NICE published the safe staffing guideline ‘Safe midwife staffing for maternity settings’ on 27^th February 2015. The guideline makes recommendations on supporting, determining and monitoring safe midwife staffing requirements for maternity care provided across all settings. The guideline includes recommendations which are aimed at Trust Boards, senior managers and commissioners, which brings me to the information that we are seeking with this request. In order to better understand how the guideline is being implemented at Trust level I would be grateful if you could provide the following information.

Information for the period 1^st July 2016 to 31^st December 2016

1. For the period 1st July 2016 to 31st December 2016, when did your Trust Board last review, as an agenda item, the midwifery staffing establishment for your Trust’s maternity services?

Unify return and Public Board of Director’s report on 24^th October 2016.

2. What were the main findings of this review?

Assurance that funded establishment met need:-

“The current position identifies that there is no shortfall of midwives to the funded establishment and that there are 13.44 wte midwives more than required for the current births and acuity. However there is a shortfall of 4.23 wte B3/4 Midwifery Assistants and 16.16 wte B2 Midwifery Support Workers. Detailed work needs to be undertaken across the service and any changes will be subject to a full Quality impact assessment.”

3. What if any recommendations did the review make about midwifery staffing?

That there were sufficient staffing levels:-

“The Divisional Team will:
• Review the workforce to ensure midwives are in the right place at the right time
• Ensure the skill mix is correct in each area
• Update rosters to reflect the outcome of the workforce analysis and budgetary adjustments undertaken
• Undertake a full and comprehensive review of the community midwifery service including skill mix and caseloads
• Review the impact of the change in the function of statutory supervision
• Ensure the planned increase in headroom is undertaken from 20% to 25% from 2017/18
• Ensure the establishment on the Delivery suites supports one B7 to be supernumerary to co-ordinate the shift and one B7 undertakes managerial responsibilities
• Continue the review of the triage system on BHH site and make it more effective
• Review skill mix of fetal medicine and antenatal screening midwifery teams
• Review skill mix in antenatal clinics”

4. What decisions did the Board make in relation to any recommendations arising from the review?

Nil – assurance taken.

5. Please specify the name of any workforce planning tool that was used to inform the review?

Birthrate Plus and professional judgement

6. Did the review include analysis of any midwifery red flag events that may have occurred in this period?
8. If so, how many and what type of midwifery red flag events were reported to the Board?

8. During this period how many red flag events were initially reported by service users and how many by maternity services staff?
10. What if any actions did the Board agree on in response to the reported midwifery red flag events?

Not applicable.

1. Did the Head of Midwifery or Director of Midwifery present to the Board in person as part of the review?

Information for the period 1st January 2016 to 30th June 2016

1. For the period 1st January 2016 to 30th June 2016, when did your Trust Board last review, as an agenda item, the midwifery staffing establishment for your Trust’s maternity services?

Monthly unify return.

2. What were the main findings of this review?

Assurance taken.

3. What if any recommendations did the review make about midwifery staffing?

Appropriate staffing levels.

4. What decisions did the Board make in relation to any recommendations arising from the review?

5. Please specify the name of any workforce planning tool that was used to inform the review?

Professional judgement.

6. Did the review include analysis of any midwifery red flag events that may have occurred in this period?
8. If so, how many and what type of midwifery red flag events were reported to the Board?

Not applicable.

8. During this period how many red flag events were initially reported by service users and how many by maternity services staff?
10. What if any actions did the Board agree on in response to the reported midwifery red flag events?

Not applicable.

1. Did the Head of Midwifery or Director of Midwifery present to the Board in person as part of the review?
   No – the Chief Nurse did.