Introducing a new retention midwife role within NHS maternity services in England: a qualitative study.

OBJECTIVE

To explore the perspectives of 'retention midwives' about the implementation of their novel role supporting the retention of colleagues in maternity services in England.

METHODS

A qualitative descriptive study, based on semi-structured interviews with 21 retention midwives, analysed using inductive thematic analysis.

RESULTS

Three themes were developed: (1) 'Defining the role: flexibility and ambiguity'; (2) 'Implementation context: buy-in and readiness to change'; and (3) 'Supporting midwives in specialist roles'. Effective implementation was characterised by role clarity balanced with the flexibility to adapt the role locally without losing the focus on retention; by a local context where leaders were open to innovation, willing to take risks and not overwhelmed by extreme funding and staff shortages; by clear reporting structures and accountability; and by access to peer support through organised networks. It was undermined by short-term funding; role overload; unclear communication about the role from funders to maternity leaders and from leaders to staff; and a lack of management training for clinical midwives in their first management role.

CONCLUSIONS

The non-negotiable components of a new role should be clearly defined to ensure that it is implemented effectively in all trusts, and not reliant on enthusiastic individual leaders who are willing to take risks on innovation. Funding structures should ensure that the creation of a new role does not exacerbate understaffing in non-specialist areas. Future national implementation of specialist midwifery roles could include more structured use of change management principles and be accompanied by formal process evaluation.