Narratives from the Blackburn West caseholding team: building up

The first paper in this series described the development and early set-up of a caseloading group midwifery practice in East Lancashire Hospitals NHS Trust in 2004. This second paper details the processes that took place after the team leader was appointed, including an analysis of the changes that took place in the first two years in staffing organization and on-call arrangements. Intervention rates were markedly lower in the caseholding team when compared to both the local hospital and a local midwifery team with a similar demographic profile and rates of normal birth without intervention being particularly high. The paper identifies and expands on nine key factors that appear to be important in promoting the effectiveness of the group practice. These were: continuity of carer; visibility in the community; multi-agency involvement; inter-disciplinary collaboration; leadership; strategic partnership; ability to be innovative and flexible; involvement of local community and individuals; and shared group philosophy.