Title: Maternity Matters Choice, Access and Continuity of Care in a Safe Service
1Maternity MattersChoice, Access and Continuity
of Care in a Safe Service
- Caroline Donovan
- Deputy Head of Workforce Development
- West Midlands Workforce Deanery
2Purpose and aims of today
- An opportunity to hear the key workforce
challenges of Maternity Matters from a range of
stakeholder perspectives - Hear about the support, guidance and tools to
help local workforce planners supporting delivery
of Maternity MattersHear and share some local
examples of good practice - Through locality based discussions identify
priorities, levers and challenges in
implementation - The workshop will support organisations in
developing the integrated workforce plans that
will be needed to deliver the new policy. - Define regionally and locally our next steps
3- Welcome and enjoy the day!
4Issues identified from the NHS WM/ DH/CSIP day
15th May 2007
- Sue Hatton
- Workforce Specialist
- West Midlands Workforce Deanery
5 Issues identified from the NHS WM/ DH/CSIP day
15th May 2007
- Wealth of expertise and good practice
- Useful to have an opportunity to air issues in
safe environment - To meet colleagues and find Commissioners (!)
- The need for local vision around maternity
services. - Areas are at different stages of development for
implementation there are specific local
challenges. - Self assessment benchmarking tool (SAM) useful
- Concerns about how to guarantee choice
- Importance of user involvement, clinical
leadership and multidisciplinary working.
6Contd
- Development of multi-agency care pathways with
the right skills and competencies essential - Maternal Mental Health pathway
- Workforce solutions/skill mix to increase
workforce capacity e.g. MSW - Need for more midwives, increase in training
commissions and further development of the role
of MSW (around home births) - Community midwifery caseloads vary in between 90
to 180 per midwife. - Return to Midwifery Practice
- How do we prepare clinicians/ have skills to
offer choice - Share good practice using CSIP Share Spread
- site
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8Useful websites
- www.cypf.org.uk/maternity
- for resources relevant to Maternity Matters and
sharing promising - practice.
- www.cypf.org.uk/maternity/tools
- for links to the online maternity matters
baseline self assessment - Matrix to benchmark progress and support action
planning and - other key tools.
- http//kc.csip.org.uk/groups.php?grp593
- to join the discussion area.
9New Challenges
- Commissioning
- Payment by results (PbR)
- Close (seamless) working with other organisations
in new locations - Closer working with women (choice)
- Development of current services within existing
resources - Variations across the region in trends in the
birthrate - Increasing complexity
10NHS West Midlands Workforce Deanery
Caroline Donovan Deputy Head of Workforce
Development
11NHS West Midlands Workforce Deanery
- The West Midlands region
- One SHA
- (Population 5.6 million)
- One Workforce Deanery
- (Budget c 420million)
- Nine universities
- Three medical Schools
- Birmingham
- Keele
- Warwick
12SHA emerging priorities
- Secondary to Primary shift
- Long term conditions
- 18 weeks and diagnostics
- Women's and Children/young people
- Emergency care
- End of life care
- Mental Health
- Dentistry
- Public Health
- Empowered patients and self care
13Future Workforce Direction
- Workforce which is designed around the needs of
patients and can rapidly respond to expectations
of public - Workforce which matches demand and supply
- Workforce who is fit for purpose
- Flexible workforce who can work across teams and
organisations - Opportunities for continual increasing skills and
career pathways that are flexible and respond to
the service - Leadership at all levels
- Widening participation
- A workforce which is representative of the
community - Safe and regulated workforce
- MHC careers
14So what is the SHA role?
- Strategic overview of the workforce in line with
SHA framework - Commission for supply and quality assure
- provision
- Test and spread new ways of working and
commission new roles - Link with DH for Modernising Health Care Careers
- Recruit and train doctors
- Enable and support best HR practice
15So what is the SHA role?
- Maternity Matters workforce elements
- Lead the development of the NHS workforce
strategy, workforce modernisation and workforce
planning development - Ensure that opportunities exist for three year
and 18 month pre-registration programmes, reduce
attrition rates - programmes and flexible return to practice
midwifery programmes - Hold PCTs to account for commissioning
comprehensive maternity services - Ensure that Local Supervisory Authority standards
and activities promote safe,high quality care for
women and their babies and monitor standards of
midwifery practice - Ensure that the local community has
representation on a local MLSC orequivalent and
other user involvements groups e.g. LINKs
16NHS West Midlands SHA Workforce S/C
NHS Stakeholders
HESP
Workforce Deanery Management Team
Business Management
Innovation new ways of working
Education Workforce Development
Primary Care
Hospital Specialist
17Head of Workforce Development/ Postgraduate
Dean Professor Steve Field
Deputy Head Business Management Alan Hanna
Deputy Head of Workforce Development Caroline
Donovan
Hospital Specialist Jenny Powell
Innovation new ways of working Vacancy
Education, Research Quality Management
Jackie Wallsgrove
Primary Care workforce development Ruth Chambers
Workforce Information
Board of Postgraduate Medicine
------------------- 6 Foundation Schools
11Postgraduate schools of medical dental
specialties
Contracts
Nursing/ AHPs
Surgery / Anaesthesia
Leadership development
Quality Assurance
Commissioning
Access/ Assistant Practitioners
Deanery Action Team- WTD
Medicine
GP
Medical dental training recruitment and
programme management
New ways of working productivity
Education Development research
Pharmacy
Mental Health
Women Children
Public Health
Supporting trainee doctors in difficulty
Advancing Practice
Regional Library Unit
Diagnostic and Scientific
Dental workforce
Modernising Healthcare Careers
18How do we want to work?
- cost effective and efficient.
- demonstrate accountability for Multi Professional
Education and Training (MPET) levy funds. - being flexible in responding the workforce issues
emerging from clinical and service priorities. - working in partnership with key stakeholders
egTrusts, FTs, PCTs, LSC, Skills for Health, NHS
Institute, Social Care, Higher and Further
Education and Voluntary and Independent Sector. - demonstrating probity and sound corporate
governance. - ensuring that reducing inequalities and
regenerating local communities is a core
principle of operation.
19The Career Framework
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21Classical organisation profile (band width
indicates no. of jobs)
Level 9
Level 8
Level 7
Level 6
Level 5
Level 4
Level 3
Level 2
Level 1
22Main themes of maternity matters
- Choice of how to access maternity care
- Choice of type of antenatal care
- Choice of place of birth
- Home/Local facility/Hospital
- Choice of place of postnatal care
- Continuity of care
23Where are we starting from?
- Excellent training
- Good reputation
- Lots of enthusiasm
- Wealth of expertise
- West Midlands traditionally have poor home birth
rates - High perinatal mortality rates
- Different models of practice around when women
are booked, community midwifery caseloads etc..
24Birth rate trend in England Wales and the West
Midlands.
25But.
- West Midlands Region has the highest perinatal
mortality rate in England, and the gap is
widening 1.0 above the England rate in 1993,
1.9 above in 2005 - Some areas have very high levels of deprivation
26cont.
- Birth rates are much higher in some areas with
younger populations 50 of population in HOB is
of childbearing age compared to 36 in Shropshire
- Increase in demand from migration from the
accession countries to the WM (46,000), about one
third of which are female and of childbearing
age. (1.6 of all women 15-44 in WM) - This has a disproportionate impact in some areas
27Current workforce
- There are 2,092 FTE midwives in the West Midlands
(2,770 headcount) - 5 increase in England but no increase in WM
since 2001 - and 1.5 reduction 2005-2006
28Current workforce
- The non-registered maternity workforce in the WM
has also changed little since 2001. - Most midwives (80) work part-time (gt.9 FTE)
- Part time working has risen more in the West
Midlands than England - 3 month vacancy rates are low and have fallen
from 0.9 in 2005 to 0.2 in 2006 - Only 16 new graduates reported not to have found
jobs in NHS in 2006/07 - 7 redundancies in 2006/07- all voluntary
29Age profile of midwives in the WM
- Significant numbers of midwives are likely to
retire over next 5 years - 23 aged over 50, 10 over 55
30Future workforce
- The number of education commissions was increased
by 10 in 2003/04 and 2004/05 graduating in
2006 and 2007 - This should lead to a slight overall increase in
the numbers of midwives over the next 5 years - There are 148 OG consultants and 323 other
medical staff. - There are plans to increase the numbers of
consultants in the medium term through changes to
the training grades - Nationally, there has been a much larger increase
in the number of OG consultants (40) than in
midwives (5) since 1997
31Workforce Issues- In Summary
- Organisational culture leadership, flexible and
multi-professional working - Overall, skills and knowledge rather than roles
need to be looked at from an early stage. This
emphasis may lead to the development of new roles
and ways of working. - Education and development
- Return to midwifery practice
- Improving working lives including practice models
and skills mix
32Summary Next Steps
- Peter Blythin
- Director of Nursing and Workforce Development
33Thoughts from Today
- Lots of enthusiasm.
- Wealth of expertise and examples of good
practice. - The need for local vision around maternity
services. - Importance of user involvement, clinical
leadership and multidisciplinary working. - Areas are at different stages of development for
implementation there are specific local
challenges. - Workforce solutions/skill mix to increase
workforce capacity. - Development of multi-agency care pathways.
34Next Steps From Today
- NHS West Midlands is working in partnership with
CSIP, GOWM and NWP. - Record discussions and ensure all materials on
line. - Local implementation arrangements.
35Next Steps
- NHSWM - Geographical based action learning sets
around workforce planning. - CSIP to support implementation of the maternity
toolkit, the MM Self Assessment Tool and working
within the patch to decide the best way on how we
will deliver on this. - West Midlands Maternity Matters Implementation
Board. - Directors of Commissioning meeting.