A Study using action research to help midwives influence and change maternity services

In April 2001, Calderdale NHS Trust and Huddersfield NHS Trust merged to become
Calderdale & Huddersfield NHS Trust. Until this time each of the trusts have worked
very much (get rid of ‘very much’) independently having developed their own
organisational styles and cultures. To add to the challenge of a recently merged
organisation, midwifery managers are also faced with the increasing demands of
modernising and improving the quality of maternity services (DoH, 1999).
In Huddersfield Royal Infirmary (HRI) there is a labour ward and independent
antenatal/postnatal ward, both of which are serviced by hospital based midwives. In
comparison, Calderdale Royal Hospital (CRH) moved from the traditional model of
maternity services (i.e. having separate delivery suites and antenatal/postnatal wards),
to a Labour, Delivery, Rest and Postnatal (LDRP) suite where women stay from
admission until transfer home. This is staffed by hospital based midwives. The
independent midwife led unit on the same floor is staffed by community midwives.
Prior to the introduction of the changes in Calderdale, a series of focus groups were held
in order to elicit midwives views of the service (Deery et al., 1999). Key areas affecting
midwifery morale were identified; in particular staffing levels, working relationships and
organisational issues. The following year in November 2000, further focus groups were
held to enable midwives to reflect on their experience and the changes that had taken
place since. Whilst midwifery morale was still low, participants were more politically
analytical of, and actively involved in changing their situation (Deery et al., 2000). The
findings from this study indicated that focus groups could be an important means of
positively developing maternity services and moving midwifery culture forward.
The above research studies helped the facilitation of culture and practice development
at CRH which is now well developed. In order to give the midwives at HRI the same
opportunity to become more actively involved in the planning and provision of future
services, we replicated the study that was undertaken in CRH. The two modern matrons
and Head of Midwifery services have collaborated and participated in this project. In
addition, as a means of understanding how the midwives views could link with
maternity managers, we also conducted further focus groups with maternity services
managers including the general manager and medical director of services
The aims of the midwives’ focus groups were to:
1. To provide a forum for midwives to explore current service provision.
2. To engage midwives in discussion of practice and service development.
3. To establish a ‘snapshot picture’ of midwifery in Huddersfield.
4. To gain an insight into midwifery morale.
5. To make written recommendations to the Children’s and Women’s Services
Division.