All the materials used within a Birthrate Plus(R) Workforce Planning study are included in;

MATCHING WORKFORCE TO DEMAND IN A TIME OF CHANGES IN SERVICE

At this present time many maternity services are facing change, including the merging and development of services, and need to review their staffing needs.

Although a number of services have commissioned a full BR+ study, others may find that this is practical either because of time/financial constraints , or because of major changes in services which mean that staffing needs to be based upon projected annual numbers of hospital or home births and the likely volume of community care.

BIRTHRATE PLUS(R) CAN NOW OFFER THREE OPTIONS FOR WORKFORCE PLANNING IN MIDWIFERY, DRAWING ON OUR NORMAL METHODS, OR USING THE DIFFERENTIATED RATIOS ARISING FROM THE BR+ DATABASE. 

Option 1: The objective of this option is to provide a detailed staffing profile of midwifery & non-midwifery establishments for all areas of service based on current and projected activity, and models of care.  

This is the recommended option for undertaking a detailed review of workload and activity in order to provide a comprehensive midwifery and non-midwifery workforce profile. 

staffing. 

A service have had previous experience of  applying the Birthrate Plus(R) methodology, but have experienced significant changes in the numbers of clients or in patterns of care and it would be unwise to "old" data.

The intrapartum casemix has the major impact on the hospital workload and the midwifery establishment and it has been found that it is possible to produce robust data from a reduced period of data collection for 4 months.

The intrapartum data and other records of client and midwife activity will  provide detailed staffing for each area of hospital and community care and reflect quality standards.  This will enable a review based on ‘models’ of care, such as a Birth Centre/Midwife Led Service.
 
BR+ will provide the following services:
· Training of project midwife with on & off site support to the project midwife to ensure robust data
· Provision of all material needed both for training and data analysis
· Support implementation throughout the data collection period
· Data validation & analyses both on & off site
· Interim Feedback, with midwifery & skill mix recommendations
· Option appraisal using interim data and to assess changes to service, clinical practices, model of care, etc.
· Final Workshop with Presentation to Executive Team/ Trust/ Health Board and midwives
· Final Report

Option 2: The objective of this option is to provide separate midwifery establishments for hospital and community workload based on current casemix and total births, and by applying national ratios.
This option will provide a total midwifery establishment for hospital care and for community services, with detailed staffing profile for the labour ward and clinics, but not specific to the wards, thus partially assisting with deployment of midwives.  It will contribute to a review of skill mix in terms of the contribution from non-midwives.

This approach will  collect data on the current clinical casemix for hospital births over a period of 3 months, and on hospital clinic activity. This will enable decisions to be made on the appropriate ratios of women/births to midwives (drawn from the national database )to be applied to projected annual hospital and home birth figures.

This option will also collect data about extra activity incurred in community, namely, imported cross border cases, i.e. those whose births take place outside the particular maternity service and ensure that the parameters used in the calculations to "match" local patterns of service. 

This approach will not enable a review of staffing for the different ‘models’ of care.

B.R + will provide the following services;
Training in the collection of casemix data

External support to validate and analyse the data. 

On site meetings to plan and train, provide a mid stage data review and finally to present results. 

Off site support is available throughout the study.

Option 3: The objective of this option is to provide separate midwifery establishments for hospital and community workload based on total births by applying national ratios and over a shorter peiood of time. This option is most suited to a population based approach and may be most useful to planners at SHA level or where PCT,s are apprasing different pattemrs for provision of services.

This option will provide a total midwifery establishment for hospital care and for community, but not give a detailed staffing for intrapartum, ante & postnatal care; nor enable a thorough review of skill mix.  Such an approach will use ratios of women/births to midwives, based on current and projected annual hospital and home birth figures, plus data on extra activity incurred in community, namely, imported cross border cases, i.e. those whose births take place outside the particular maternity service.

A judgment of the current casemix will be made based on intrapartum statistics for types of delivery.  No additional data collection is required. This approach is useful when dealing with population based data and a baseline is required, rather than information on the clinical profile.  This is not recommended for a review of midwifery workforce at Trust level, but more for use by PCT’s and commissioners of maternity services.

On receipt of the data and following any further telephone follow up; the information will be analysed and combined with appropriate national ratios to produce a staffing profile.  A report would then be produced and presented on site so that discussion and clarification can take place.

Options 2 & 3 do not enable a review of staffing for different models of care, such as midwife led and obstetric led services.  In discussion with the midwifery management team, midwifery hours for governance, general management, project posts and other non-clinical specialist work will be calculated. Contribution from non-midwifery roles to assist and support the midwives can be included if required.