Hospital Dr News

Lack of staff holding maternity services back

Maternity services are improving but there are still significant barriers to progress, a King’s Fund report claims.

Teams reported that the barriers preventing progress include a lack of staff, poor communication between staff from different disciplines or different units, particularly during transfer, and a lack of leadership.

The report is based on the outcome of a series of regional events held with midwives, obstetricians and risk managers. It’s the first stage of the Safer Births Initiative – a service improvement programme.

Solutions identified by the teams included new ways of deploying staff, such as case loading or flexible rostering across labour ward and community teams, developing support roles to take on new responsibilities and enabling midwives and obstetricians to attend the same multidisciplinary handover.

Dr Anna Dixon, director of policy at The King’s Fund, said: “This report shows that maternity professionals are introducing new ways of working that should improve the safety of care provided to mothers and babies. We are seeing progress and an appetite locally for change – there are many examples of local innovation where solutions focus on making the best use of existing resources to deliver safe care.

“Yet frontline staff who took part in our events also identified obstacles they face in providing the safest possible care. They told us that they want to be able to exchange ideas and good practice with other trusts and that they need practical advice on how to improve safety, tailored to their local circumstances, not simply more guidance.”

The RCOG welcomed the report but also called on the government to ring fence, at trust level, the £330m it’s promised maternity services between 2008 and 2010. Clinical directors and heads of widwifery need to work with NHS managers to ensure that these funds are secured and appropriately allocated, it said.

The RCOG acknowledged that finding trained staff was a problem and that, while rota and service redesign could help, there was still a need to recruit more midwives to provide one-to-one midwifery care to women throughout their pregnancy and for more consultant presence on the labour ward.

Professor Sir Sabaratnam Arulkumaran, RCOG president, expressed support the drive for more effective use of existing resources. “You can pour money into the system however what is fundamental is not what you buy but how you go about planning your services when funds are tight,” he said. 

Read more on the RCOG’s solutions to the challenges.

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