Role redesign in the National Health Service

Abstract

This article examines the effects of role redesign on the work and professional boundaries of midwives employed in the National Health Service. It outlines midwives' views and experiences of attempts to change their skills and professional boundaries and, using the concept of closure, considers the implications for the midwifery profession. The findings show that role redesign is changing midwives' work and that the traditional emotional, social and caring skills associated with a midwife are being undermined by the growth in technical work. Importantly, midwives' attempts to use closure have met with limited success and aspects of their work which they enjoy are being delegated to maternity support workers, while midwives' roles expand to include work traditionally performed by doctors. Midwives' concerns about the implications of work redesign for maternity care and their professional boundaries reflect the uncertainty surrounding the profession about the future role and skills of a midwife.