1 / 22

Birthrate Plus

Birthrate Plus. More than just a number. What is it and who can use it?. National tool that for any given maternity service calculates the number of clinically active midwives required to deliver a safe high quality service

holt
Download Presentation

Birthrate Plus

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Birthrate Plus More than just a number

  2. What is it and who can use it? • National tool that for any given maternity service calculates the number of clinically active midwives required to deliver a safe high quality service • Individual trusts use it to determine their own staffing needs (individual ratio) • Regions or areas use it for workforce planning, commissioning student numbers (aggregate ratio) • National orgs (DH, RCM) use it to make broad statements about supply and demand (overall ratio)

  3. So simply? Number of births _______________ Number of midwives

  4. 1.Using BR+ in an individual unit • Quantify all activity – how many births, how much antenatal care/postnatal care, how many home births how much additional work: inductions, women not in established labour • Distinguish work involved – 5 point categorisation from normal/healthy “simple” maternity care to high risk/complex high degree of support and intervention • Collect data over agreed period usually 4/6 months • Data analysis makes allowance for time lost (travel, sickness, leave etc)

  5. Translating labour ward workload into midwifery hours

  6. Example: St Anywhere Trust – 5,200 Women: Labour Ward Workload

  7. Assessing staffing needs in all other aspects of midwifery care • Hospital: antenatal clinics, antenatal admissions, triage, day care postnatal inpatient stays • Community: antenatal care, parentcraft education, postnatal care • Methodology: Expert Group/Professional Judgement

  8. Example: St Anywhere’s community workload for 5200 deliveries

  9. Example: St Anywhere’s additional hospital workload

  10. What’s in & out

  11. Result: An individual ratio • Ratio is expressed as midwife to births • Could be anywhere in the range 1:27 – 1:32 THIS IS ONLY CLINICAL MIDWIVES • Depending on • Split between high/low risk women • Amount of time given to travel and other variables • Cross border activity ie antenatal/ postnatal care to women not counted as births

  12. Local decisions using ratio • How many additional non-clinical midwives (usually between 8-10%) • How many midwives can be replaced by MSWs (usually between 10-15%) • How to deploy midwives – staffing and service models THIS WILL DETERMINE HOW MANY ACTUAL MIDWIVES ARE EMPLOYED

  13. 2. Using BR+ at a regional/planning level – desk top exercise • For hospital activity only • Tertiary services 1:38 • DGH with >50% in cat IV & V 1:42 • DGH with <50% in cat IV & V 1:45 • Homebirths & MLUs 1:35 • For community activity only • Antenatal/postnatal 1:96

  14. Example: Smallcity Trust Wengerville Trust is a medium size obstetric unit with a small free standing midwifery unit. There is a neighbouring Trust nearby and in consequence there is some cross border movement of women

  15. Calculating Staffing Using Differentiated Ratios

  16. How do you express that? • 191.41 wte is a ratio of 1:27.8 across all BIRTHS • In the OU the ratio is 1:28.3 across BIRTHS but 1:28.5 across all activity • In the FMU the ratio is 1:21.5 across BIRTHS but 1:55 across all activity The amount of antenatal/postnatal care is a significant part of the story

  17. Planning midwife numbers • Desk top review easily identifies number of midwives required in each trust • More robust than simply applying 1 national ratio • Local decisions about management time and MSWs • Compare requirements with actual staff in post • Develop plans for moving from here to there • Factor in vacancy rates, retirement predications, local churn • Determine number of student midwife commissions required to move from here to there

  18. Safety when BR+ is not met? • How many women get 1 to 1 care in labour? • What % of women are booked by 10/40? • What degree of continuity do women receive antenatally and postnatally? • Is there a supernumerary ward coordinator on every shift? • What specialist roles are funded? • How many non-clinical midwifery roles are funded? • What are levels of vacancy, turn-over, staff morale and sickness?

  19. 3. Using BR+ at a national level ASSUMPTIONS? • Average ratio around the country 1:29.5 • Birth rate in England around 700,000 • Around 96% births in OU • Around 8% additional non-clinical midwives required • Around 10-15% of clinical midwifery posts can be replaced by MSWs

  20. Translates into ?

  21. Issues going forward • National overall ratio changes over time • Are we going with 1:28, 1;29, 1:29.5? • Professional consensus on time for community activity probably needs review • Professional consensus on MSW time definitely needs review • How do we draw attention to the implications of NOT staffing at BR+ recommended ratio? • As birth rate goes down will need for midwives? • Not if you take into account increasing complexity

  22. Download a copy of the tool http://www.rcm.org.uk/college/policy-practice/joint-statements-and-reports/

More Related