Maternity care pathway workforce model testing the prototype

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1 Maternity care pathway workforce model testing the prototype The CfWI produces quality intelligence to inform better workforce planning, that improves people s lives

2 The CfWI nursing and midwifery programme National supply and demand forecasts for the nursing and midwifery workforces to support more effective planning 2 Review of the shift of care into primary and community settings and the implications for the shape of the nursing workforce Development of a multidisciplinary workforce 3 model for the maternity care pathway (MCP)

3 Developing the MCP workforce model

4 The maternity care pathway workforce model - prototype The MCP model is: designed for use by providers of maternity services designed to analyse a service s maternity workforce along summary care pathways aligned with the proposed new maternity tariff designed to provide analysis about possible future change scenarios an aid to better informed workforce decision-making reliant on data inputted by the service Excel-based an aid to service comparison. The MCP model is not: a benchmarking tool a replacement for other established tools such as BirthRate+ a source of the right answer an accounting tool a finished product, yet.

5 The maternity care pathway workforce model - prototype Benefits include: modelling your maternity workforce based on possible service change scenarios, for example: a change in birth rate revisions to NICE guidelines a proposed service improvement a better understanding of how your staff are deployed, by care pathway linking your decisions about staffing more closely with the new maternity tariff. To use the model: commit a small change team to develop and validate your service s pathway maps (2 x 3 hour workshops) commit a senior staff member to lead the process commit an information analyst s time to support data gathering and entry. The model will produce a range of reports which can be individually exported.

6 Maternity care pathway workforce model - benefits Kingston Hospital Trust found, when comparing its transitional care ward staffing and the general postnatal ward staffing per woman, that the former had slightly lower levels of staffing. This is being reviewed. University Hospital Southampton carried out an audit to analyse the level of unscheduled care that was being demanded during the third trimester, across midwife, admin and obstetrician time. A scenario describing the staffing of a new, midwife-led triage service is being developed in order to model this change of care and its staffing implications. Comments from Heads of midwifery: It will be helpful in presenting the staffing levels for our care pathways when meeting with our commissioners. I like the fact that it can work with the new tariff. It could provide me with better information to include in a business care to my directors. 6

7 The MCP model

8 Maternity care pathway workforce model demo 1. Summary care pathway maps: examples from University Hospital Southampton and Kingston Hospital Trust. 2. Birthed women data, linked to new tariff. 3. Staff information and maternity roles. 4. Inputting a service s maternity care activity information. 5. Examples of reports. 6. Summary and possible dissemination. 8

9 Maternity care pathway workforce model dissemination January March 2013: national testing with service leaders and with individual maternity services. Prioritised list of improvements to the MCP model agreed with the Department of Health. Final model development and technical testing.* Launch and dissemination MCP model available for free download from the CfWI website.* Review and evaluation.* * subject to commissioning by the Department of Health 9

10 Appendix Provider profile of Southampton and Kingston Steps to using the MCP model Screenshots of model

11 Provider profile: University Hospital Southampton FT Based from the Princess Anne Hospital (PAH): it opened in 1981 and hosts specialist services in obstetrics, gynaecology, neonatal medicine/surgery and breast care. PAH serves Southampton City, which has significant areas of deprivation, as well as the communities around the city and rural, south-west Hampshire (the New Forest) : 6,225 women gave birth. Births on three sites as well as at the woman s home: the PAH labour ward, the co-located Broadlands Birth Centre and the standalone New Forest Birth Centre. Workforce includes: 197 full-time equivalent (FTE) midwives (241 headcount), 52 FTE midwifery support workers, obstetrics staff, nursery nurses, clerical staff, sonographers and nurses. Provider profile: Kingston Hospital NHS Trust Based from the maternity unit at Kingston Hospital (KH), which opened in In addition to core services, it hosts specialist services in obstetrics and gynaecology, including a neonatal unit. KH serves an area of outer, south-west London including Kingston, Sutton, Merton and Richmond. Although there are pockets of deprivation and fairly high ethnic diversity, these are among the wealthier London boroughs : 5,934 women gave birth. Births on two sites, as well as at the woman s home: the KH labour ward and the co-located, midwife-led Malden Suite. Workforce includes: 185 FTE midwives, 57 FTE midwifery support workers/maternity assistants, obstetrics staff, anaesthetists and ODPs, nursery nurses sonographers and staff nurses.

12 Steps to using the MCP model A maternity provider will need to carry out a process to develop summary care pathway maps and assemble the necessary activity and staff timings data. The final model will provide guidance, templates and example workshop outlines to support this. Elements of data for each care pathway (per woman) Care activity Frequency of activity Staff roles delivering each care activity Typical staff time allocation per care activity Women birthed data Birth activity for a year Subdivided by care level Subdivided by intrapartum activity Plus overall staff profile Once inputted, the model then aggregates the individual care pathway staffing and multiplies this by the birth data to produce an overall staffing profile. This then needs to be matched to the actual staffing profile. Some minor alterations to the pathways information might be required to ensure matching. This tested profile needs to be saved. It provides the basis for comparison with future change scenarios. 12

13 Maternity care pathways workforce model (screenshot) 13

14 Example of possible report design

15 For further information about the maternity care pathways workforce model: Or the nursing and midwifery programme: Centre for Workforce Intelligence Blackfriars Road, London SE1 8NL General enquiries T +44(0) E

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