Working in partnership with NHS England, we co-developed a Maternity workforce deployment tool to support maternity services leads in describing current staffing provisions against recommendations. It also enables leads to then consider, and safely test, different approaches to deployment, specifically for Midwifery Continuity of Carer (MCoC).
Objective
Maternity service leads needed a way to describe current midwifery staffing positions, recruitment needs and consider how to safely deploy midwives in MCoC teams. Support was needed to supplement and extend functionality of existing planning tools.
A core project team was set up to deliver the project, comprising a single NHS England and NHS SCW team working in partnership.
What we did
The Midwifery Continuity of Carer (MCoC) model provides a named midwife who follows women throughout pregnancy, birth and the postnatal period across care settings. The policy of Midwifery Continuity of Carer (MCoC) means midwives are organised into small teams, maintaining a core staff in hospital. Expectant mothers are ‘staffed’ rather than buildings. The model of care allows midwives to spend more time with women building a relationship. The NHS England report in 2021 ‘Delivering midwifery continuity of carer at full scale’ shared evidence demonstrating that this relational intervention improves safety and quality of care that saves babies lives and significantly reduces preterm birth and other benefits.
Midwives were concerned about working in a new model, including potential impacts on staff capacity and retention and inequity of service.
The aims of the project were to:
- Provide Directors/Heads of Maternity service leads the ability to model maternity and other staff groups' workforce requirements, including core service management and MCoC teams to support service change and plans for implementation.
- Develop a high-quality, accessible local workforce deployment tool, with an easy-to-use, web-based tool, that support changes in models of care and specifically MCoC
The tool needed to incorporate information from key advisory documents and complement existing workforce tools with the flexibility to adapt to varying models of midwifery care and reflect specific local population needs.
A robust user-centred and agile design and development approach ensured that the tool was fit for purpose, met user needs, and was co-developed to support learning, adoption, and confidence.
A large Stakeholder Group (SG) was formed involving over 30 participants to review the beta version of the tool. Participants included senior midwifery and local maternity and neonatal system leaders representing a wide range of urban, rural, large, and small provider services, regional and national NHSE colleagues.
Additional interviews and engagement were undertaken with national workforce and maternity leads and wider stakeholders including Birthrate Plus® and The Royal College of Midwives. Additionally, the tool was used by the National Continuity of Carer Lead, with maternity services from across the country, whilst assisting Trusts with their CofC deployment plans.
Activity
Consultancy, strategy, and transformation
We deployed a blended multi-disciplinary team to deliver the project, including one of our clinically registered midwives, technical and development specialists supported by project expertise.
Communications and engagement
We engaged with a large stakeholder group, ensuring the tool captured the variety in how maternity services function across the country.
Workforce
Outcome
- The tool is fit for purpose and adaptable to reflect varying models of midwifery care across the country, informed by a stakeholder-led, user-centred design approach which reflects the composition of Maternity Services. Demonstrated by qualitative feedback received.
- The tool supports the narrative for providing assurance and for articulating where additional staff may need to be recruited and potential deployment scenarios. Demonstrating this to staff helps build confidence and may improve retention. This ensures key core services are not adversely affected whilst supporting the whole maternity team to work to their strengths.
- The tool supports midwifery deployment considering models of care and specific local population needs but expects service leaders to also use professional judgement to agree on final midwifery allocation supporting the whole maternity team to work to their strengths.
- Stakeholders valued being able to clearly view and analyse the composition of their workforce. Leads understand their recommended and actual staffing levels better and can safely test different approaches to deployment.
- Finalist for Nursing Times Workforce Summit & Awards, Best Use of Workplace Technology category
