to integrate nurses into the maternity team.

While reorganisations are resulting in the closure of some birthing centres, other shapers are likely to result in an increase in midwifery-led units, which will need to be supported by a full obstetrics service. It is unclear what impact the changes in service commissioning and frameworks (such as the Outcomes Framework) will have on maternity services and workforce commissioning.

In the future there is likely to be a greater plurality of provider models (such as social enterprises) and practitioners, including independent obstetricians. However, indemnity is likely to restrict their role in maternity to low-risk activities such as antenatal screening and breastfeeding support. Independent midwives could increasingly provide support for home births.

Some of the information in this section is provided by stakeholders and expert groups, and does not necessarily represent the views of the CfWI.