Using midwives and other maternity staff more effectively is the key to improving maternity care in hospitals, according to a new Kings Fund report – Staffing in maternity units: getting the right people in the right place at the right time.
Despite current debate over midwife numbers, increasing staffing levels in maternity departments will not be easy in the current financial climate. Evidence shows, however, that the maternity workforce could be more effectively utilised to improve outcomes for mothers and babies. The report recommends deploying midwife-led care more widely for women at a low and medium risk of problems, with the potential to improve outcomes for women and babies and to save costs for the NHS. In 2009/10, only 10% of hospital births in England took place in midwife-led wards. The report identifies other ways in which care could be more effectively organised within maternity teams. Shifting tasks from doctors and midwives to nurses and support workers, where appropriate, could free up the time of midwives to provide one-to-one care for women and for doctors to focus on supporting women at higher risk of problems. The report also calls for further development of the Birthrate Plus tool, which is used to plan midwifery requirements and determine midwifeto- woman ratios. Commenting on the findings of the report, Anna Dixon, director of policy at The King’s Fund said: “Midwife-led care should be the norm rather than the exception. Midwives’ time must be used more effectively with an increased use of maternity support workers providing lay support. This would free up doctors to spend more time caring for higher-risk women. Having sufficient staffing levels is important, but there is a need to rethink how staff are deployed. I hope this report will facilitate a wider debate about maternity care that recognises the need to organise the workforce more effectively.”
