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

BIRTHRATE ACUITY SYSTEM:

During 2007 Birthrate Plus® (BR+) developed a means for midwives to assess their "real time" workload in the delivery suite arising from the numbers of women needing care, and their condition on admission and during the processes of labour and delivery.

This was termed a measure of "Acuity" and an outline of the method is given below.

The initial methodology was validated by further use in the maternity services in Wales co-ordinated by Marie Washbrook.

Briefly the system is based upon an adaptation of the same clinical indicators for intrapartum care used in the well established workforce planning system Birthrate Plus®.

The scoring has been changed to enable the BR+ classification system to become a predictive/prospective tool rather than the retrospective assessment of process and outcome of labour used in Birthrate Plus®. By this mean, an hour by hour assessment can be produced of the numbers of midwives needed in the delivery suite to meet the needs of the women, based on the minimum standard of one to one care for all clients and increased ratios of midwife time for women in the higher need categories.  This provides an assessment on admission of where a woman fits within the BR+ Categories I –V which are cited in Safer Childbirth (RCOG 2007) and Staffing Guidance (RCM 2009), and alerts midwives when events during labour move her into a higher category and increased need of midwife support

The acuity system also provides a means of:

a)    classifying other women admitted to the delivery suite but who do not give birth at that time

b)    allocating ratios of midwife time required for their care.

It has always been the intention of Birthrate Plus® Consultants Ball and Washbrook to make this system available within the Health Service as we have done with the well established workforce planning system Birthrate Plus®.

However because the Acuity system is an "off-shoot of the original (Ball and Washbrook 2006 Elsevier Press), it has been necessary to take advice on protecting our Intellectual Copyright and to ensure that the new "offspring" does not infringe the existing copyright.

It is our intention to seek to license the Acuity System so as to make it available to maternity services and we have already made some progress in this direction. It will also make it easier to add further developments such as specific models for different types of maternity services.

During the summer we worked with our colleagues in the NPSA and at their request made the Acuity system available for maternity units undertaking the first pilot stage of the NPSA Maternity Scorecard. This enabled services to compare the number of midwives needed against those available in the delivery suite.

This proved successful as did further work with the Acuity System in some other maternity services in England.

It had been intended that we would provide the acuity system and support to the units embarking upon a further pilot stage of the NPSA Maternity Scorecard. However, the time scale needed to clarify our position with Elsevier (which is now completed) and to produce a license will delay the planned implementation of Maternity Scorecard.

We wish them well as this important project continues to be rolled out.

We wish to assure fellow midwives and maternity services that;

A.   The Birthrate Acuity system has always been a stand alone methodology which can be used to assess and analyse staffing needs, and to compare client needs and staffing availability whenever records are made during the working day.

B.   The score system, instructions for use and calculation file are available from Birthrate Plus together with, if needed, email and telephone support.

C.   However at this stage we must ask maternity services who wish to use the Acuity System to be willing to accept an informal letter of agreement between us which will protect our Intellectual Property and make the system widely available until the licensing process has been completed.

For more information please contact:

Jean Ball at This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

Telephone 01623 403485

Marie Washbrook at This e-mail address is being protected from spam bots, you need JavaScript enabled to view it