Normalisation process theory as a conceptual framework for continuity of carer implementation |
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| Institution: | 1. School of Health & Social Care, Edinburgh Napier University, Sighthill Campus, 9 Sighthill Court, Midlothian, EH11 4BN, United Kingdom;2. NHS Education for Scotland, Stirling Community Hospital, PDU/ Admin Block Level 1, Livilands Gate, Stirling, FK8 2AU, United Kingdom;3. Professor of Maternal and Child Health and Clinical Chair, Gold Coast University Hospital, School of Nursing and Midwifery, Griffith University, Gold Coast Campus, QLD 4222, Australia;1. Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;2. School of Public Health, College of Medicine and Health and Care Sciences, Department of Epidemiology and Biostatistics, University of Rwanda, Rwanda;3. Obstetric Unit, Sahlgrenska University Hospital, Gothenburg, Sweden;1. Department of Management Studies, School of Business and Law, University for Development Studies, Wa Campus, Ghana;2. Nottingham University Business School, Jubilee Campus, Nottingham, NG8 1BB, UK;3. Department of Planning, Faculty of Planning and Land Management, University for Development Studies, Wa Campus, Ghana;1. Research Centre for Midwifery Science, Zuyd University, Maastricht, The Netherlands;2. Department of Society Studies, Faculty of Arts and Social Sciences, Maastricht University, Maastricht, The Netherlands;3. CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands |
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| Abstract: | ProblemDespite long standing strategic level ambitions to increase access to continuity of carer (CoC) models in maternity services, implementation of CoC in the United Kingdom (UK) has been generally small-scale and short lived. This indicates problems in implementing and sustaining CoC as the main model of care provision, and as such a need to better understand the process of implementation itself.AimTo use normalisation process theory (NPT) to underpin development of a conceptual implementation framework for CoC in order to improve understanding of the implementation process.MethodsLiterature review on CoC implementation and NPT development and use, combined with immersion in the implementation of CoC context.Results and DiscussionA conceptual framework for the implementation of CoC is developed and individual components discussed, with a view to better understanding the implementation process for CoC models. The will of a critical mass of midwives to work in a CoC model and the provision and maintenance of the ‘organisational space’ required for CoC within the National Health Service (NHS) emerge as key barriers to mainstreaming CoC in the UK.ConclusionThere is utility in NPT as a means of understanding and conceptualising large scale implementation of CoC. With testing and further development into a practical tool, the conceptual framework developed here could become a useful aid to those involved in implementing and evaluating CoC in the context of renewed strategic direction and Governmental level support in the UK. |
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| Keywords: | Midwifery continuity of carer Normalisation process theory Mainstreaming United Kingdom |
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