Professionalism and person-centredness: developing a practice-based approach to leadership within NHS maternity services in the UK

ABSTRACT

This paper, based on data taken from in-depth interviews with senior midwives and obstetricians and conducted as part of a critical ethnographic study, argues for a greater appreciation of person-centred, value-led midwifery practice. The paper begins with a discussion of the way midwifery practice is shaped by encoded and embodied knowledge. The paper subsequently focuses on an emergent practice-based leadership using an adapted Aristotelian conceptual framework derived from MacIntyre [(2007). After virtue (3rd ed.). London: Duckworth]. Professional dissonance is highlighted as a difficulty experienced by repositioned managers who are also expected to be leaders in their field. Using data gathered from in-depth interviews it is contended that establishing person-centred care might be better achieved through the development of practice-based leadership (rather than solely by adherence to organisational requirements). This type of leadership could potentially nurture a professional environment that promotes qualities such as agency, commitment and high levels of competence among midwives. Such leadership is central to UK government priorities and is applicable to a global practice development agenda.

KEYWORDS:

• Midwifery
• person-centred approach
• MacIntyre
• professionalism
• professional dissonance
• autonomy

Acknowledgements

The authors are grateful to the participating midwives, obstetricians and childbearing women.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Ruth Deery http://orcid.org/0000-0002-3507-8129

Pamela Fisher http://orcid.org/0000-0002-7121-5485

Additional information

Funding

This work was supported by the Health Foundation, an independent charity working to improve the quality of health care in the UK under [grant 4421/4048].