Agenda item

To receive an update on Maternity Services. (30 mins)

The Committee received the Maternity Services report which was presented by Gill Valentine, Director of Midwifery.

Gill went through the presentation and explained in more detail the following points:

·           The number of deliveries differed from the number of births because of multiple births;

·           The number of deliveries in 2016/17 were based on the numbers at the end of September and the figures were similar to the past few years;

·           Wokingham worked towards a target of 1:28 midwife to birth ration, this was based on the profile of the local population;

·           During the last four months a ratio of 1:1 care in labour had been achieved for 100% women.  Gill confirmed that this was a top priority for the service;

·           39% of the midwifery workforce was within the 45-65 age bracket, with 27% being over 50 years of age.  This was in line with the rest of Thames Valley region and equivalent to the national profile;

·           There were 20 midwife vacancies at the moment.  The service was actively looking to recruit midwifes and also looking at different ways that nurses and other maternity care staff could help and therefore free up midwifes time;

·           A midwife from Dublin had been recruited;

·           There was going to be a Nursing Maternity Recruitment day on 12 November in Reading and it was hoped that midwifes would be recruited as a result of this event;

·           When agency midwifes were used, the service tried to negotiate so that they worked for a number of consecutive shifts to ensure consistency.  There were five or six full time equivalent agency midwifes working for the service at the moment;

·           There were development opportunities for staff as part of a programme for succession planning;

·           Reciprocal arrangements were in place with neighbouring maternity services providers.  Gill emphasized that women were only diverted when every other avenue had been explored and it was in the woman’s best interest in terms of safety to go to a different place;

·           There had been an unannounced Care Quality Commission visit into Maternity Services in 2015.  The feedback had been positive and compared favourably against the previous report;

·           The Consultant presence on delivery suite remained below the recommended level of 168 hours per week.  Consultant cover was 77-90 hours per week at the time of the inspection.  Four new Consultant Obstetricians/Gynaecologists had been employed since, which increased the Consultant cover to 116 hours per week;

·           Gill mentioned a ‘National Maternity Review 2016: Better Births’ document and stated that as a result of the recommendations contained in the report, the service had identified three priorities for each year.  The priorities for 2016/17 were listed in the presentation.

The Committee thanked Gill for her presentation and the following comments and questions were put forward:

·           Councillor Houldsworth asked if there was a housing issue involved in the recruitment of midwifes from Dublin.  Gill stated that there was limited accommodation at the Hospital, but this was only suitable for a maximum period of six months.  Gill confirmed that housing was a challenge due to the high cost of housing in this area.  Additionally, Reading was in competition with other trusts that payed higher wages due to the London weighting;

·           Councillor Dolinski was concerned with the workforce age range and mentioned having read about a ‘midwifery retirement time bomb’, he asked about the recruitment of midwifes.  Gill stated that the service was aware of the ‘time bomb’ prediction.  A programme was in place to nurture young midwifes and to train senior midwifes for managerial posts.  There was ongoing work with Human Resources to retain staff and work with universities and colleges of midwifes;

·           Gill informed that there were sufficient newly qualified midwifes and senior midwifes, but there was a shortage of ‘middle’ experience midwifes who could support the newly qualified midwifes;

·           Gill believed that it was necessary to be more creative in using the support that could be given by other health professionals so that the resources could be used as effectively as possible;

·           In response to a question Gill informed that it could be difficult to attract young people to the profession because being a midwife involved shift work and weekend work.  It was important send out a positive message and to demonstrate that this was a rewarding job and to offer flexible shifts;

·           In response to a question Gill informed that historically there have never been many males in the profession, but there had been some;

·           Members asked if there was recruitment from other parts of Europe.  Gill stated that they had in the past employed midwifes from other countries in Europe. However, this was dependent on where they had completed their training.  The difficulty was that in England midwifes were trained to work more autonomously then in other countries, so often midwifes from abroad required a lot of support initially, which the service sometimes was not able to provide;

·           In response to a question, Dr Johan Zylstra, NHS Wokingham CCG stated that when all costs involved in hiring permanent staff (holiday pay, sick pay, pension) were taken into account, agency staff were not much more expensive then permanent staff;

·           Gill stated that they had tried to offer permanent positions to agency workers, but they often came from London and did not want to relocate to Reading;

·           Gill stated that there was now a cap on how much agencies were allowed to charge;

·           Gill confirmed that the appointment of another four consultants were needed to achieve the desired level of Consultant cover.  Gill pointed out that there was a Consultant on call in the hospital at all times and women were not in any danger, this target related to the physical presence in the room;

·           Katie Summers, Director of Operations Wokingham CCG stated, that only two Local Authorities in England managed to achieve the target of 168 hours per week;

·           Councillor Blumenthal asked if diversions were a new phenomenon.  Gill stated that diversions had always happened, the process involved a risk assessment and women were only diverted when it was deemed safer;

·           Gill informed that the number of births was predicted to increase in the next few years based on the number of new houses being built in the area.  There was ongoing work in planning to increase capacity, both physically and in staffing preparation;

·           Dr Zylstra pointed out that the number of maternal death rates had not changed significantly in the past 20 years, irrespectively of the number of consultants in hospitals.  He stated that the current levels were very safe.

RESOLVED That:  The Maternity Services presentation be noted.