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

                                   MORE INFORMATION  

ON THIS PAGE YOU WILL FIND; 

1. Brief overview of the Birthrate Plus Programme in the NHS and other maternity services

2. Details of the workload data  and staffing information captured during a Birthrate Plus study within a Maternity Service

3. List of what a Birthrate Plus plus does not cover. 

Further  information and references can be found in the section; Use and Validation of Birthrate Plus.

1. Brief Overview of the Birthrate Plus Programme in the NHS and other Maternity Services

From 2001 - March 31st 2005; a programme led by Marie Washbrook, Programme Director, together with Jean Ball Research Advisor and a number of midwife facilitators, supported by the Royal College of Midwives, provided expertise and assistance to Maternity Services in the United Kingdom who wished to implement BR+ in their services.

Birthrate Plus has also been implemented in non NHS services in the Channel Islands and in Eire, and more recently in Australia.

In April 2005  Birthrate Plus(R) Consultancy Ltd came into being in order to continue the work, and we wish to acknowledge the support received from the Royal College of Midwives. 

To date the programme has conducted studies in over 200 Health Authorities in the United Kingdom.

Data from these studies have been used to inform local health authority planners and the DOH Workforce Review Team, The Retention and Recruitment of Midwives Campaign.

Further Reading

BIRTHRATE PLUS ( BALL J.A. & WASHBROOK M 1996)  A FRAMEWORK FOR WORKFORCE PLANNING AND DECISION MAKING FOR MIDWIFERY SERVICES

Books for Midwives Press/ Elsevier Press. 

Please see other references on Use and Validation of Birthrate Plus page

2.  Details of the Workload Data  and Staffing Information captured during a Birthrate Plus Study within a Maternity Service 

A. Hospital based

Antenatal Service

· Annual number of admissions to inpatient antenatal care, ward attendees and the staff needed
· Staff needed for antenatal day care/fetal medicine services, where provided
· Staff needed for antenatal clinics including midwife and obstetrician managed, both hospital and peripheral/satellite settings.

Intrapartum care measured over 6 months including
· Number of women receiving care
· Casemix; based on number and % of births classified by BR+ categories thereby indicating level of intervention and risk/normality of labour outcome for mother and baby
· Mean measured hours of Intrapartum care from midwives, which are required to meet the standard of one to one care throughout labour and delivery classified by BR+ categories, and including extra percentages of time for the three higher need categories
· Extra workload on delivery suites; inductions of labour with prostin; number of unplanned/low risk cases; antenatal emergencies; escorted emergency transfers out of the unit, postnatal readmissions, non-viable births and the mean hours of care needed.
Cross border exports; These are women who give birth in a particular hospital but receive community based ante and postnatal care from midwives in another health district . Therefore the hospital where the birth is recorded is providing only hospital based care and adjustments are made to staffing figures to reflect this.

Postnatal Care in hospital
· Numbers of mothers and babies transferred to postnatal ward, length of stay and the staff required
· Details of how many cases included in the number of births are transferred back to community units a) within the local catchment area and b) those returning to community care in another health authority.
· Postnatal ward attendees and readmissions
· Provision of ‘transitional type’ care to neonates in the postnatal ward
· Neonatal examination of babies by midwives previously carried out by junior doctors. 

B) Community based

· Home births all antenatal, intrapartum and postnatal care

.For all women booked for hospital delivery:
· Antenatal care plus parent education
· Postnatal care to women delivered in hospital

Numbers of imported cross border work* and the wte required to provide community care where applicable.

* Definition of cross border imports;  women who have given birth in another health authority but received antenatal and postnatal care in their "home" area. These are known as cross border imports. They do not appear in the number of births recorded in their "home" health authority and the staff needed for their care must be added to the numbers of w.t.e. midwives based on recorded births.

C) Other allowances for total hospital and community service
· Travel allowances (i.e. time spent in travelling across work area) for community-based work based on local management decisions.

· Statutory supervision of all midwives

· Agreed holidays, sickness and study leave allowances

3. What Birthrate Plus® does not measure
 
 Birthrate Plus does not assess;

· the needs of staff for special or intensive care of babies
 
· nor does it prescribe the numbers of health (maternity) care assistants required. It does however record for each service what the local mix of trained to untrained staff was at the time of the study, and the experience of using BR+ in other services means that advice is offered on percentage skill mixes used elsewhere
 
· It also records, but does not prescribe, the number of other midwives engaged in specialist or management roles within a service.  The inclusion of such roles is discussed with managers and thereby is a local decision.  However there are common roles required by all maternity services, such as clinical governance, practice development, plus additional time for strategic planning and general management.

· Clinical Midwife Specialist roles are dealt with as above by assessing the additional hours to that included in the midwifery establishment to provide 24 hour care.  The local requirement for such roles does vary between maternity services, and is dependent on factors, such as, vulnerable groups, risk factors, geography.