Briefing: Midwifery staffing workforce review
Date of issue: Wednesday 27th June 2012
As part of creating an expanded maternity workforce which is sustainable and safe, a formal staff consultation has been carried out into the skill mix within midwifery. This consultation is about net investment in our maternity service, which will increase the number of midwives and improve quality.
Evidence clearly shows a direct relationship between the number of midwives and quality and safety. We are absolutely dedicated to delivering a ratio of 1:27 in our maternity service and ensuring that the skill mix of our staff reflects the needs of service users and brings us into line with best practice elsewhere. This will ensure that safety and experience for mothers and babies is the best it can be.
We are satisfied that the current proposals represent the best way to make changes that deliver maximum benefit for service users - by increasing the overall number of midwives in a way that is sustainable in the future, and increasing the amount of time they are able to spend directly caring for women.
We have confidence in the robustness of the process in place, led by the head of midwifery, and we fully expect the investment we are making to increase the number of midwives in the service to successfully help us sustain the 1:27 ratio in future, as well as increase safety and quality in our service.
The recommended ratio of midwives to women in a maternity service is one midwife per every 28 women (Safer Childbirth, RCOG 2007). We are investing £2m to increase the number of midwives to achieve a ratio of one midwife per every 27 women (as recommended by Birthrate Plus, workforce planning for midwifery services) and improve safety and quality. Recruitment of these additional staff is underway and plans are also being put into place to ensure that this important ratio of midwives to women (1:27) can be sustained into the future.
As part of creating an expanded maternity workforce which is sustainable and safe, a formal staff consultation has been carried out into the skill mix within midwifery. The purpose is to explore reshaping the workforce to deliver a high quality service in line with national recommendations that accurately reflects the needs of local women. We also aim to increase the amount of time that each of our midwives has to care directly for the women they are caring for.
The consultation recommends a reduction in the number of Band 7 midwives. It is important to make clear that the consultation does not recommend a reduction in the number of overall midwifery posts – we are investing to increase the number of midwives in the service.
Any eventual changes to the skill mix will ensure that the appropriate leadership, skills and experience is in place to meet the needs of all the women using the service, including increasing numbers of women with co-morbidities and complex pregnancies.
We have carefully benchmarked the skill mix of our maternity staff against other maternity units, including similar teaching hospitals in London. Our midwifery service currently employs more Band 7 midwives than other similar services.
We aim to introduce a higher number of band 5 and 6 midwives, supported by additional general nurses and maternity support workers. These changes will assist the trust in making the department more cost efficient and create a more sustainable workforce for the future.
A full consultation has been completed with maternity staff and we have received their feedback. No final decision has been made and we will be taking into consideration all the views of our colleagues when determining how the maternity service can better meet women’s needs now and into the future.
The process is in line with the trust’s change management policy and there are no planned redundancies as part of the review - in every case we aim to redeploy any midwife whose post is affected.
Chief nurse and director of operations
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