Limited research suggests that successful implementation of integrated nursing increases perceptions of overall primary health care team functioning. This paper reviews those studies and also reports on the findings of relevant studies of teamwork in the wider primary care context. Effective teamwork is essential if the concept of a primary care-led NHS is to become a reality. Achieving effective teamwork however is fraught with difficulties and requires skilled facilitation to overcome obstacles such as fear of change, professional jealousies and diverse lines of accountability. The facets of good teamwork include a high level of participation by all members, support for innovation, clarity of team objectives, task orientation and mutual role understanding. The diversity of problems encountered in primary care makes auditing the collective work of teams very difficult. As a result, most research in nursing and primary health care teams has concentrated on team process rather than outcome. Efforts should now be channelled into refining existing methods of evaluation and developing new outcome measures.

Midwifery care is generally very limited in early pregnancy, which can be a worrying, uncertain and unstable time for potential parents. An early pregnancy assessment unit provides a special place for the midwife to give support, understanding and advice for women with possible problems.

In the first of a series of articles on how to undertake research, Hilary Paniagua asks what are the benefits and explains how to begin.

This article explores the suitability of the EFQM excellence model (a model that originated in business) for delivering clinical governance within maternity services. It also explains some of the key aspects that emerged from the initial stages of implementing the model within a particular maternity unit. The potential for the model to stimulate continuous improvement for the benefit of all customers of maternity care was soon recognized.