Independent evaluation of the implementation of Midwifery Continuity of Carer

The Midwifery Continuity of Carer (MCoC) model, which is part of the Maternity Transformation Programme (MTP) and builds on the recommendations of Better Births supports the commitment of the NHS Long Term Plan for safe, personalised care and achieve 50% reductions in stillbirth, maternal mortality, neonatal mortality and serious brain injury, and to reduce the rate of preterm births from 8% to 6% by 2025.

The ambition for the NHS in England is for MCoC to be the default model of care for maternity services and available to all pregnant women in England, with rollout prioritized to those most likely to experience poorer outcomes. In accordance with the principle of proportionate universalism this means that as continuity of carer is rolled out to most women, women from neighbourhoods with high numbers of women from Black, Asian, and Mixed ethnic groups, and women living in deprived areas are prioritized, with plans for implementation in place by June 2022, with safe staffing and building blocks taken into consideration. The aim is for 75% of women in these groups receiving continuity of carer by March 2024 (Equity and equality Guidance for local maternity systems 2021).

NHS England are working with the Department of Health and Social Care to implement the 15 Immediate & Essential Actions (IEAs) and every trust, ICS and LMS/LMNS Board must consider and then act on the report's findings. In the context of this recommendation, the 1 April letter from the Chief Executive, Chief Nursing and Chief Medical Officers at NHSEI restates the 15th June deliverable for the agreement of MCoC plans staffing. This guidance builds and updates on Delivering Midwifery Continuity of Carer at full scale (October 2021).

Updated system guidance published on the 6th May 2022 within the context of the Final report of the Ockenden review and the Immediate and Essential Actions (IEAS) that relate to Continuity of Carer includes:

• Requirements relating to the agreement of plans to deliver Midwifery Continuity of Carer (MCoC) as the default model of care by March 2024, or to timescales linked to essential recruitment of midwives, as agreed with Regional Boards.
• As part of this, how to use the Assurance Template to summarise plans for regional and national assurance.
• How systems should plan to roll out Enhanced MCoC teams for the most deprived areas, with a view to receiving funding for implementation from Q3 2022/3. Note the enhanced scheme for continuity of carer will be the subject of separate research.

There is now a clear need for an evaluation to be undertaken on the implementation of MCoC to assess its effectiveness, the impact on maternity services, the women who use them and any unintended consequences. This evaluation will also inform the ongoing implementation of MCoC.