Implementing and Evaluating Maternity Service Provision in Remote and Rural Scotland

Summary

Executive summary. (Adobe PDF)

Background

Falling birth rates and medical workforce issues are driving further centralisation of acute obstetric and neonatal services in Scotland. Policy is seeking woman-centred care, and strategically improved workforce training and manpower planning to deliver sustainable local maternity services in remote and rural locations. This proposal seeks to build on an earlier national study of multi-professional staff views on workforce issues, competencies and training requirements to sustain high quality maternity care, including intrapartum care, in remote and rural settings in Scotland, in a new evaluated intervention study.

Aims

In collaboration with the North of Scotland Planning Group, this proposal aims

• to develop and implement policy recommendations and demonstrate new EGAMS level-1 models of maternity care for low risk women in remote and rural settings.
• To evaluate service process, quality of service models, and managed implementation of service redesign.

Design And Methods

The proposed pragmatic and composite evaluation design has three modules to meet the brief specifications:

1. An internal process monitoring to describe and inform the service intervention and change management.
2. An external evaluation of quality of care examining patient preferences for attributes of services, appropriateness of care, and costs.
3. An external evaluation of managed change in the intervention seeking generalisable evidence of best practice to achieve maternity service redesign as specified by EGAMS.

It uses both qualitative and quantitative methods.

Settings

Three case study sites (each representing one EGAMS level of care) with the intervention, compared with three comparison sites with no intervention at this time.

Study Outputs

The intervention will be evaluated against the strategic process of strengthening workforce capacity and sustainable service and include examination of key process and quality of care issues. Selected models of care and comparative methodology will produce timely and generalisable findings to inform practice and policy.

Investigators

Dr Janet Tucker, Dugald Baird Centre
Dr Jane Farmer, Management Studies
Ms Helen Bryers, Maternity Services Co-ordinator NoSRPG / HIHRI
Dr Alice Kiger, Centre for Advanced Studies in Nursing
Dr Edwin van Teijlingen, Dugald Baird Centre / Dept of Public Health
Professor Mandy Ryan, Health Economics Research Unit
Ms Emma Pitchforth, Dugald Baird Centre

Implementing And Evaluating Maternity Service Provision in Remote and Rural Scotland is funded by RARARI, NHS Scotland.

For more information contact: Sustainable Maternity Service Provision in Remote and Rural Areas in Scotland , Dugald Baird Centre for Research in Women’s Health, Department of Obstetrics and Gynaecology, University of Aberdeen, Cornhill Road, Aberdeen AB25 2ZA. (Tel: (44) 1224 559737, Fax: (44) 1224 553708, Email: Dr Janet Tucker (j.s.tucker@abdn.ac.uk)