Norfolk Health Overview and Scrutiny Committee
24 February 2005
item no ….
Midwifery Services
Suggested approach from Health Scrutiny Support Manager
At the Committee’s awayday in December, midwifery services were identified
as an area to look into. This was based on concerns received by members
over the shortage of midwives in Norfolk and the clear impact this has on the
services delivered. Today’s briefings will outline the issues locally, along with
some national context, to allow members to decide whether to investigate this
issue further with a view to making useful recommendations at a later stage.
Brief background
A recent report from the Royal College of Midwives has suggested that Britain
needs another 10,000 midwives to “repair the shortages, tackle long-term
vacancy rates and relieve the heavy workloads and stress on those currently
in post” (Royal College of Midwives Annual Staffing Survey, 2004 (see
www.rcm.org.uk)). The numbers leaving and long-term vacancies have
increased, although the number of midwives qualifying has increased in 2004
(to 868 from 573 in 2003).
In September 2004, the National Service Framework (NSF) for children,
young people and maternity services was published by the Department of
Health. The maternity services section addresses the requirements of women
and their babies during pregnancy, birth and after birth. It includes women’s
partners and their families; and it addresses and links to pre- and postconception health promotion and the Child Health Promotion Programme.
The aim is that “Women have easy access to supportive, high quality
maternity services, designed around their individual needs and those of their
babies”.
The vision of the NSF is:
 Flexible individualised services designed to fit around the woman and her
baby’s journey through pregnancy and motherhood, with emphasis on the
needs of vulnerable and disadvantaged women.
 Women being supported and encouraged to have as normal a pregnancy
and birth as possible, with medical interventions recommended to them
only if they are of benefit to the woman or her baby.
 Midwifery and obstetric care being based on providing good clinical and
psychological outcomes for the woman and baby, while putting equal
emphasis on helping new parents prepare for parenthood.
(full document: http://www.dh.gov.uk/assetRoot/04/09/05/23/04090523.pdf).
Locally, it seems as though several midwives are leaving to become health
visitors. Norfolk possibly has greater problems in recruiting than Suffolk and
Cambridgeshire, where there seem to be fewer shortages.
Issues other than recruitment and retention of staff include increasing
expectations on the service, increased ante-natal screening, increased
Caesarean and a rise in the number of births during 2003, a trend that is
continuing into 2004 (see table below).
Maternity Unit
2000
2001
2002
2003
Trend
Rosie (Cambridge)
Peterborough
Ipswich
Norfolk & Norwich
Hinchingbrooke
West Suffolk
King’s Lynn
James Paget
4516
3320
3456
4819
2246
2255
1973
2003
4520
3303
3190
4397
2142
2255
1925
2011
4563
3304
3174
4604
2147
2318
2021
1979
5067
3427
3456
4801
2181
2431
2019
2132
504 ↑
123 ↑
282 ↑
197 ↑
34 ↑
113 ↑
2↑
153 ↑
24,588
23,743
24,110
25,514
1404 ↑
758 ↓
845 ↓
367 ↑
1404 ↑
Total births
Total Rise/Fall
The purpose of this session



To receive presentations from:
 Neal Barker, Divisional General Manager, Women, Children & Sexual
Health Services; Christine Baxter, Director of Nursing & Education; and
Sue Marshall, Head of Midwifery, all from the Norfolk and Norwich
University Hospital
 Julie Lindsay, Lead Midwife for Education/Professional Head,
Midwifery, School of Nursing and Midwifery, University of East Anglia.
To gain an understanding of the local and national issues facing midwives,
patients and the management of the services.
To decide whether to pursue any issues in more detail or to ask for further
information.
Please note: Representatives from James Paget and Queen Elisabeth
Hospitals have been invited but were unable to attend this meeting. They
have all expressed willingness to help in future meetings should the
Committee want to go further.
Suggested approach


After the presentations, members could ask questions to clarify the issues.
Members should decide whether to pursue any issues further. If so, they
should decide whether to scrutinise in committee or to set up a working
group, bearing in mind the forthcoming elections and pressures on their
time.