Is caseloading Sustainable? 25-year History of Caseloading at King’s College Hospital

Abstract

Caseload midwifery is defined as follows: When a midwife carries a caseload she is the primary provider of midwifery care (the named midwife) during pregnancy, birth and the early postnatal days for an agreed number of women. She may be providing care to women wherever they are: at home, in the community or in a maternity unit. She has responsibility for the planning and monitoring of care throughout for the women on her list. She liaises with medical colleagues and social agencies as appropriate (National Childbirth Trust 1995). Caseloading is a relational model of care provided by a small team of midwives who do on-calls in order to provide a 24/7 service. Midwives have autonomy over their workload, allowing them to respond to the individual needs of women and their families. Mixed-risk caseloading has been an important element of maternity care at King’s College Hospital for 25 years, where currently almost 20 per cent of the 5-6,000 women who give birth there each year receive caseloading care.

Is Caseloading Sustainable? Lessons from the Front Line at King’s College Hospital

“…A major reorganisation of community services at King's in 2015 seeking to ensure parity across the whole King's area (Wiseman & Holland, 2018) involved moving caseloading teams to areas of significant socio-economic and ethnic diversity. The Lanes team moved from affluent East Dulwich to Brixton/Camberwell, becoming 'Electric' (after the famous Electric Avenue in Brixton).…”

“…At King's College Hospital in Camberwell, south London, we have a 25 year tradition of NHS caseloading, with named midwives providing continuity for all antenatal, intrapartum and postnatal care for women and their families (Wiseman & Holland 2018). Caseloading midwives care for 900-1,000 mixed-risk women each year, about 18% of King's 5000-5,500 births.…”