Midwife staffing recommendations published
There should be one midwife to each woman during birth, National Institute for Health and Care Excellence (NICE) has recommended.
Posted: 2 March 2015
The cost of the new recommendations is estimated to be around £4m. However, it is claimed should all current midwife vacancies be filled - it may not add any additional costs to the health service.
Commissioners, hospital boards and senior management should focus on the needs of each woman and baby, irrespective of the time or day of the week, said the NHS watchdog.
Care should be provided for the woman throughout labour “exclusively by a midwife solely dedicated to her care”, according to the guidance. However, it doesn’t necessarily have to be the same midwife throughout the entire labour process.
Midwifery staffing adequacy should be reviewed at least every six months by the board of commissioners, trust boards and senior management and local records should be used to help predict potential requirements and variations in demand.
Escalation plans in the event of unexpected demand for services should include: sourcing extra staff using on call staff and temporary staff, redistributing the workload to other “suitable trained and competent staff” and rescheduling non-urgent work.
Red flag events such as delayed or cancelled time critical activity, any occasion when one midwife is not able to provide continuous one-to-one care and support to a woman in labour should be notified to the midwife in charge.
Director of health and social care at NICE, Professor Gilian Leng, said the care provided by midwives has a lasting impact on a woman’s wellbeing as well as the health of her baby.
“This new guideline provides evidence-based advice to the NHS on how to ensure midwifery staffing is safe in whichever setting a woman may choose, be it at home, in the community or in hospital.”
Chief executive of the Royal College of Midwives, Cathy Warwick, said the report highlighted the vital importance of ensuring adequate staffing in the antenatal and postnatal periods as well as in labour.
“I am very glad that the guidance focuses primarily on the needs of women and babies, and the importance of making time to give them individualised care; this will help ensure women and babies get the care they deserve.”
The link between staffing levels and safe care is “indisputable” according to chief executive of the Royal College of Nursing, Dr Peter Carter.
“This focus on safe staffing levels is welcome, and it must be supported by the government with a sustained national investment in the workforce, to ensure trusts are able to employ the staff they need to provide safe care.
“No two departments are the same, and staffing levels should be monitored regularly to ensure they are locally appropriate and able to cope with any rise in demand.”
Dr Carter warned the guidance will do nothing to ensure the safe care of mothers and babies without a “sensible, long-term workforce plan”.