HOSPITAL managers will be forced to swap their suits for scrubs this summer as Oxford University Hospitals NHS Foundation Trust (OUH) desperately tries to fill front-line midwifery roles.
Amid an ongoing NHS retention and recruitment crisis, the trust has seen midwife staffing levels fall below the required level and would otherwise be at a point where services ‘will be impacted’.
In an effort to boost midwife staffing levels, the trust has said it will be using ‘senior management and non-frontline midwives’ in clinical roles to temporarily plug the vacancies until the staffing situation improves.
NHS figures show that the number of full-time equivalent midwives employed by OUH has dropped from 296 in March 2016 to 259 in March 2018, despite an ongoing recruitment drive.
As of June there were around 26 full time midwife roles to be filled.
An OUH spokesman said the temporary move for bosses would mean the trust’s required midwife to births ratio would be met and that no adverse impact on patient care was anticipated.
To remain registered with the Nursing and Midwifery council, clinicians must have had at least 450 hours of practice over the previous three years to remain.
However, concerns have been raised about using clinicians who may have been out of regular front-line care for a number of years.
Spokesman for Oxfordshire Unison Health Branch, Ian Mckendrick, said: “People get rusty; running a service and delivering babies are not the same thing.
“What amount of practice have they had? Or are they going to be running refresher courses, because people do become de-skilled.”
Around 8,200 babies are delivered each year across the sites managed by OUH including the midwife-led units at the Horton General Hospital in Banbury and the Spires Centre at the John Radcliffe Hospital in Oxford.
As well as placing managers on the front line, the measures will also see a number of bed closures on level seven of the JR, with maternity services consolidated on levels five and six at the Women’s Centre - the regional referral unit for women with high-risk pregnancies.
Women will still be able to access the alongside midwifery led unit The Spires on Level seven, but access to the amenity rooms (single rooms) will not be possible over the summer.
Chief nurse at the trust, Sam Foster, said closing beds on level and consolidating the service on was a ‘more effective way of staffing the unit’, adding: “This, and other measures such as midwives who have been working in management or education roles will be increasing their direct clinical hours which will allow us to safely manage births across the summer.”
However, as staff in maternity wards become increasingly stretched, fears have been raised that midwives will be unable to dedicate the same amount of time to patients.
New mum Charlotte Herring, from Fyfield Wick, near Abingdon, said her experience highlighted the vital role midwives play and the importance of being able to spend time with each patient, particularly those experiencing complications.
The 26-year-old was transferred to the Women’s Centre after experiencing difficulties during the birth of her son, Bear, last Christmas Eve.
She said: “The care that I received was first class.
“The midwife who looked after me I felt as though she was like a mother to me - she was with me all the time – my husband felt the same.
“If she wasn’t there I would have been completely lost.”
The trust says it has recruited 40 newly qualified midwives who are due to start in September and October, however, this could only be a temporary reprieve with the trust currently losing midwives and nurses quicker than it can replace them.
According to a report presented to the OUH board last week, the high turnover is due to the cost of living, travel and parking.
In total, 41 midwives left the trust last year, equating to around 15 per cent of midwifery staff.
Executive director of Healthwatch Oxfordshire, Rosalind Pearce, said hospitals must find a long-term solution to the recruitment and retention problem.
Speaking about placing managers on the front line she said: “As long as those staff being re-deployed have the required experience and qualifications, and that patient safety is not compromised in any way, this would seem a sensible, if temporary, solution to the problem.
“However a longer term resolution to the issue of staff recruitment and retention needs to be found, and that solution may be part of a much bigger, national initiative.”
Mr Mckendrick also called for a long-term solution to be found adding: "Is the government really prepared to jeopardise the well being and safety of pregnant mothers and their babies in their continuing refusal to address the staffing crisis in Oxfordshire's midwifery service?
"The measures being discussed are clearly a stop gap, and an ad hoc response to a long running staff crisis that has yet to be propperly addressed."
Meanwhile, despite constant efforts, the trust has admitted that it has been unable to attract new doctors and midwives to the Horton General Hospital in Banbury after the unit was downgraded from consultant-led to midwife-led last year.
Ms Foster said: “For several years now we have been trying very hard to recruit doctors to work in obstetrics at the Horton.
“We have had permanent adverts out in all the places that an obstetrician would expect to find a job in the NHS. We have offered additional help with accommodation, help with GMC registration, and visas (nearly all applicants have been from overseas).
“Although we have recruited some doctors in this period, others have left and we have not recruited enough to be able to operate the service.
“There is a national shortage of obstetricians, as well as neonatal nurses.”
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