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Since 1980 the standard of one to one care for women in labour has been held to be the desired level of midwifery care, and this was reinforced by the Winterton Report (House of Commons 1992) and the Cumberlege Report (DOH 1993)...........................but determining the number of midwives needed to meet that standard is not an easy task. It was to meet this need that the workload assessment system BIRTHRATE*** (Ball 1986) was first developed and was at that time centred upon Intrapartum Care.
Continuing work in the NHS extended the system to cover all aspects of midwifery care whether in hospital or community services. This was published as BIRTHRATE PLUS (Ball and Washbrook 1996). Since 2001 BIrthrate Plus has been implemented in over 200 Maternity Services of widely differing sizes and settings in the United Kingdom, in Eire and in New South Wales Australia. BIRTHRATE PLUS...A GOLD STANDARD? Birthrate Plus has been described as " the gold standard" for maternity care. We consider this to be a compliment as it reflects the standard of one to one care which so many Government and professional reports have cited as the required level of care for women in labour. However on occasion this term has been used to suggest that Birthrate Plus raises "unrealistic" expectations. Birthrate Plus standards for midwife work are based upon NICE Guidelines for antenatal and intrapartum care and are regularly updated to reflect changes in care practices and policies. Experience in many different maternity services has shown that the results of a study not only informs local managers about staffing needs, but also indicates care practices, client flows and other issues which can be addressed in order to increase efficiency and effectiveness in the use of resources. More information can be found on the Feedback from Managers page on this website. BIRTHRATE PLUS(R) CONSULTANCY LTD have now compiled an unique database which stores detailed information from all studies enabling us to identify factors affecting workforce needs, and to produce ratios of births/whole time equivalent midwives for different sizes of services. This has shown that there are signifcant local variables which affect the ratio of births to whole time equivalent midwives, including the number of clients who move between maternity services for different components of their care.
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